A snapshot in time: The state of malaria
Last year’s World Malaria Report reflected the hard-won gains of countries across across the globe: between 2000 and 2024, sustained investment in malaria prevention and disease control averted 2.3 billion malaria cases and 14 million deaths.
But the report also revealed concerning realities: drug and insecticide resistance are growing. Climate change is expanding the geographic footprint of malaria risk. Many malaria-endemic countries continue to face a severe shortage of funds for malaria control and other key health services.
Overall, the number of malaria cases and deaths increased. In 2024, public health officials recorded 282 million malaria cases globally and 610,000 deaths. In 2023, there were 263 million cases and 597,000 deaths.
Follow us on WhatsApp | LinkedIn for the latest headlines
Funding for malaria control is declining globally. Consequently, at least 21 countries reported the cancellation or reduction of key malaria control activities, such as disease surveillance and monitoring and evaluation, which together form the foundation of malaria control and elimination.
The critical importance of surveillance
Malaria surveillance is the systematic and continuous collection, analysis, interpretation and timely dissemination of malaria-related data to decision makers to inform the most appropriate and effective response. The data tell us who is getting sick, how severely, where infections are spreading and which interventions are working. Crucially, it also informs what is needed to correct course, enabling us to lower malaria transmission and caseloads, and to prevent and respond to outbreaks.
Without quality data, epidemiologists will miss the earliest cases of re-emergence, and malaria may once again become endemic in a region that once worked so hard to eradicate the disease.
In the context of increase drug and insecticide resistance, surveillance is a frontline defence, helping us to understand how malaria parasites and mosquitoes are changing. Therapeutic efficacy studies track whether frontline drugs are still clearing infections; integrated drug efficacy surveillance uses routine data to spot early treatment failures in real time; and molecular and genomic monitoring detect gene mutations before they cause widespread clinical failure, giving programmes a vital head start.
For insecticides, resistance studies reveal shifts in mosquito susceptibility, guiding decisions on which nets or sprays to deploy. These data-driven approaches allow health authorities to adapt strategies — switching drug regimens, rotating insecticides or introducing new tools — before resistance undermines control efforts.
Without surveillance, we cannot link evidence to action, and we cannot assess the impact of policies and programmes to improve national strategies or attract the philanthropic investment needed to drive progress.
James Tibenderana, Chief Executive of Malaria Consortium
To be useful, surveillance data should be of high quality, and mechanisms should be in place to enable timely reporting and support the use of the data for action. This is essential not only for public health officials and community health workers on the ground, but also for lawmakers and policy makers with the power to direct funds and personnel or implement policies. Without surveillance, we cannot link evidence to action, and we cannot assess the impact of policies and programmes to improve national strategies or attract the philanthropic investment needed to drive progress.
But the impact of strengthening surveillance is often hard to measure and cannot be directly attributed to a drop in cases. In some instances, strengthening surveillance may actually look like an increase in cases. In reality, it is improved surveillance quality that enables the detection of previously missed cases. Yet, high-quality surveillance systems are quite resource intensive, particularly in rural settings where the traditional model is on-site supervision.
Without solid surveillance efforts in place, we are navigating the future of malaria control without using all the tools at our disposal, which has direct life-and-death consequences. When public health officials do not have the data necessary to predict or detect a surge in cases, this will dictate how quickly they can respond to outbreaks, and the extent to which they can limit the spread.
We need alternative, low-cost solutions and opportunities to integrate surveillance activities, such as conducting surveys, into existing infrastructures. And we need to be better at advocating for surveillance resources based on the lessons learnt from programme implementation.
Success stories from Cambodia and Ethiopia
Investing in stronger surveillance systems takes us one step closer to elimination. In Cambodia, Malaria Consortium and the National Malaria Programme are working with networks of locally recruited and well-trained mobile malaria workers (MMWs) to offer quality malaria services to remote, mobile and migrant populations across six northern provinces along the international border with Laos, Thailand, and Vietnam. Thanks to MMWs’ knowledge of local population movements, we are rapidly identifying and treating remaining pockets of malaria cases and preventing cross-border re-introduction.
The team incorporates geospatial modelling approaches into decision-making about the locations of mobile malaria posts and outreach activities to maximise resource efficiency and ensure no high-risk areas are left behind. These efforts are accelerating progress towards elimination. Malaria cases in Cambodia fell by over 99 percent between 2004 and 2024, and no malaria deaths have been recorded since 2018.
Ethiopia’s recent experience demonstrates how robust surveillance can change the course of an outbreak. After years of steady progress in controlling malaria, the country faced an unexpected resurgence in 2024, placing more than 75 million people at risk. Malaria Consortium partnered with Ethiopia’s Ministry of Health, leveraging high-level advocacy, targeted training, rapid community-based surveillance and strong collaboration with local health authorities to stem these numbers.
Targeted training in epidemic surveillance and response and case management for health staff resulted in major improvements, enhancing early detection, prompt treatment and proactive, targeted planning. Alongside these efforts, hands-on mentorship improved real-time reporting and decision-making. In 18 months, from July 2024 to December 2025, more than 1.7 million people have been reached, and cases have dropped by 29 percent in 18 districts supported by Malaria Consortium.
These examples demonstrate that stronger surveillance is the foundation of sustainable epidemic response and disease control and, ultimately, elimination.
Next-gen malaria control tools
Promising new tools are emerging that will transform the fight against malaria. These include next-generation mosquito nets, repellents, improved diagnostics, medicines and malaria vaccines. As these technologies begin to scale — especially amidst a lack of government funding — surveillance will be even more critical to ensure we use these resources efficiently.
Surveillance data also allow us to document learning and impact, and to attract investors. One of the misconceptions in global health is that philanthropy is constrained, that donors are unwilling or unable to invest in malaria. In reality, many organisations have capital to deploy, but they need confidence that their investment will produce measurable results.
What limits philanthropic engagement is not the lack of funding; it is the lack of comprehensive, reliable data demonstrating impact and cost-effectiveness.
Sign up for free AllAfrica Newsletters
Get the latest in African news delivered straight to your inbox
Partnerships that strengthen national ownership
If there is one lesson from the last two decades of malaria control, it is that progress depends on partnerships. And not just global alliances, but in-country coordination that ensures alignment, sustainability and national ownership. Just as important is our collective ability to meaningfully harness opportunities to integrate health services and interventions for optimal reach and effectiveness.
Surveillance systems thrive when ministries of health lead the agenda, when partners coordinate rather than duplicate efforts, and when data are shared securely and transparently. The future of malaria control will be most profoundly shaped by health workers, district officials and national programme managers who understand the realities of their communities.
Cross-sector collaboration between governments, NGOs, donors, researchers and private-sector innovators is essential. But it must be grounded in national strategies and local needs, not donor-driven programme silos.
The future of malaria control
We are entering a new era in malaria control. There is hope in emerging tools and an increased emphasis on in-country partnerships and local ownership. But malaria transmission is shifting, re-emerging in some places, emerging for the first time in others. Growing drug and insecticide resistance and climate pressures threaten to reverse already hard-won progress. This new era of malaria control demands stronger surveillance, smarter integration and more cohesive partnerships than ever before.
If we invest in robust surveillance systems, strengthen national leadership, and align global and local efforts, we will not only protect the gains of the past two decades; we will accelerate them.
The world has the tools to change the trajectory of malaria. Now, we need the data, coordination and political commitment to deploy them effectively.