Holding the line: Why we must sustain the momentum on malaria, By Cynthia Mwase

We must reaffirm our shared commitment to ending malaria. Governments, policymakers, funders, and the private sector must align to reignite the fight and finish what we started. For our health, our children and our future, we must advance African economic growth and potential and leave endemic malaria in the past.

Malaria is a preventable disease, yet it remains one of the greatest threats to Africa’s future, to our health systems, economies, and most importantly, to our people. As of 2023, 95 per cent of global malaria cases occurred in Africa.

The impact is huge: African economies lose an estimated $12 billion annually to malaria. That is $12 billion that could go to improving health, creating jobs, and strengthening our economies: but instead, that potential is lost – to a disease we already know how to prevent.

The 2025 World Malaria Day offers a vital moment to raise awareness of the costs of this deadly disease, but also to celebrate the progress being made, and the African scientists, institutions, and innovations driving change to protect our people and economies.

Since 2000, global efforts have helped prevent more than two billion cases and saved 13 million lives. This progress has been driven by more intelligent, targeted approaches, powered by local data and local leadership. Countries like Kenya, Mozambique, Tanzania, and Nigeria are now using granular data to identify high-risk areas, enabling them to deploy interventions more strategically and effectively.

These efforts reflect the spirit of the Yaoundé Declaration: using the right data to take the right action, in the right places.

African scientists are at the heart of this shift, leading breakthroughs that are saving lives. Dr Corine Ngufor, associate professor of Medical Entomology at LSHTM, has spent years improving the control of insecticide-resistant malaria vectors. Her work has been key to the development and rollout of new mosquito nets — treated with both pyrethroid and chlorfenapyr — that are helping to fight insecticide-resistant malaria across Sub-Saharan Africa.

We are also seeing greater continental commitment to health sovereignty, from the push for mRNA vaccine manufacturing on the continent. We at the Gates Foundation are proud to support these efforts, partnering with governments and local institutions to strengthen health systems and scale home-grown solutions that work for Africa.

In Nigeria, Dr Ify Aniebo is advancing the use of genomics data in malaria surveillance systems, pushing to move from a four-year reporting cycle to annual, real-time data that can strengthen disease monitoring and improve elimination strategies, not just for malaria, but for other infectious diseases.

And in Ghana, Darlington Akogo and the MinoHealth AI Lab have leveraged artificial intelligence to design antibodies that target the malaria parasite. Their work is helping to transform drug discovery in Africa and could lead to new treatments developed right on the continent. By using AI to handle complex tasks, like testing and analysing thousands of antibody designs in a fraction of the time, the lab is accelerating the pace of discovery for cutting-edge malaria treatments.

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These are not isolated stories. They reflect a broader shift toward African-led innovation and the use of homegrown solutions for Africa’s most pressing health challenges.

We are also seeing greater continental commitment to health sovereignty, from the push for mRNA vaccine manufacturing on the continent. We at the Gates Foundation are proud to support these efforts, partnering with governments and local institutions to strengthen health systems and scale home-grown solutions that work for Africa.

But continued progress is not guaranteed. The biggest threats to malaria elimination today are funding shortfalls, disruptions in access to key tools, and declining urgency from decision-makers in the hardest-hit countries.

The mandate is clear. If we doubled our commitment to the fight now, the $12 billion lost annually to malaria could become $16 billion added to national GDPs across Africa. But instead of commitment and progress, we are seeing inaction and backsliding: reduced access to key prevention tools like insecticide treated bed nets, insecticide spraying, diagnostic tests, and reduced access to essential medicines across several regions.

In recent months, shifting global priorities have placed increased pressure on malaria programmes. According to African Leaders Malaria Alliance, funding shortfalls and climate change are projected to cause over 100 million extra cases, and nearly 300,000 more deaths, by 2030. This setback would undo years of hard-won progress. What is working and what must continue is the growing ownership of malaria innovation by African institutions, and the political commitment to make malaria elimination a public health and development priority.

Cabo Verde provides a powerful example. Malaria was eliminated in the country after years of coordinated health policy, adequate investment, and a strategic shift in how malaria control efforts were designed and delivered. Transmission was interrupted for four consecutive years before the country received WHO certification.

The mandate is clear. If we doubled our commitment to the fight now, the $12 billion lost annually to malaria could become $16 billion added to national GDPs across Africa. But instead of commitment and progress, we are seeing inaction and backsliding: reduced access to key prevention tools like insecticide treated bed nets, insecticide spraying, diagnostic tests, and reduced access to essential medicines across several regions.

The cost is too high – and the opportunity before us is too great.

We must reaffirm our shared commitment to ending malaria. Governments, policymakers, funders, and the private sector must align to reignite the fight and finish what we started. For our health, our children and our future, we must advance African economic growth and potential and leave endemic malaria in the past.

Cynthia Mwase is the director of Health, Africa, at the Gates Foundation.