Malaria deaths fall, but resistance threatens progress

GENEVA — An estimated 1 million lives were saved from malaria in 2024 thanks to the expanded use of new prevention tools, but rising drug resistance, funding shortfalls, and biological threats now endanger that progress, according to the World Health Organization’s (WHO) World malaria report.

The report credits new malaria vaccines, dual-ingredient insecticide nets, and expanded seasonal malaria chemoprevention with preventing approximately 170 million malaria cases and 1 million deaths in 2024 alone.

Since WHO approved the world’s first malaria vaccines in 2021, 24 countries have introduced them into their national immunization programs.

Seasonal malaria chemoprevention now reaches 54 million children across 20 countries — a dramatic increase from just 200,000 children in 2012.

Despite these gains, the global malaria burden remains high. WHO estimates there were 282 million malaria cases and 610,000 deaths in 2024 — around 9 million more cases than the previous year.

Approximately 95% of all malaria deaths occurred in the WHO African Region, with most victims being children under 5 years old.

“New tools for prevention of malaria are giving us new hope, but we still face significant challenges,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus.

“Increasing numbers of cases and deaths, the growing threat of drug resistance, and the impact of funding cuts all threaten to roll back the progress we have made over the past two decades. However, none of these challenges is insurmountable. With the leadership of the most-affected countries and targeted investment, the vision of a malaria-free world remains achievable.”

Drug resistance threatens treatment

The report spotlights growing antimalarial drug resistance, especially against artemisinin-based therapies — the global standard since the failure of earlier drugs like chloroquine.

Partial resistance has now been confirmed or suspected in at least eight African countries, and some evidence suggests reduced efficacy in partner drugs used with artemisinin.

The emergence of Anopheles stephensi, a mosquito species resistant to many common insecticides and adapted to urban environments, in nine African countries, is also making malaria harder to control, particularly in cities.

Adding to the challenge, WHO has identified 48 countries with confirmed pyrethroid resistance — undermining the effectiveness of long-lasting insecticide-treated nets.

Meanwhile, malaria parasites with pfhrp2 gene deletions are impairing the accuracy of rapid diagnostic tests.

Weather, conflict, and underfunding hamper response

Environmental and social factors are compounding the biological threats.

Extreme weather events, driven by climate change, are altering mosquito habitats and malaria transmission patterns.

Conflict and political instability in affected regions are further disrupting health services and access to care.

Compounding these issues is a chronic funding gap.

In 2024, global malaria spending totaled USD 3.9 billion — less than half of the Global Technical Strategy’s 2025 funding target of USD 9.3 billion.

Reductions in Official Development Assistance have forced widespread cancellations or delays in malaria surveys, weakened routine health surveillance, and increased the risk of supply shortages for life-saving interventions.

Country-led and innovation-driven responses

Progress in malaria elimination has not halted entirely.

A total of 47 countries and one territory have now been certified malaria-free by WHO. Cabo Verde and Egypt achieved this milestone in 2024, followed by Georgia, Suriname, and Timor-Leste in 2025.

Still, global targets remain off track. In 2024, the malaria death rate was 13.8 per 100,000 people — more than triple the global target of 4.5 deaths per 100,000 set for 2030.

“The World Malaria Report is clear: drug resistance is advancing. Our response must be equally clear — new medicines with new mechanisms of action,” said Dr. Martin Fitchet, CEO of Medicines for Malaria Venture.

“The development of the first non-artemisinin combination therapy, Ganaplacide–Lumefantrine, is proof that this is possible, and it represents the beginning of a new chapter in malaria resilience. Together with a global partnership of expertise, commitment, and funding, we can stay ahead of resistance and deliver new medicines to ensure malaria is no longer a threat.”

WHO is calling on malaria-endemic countries to reaffirm their political commitments under the Yaoundé Declaration and support collective action through the Big Push initiative.

“Political commitments need to be translated into resources and actions with sustainable and equitable impact,” the report emphasized.

With continued innovation, investment, and global solidarity, the WHO says a malaria-free future is still within reach.