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News — World Malaria Day is commemorated every year on 25 April, and is a global effort to raise awareness and drive action against one of humanity’s oldest and deadliest diseases. This year’s theme – ‘Malaria Ends With Us: Reinvest, Reimagine, Reignite’ – calls for renewed, strengthened partnerships and bold solutions to eradicate this preventable and treatable disease.

A decade of progress and new challenges

Malaria remains a major public health challenge. According to the World Health Organisation’s (WHO) 2024 World Malaria Report, there were 263 million cases of malaria worldwide in 2023 – 11 million more than in 2022 – and an estimated 597 000 deaths were caused by the disease. Most of the burden remains in the WHO African Region, with 94% of cases and 95% of deaths occurring there, particularly among children under the age of five in sub-Saharan Africa.

Although efforts to control malaria prevented more than 2 billion cases and nearly 13 million deaths globally since 2000 – thanks to innovations in treatment, prevention and surveillance – progress has stalled since 2017. Insecticide-treated bed nets, rapid diagnostic tests, artemisinin-based combination therapies (ACTs) and the recent rollout of malaria vaccines have been game-changers. But persistent challenges threaten to reverse the hard-won gains of the 2000s and early 2010s. These include resistance to ACT and insecticides, undetectable Plasmodium falciparum strains, mosquitoes changing their behaviour from indoor to outdoor biting, climate change, the spread of the Asian vector Anopheles stephensi in Africa, cross-border transmission and funding shortfalls.

A low-risk country in a high-risk region

While South Africa is a low-risk malaria country, its geographical position places it at the frontline of regional transmission. The country’s malaria-endemic provinces – Limpopo, Mpumalanga and KwaZulu-Natal – have benefitted from effective vector control strategies, including indoor residual spraying, and early detection and treatment programmes. However, South Africa is part of the Southern African Development Community (SADC), which includes countries with high malaria burdens, such as Mozambique, Angola and the Democratic Republic of the Congo. Given the high number of people moving between these regions, cross-border malaria transmission remains a major challenge. Regional collaborative initiatives are instrumental in coordinating malaria control strategies across SADC countries, but progress is at risk due to funding constraints and shifting global health priorities.

The growing funding crisis

Malaria control and elimination efforts depend on sustained investment, yet global funding has stagnated in recent years. In addition, recent budget cuts from major contributors, including the US, threaten to derail progress, particularly in Africa. The President’s Malaria Initiative, a US government initiative, and the Global Fund to Fight AIDS, Tuberculosis and Malaria have been crucial in providing resources for malaria programmes, research and intervention rollouts. A reduction in these funds risk setbacks such as the resurgence of cases in regions that were on the verge of elimination.

Identifying new funding sources is critical. Without consistent investment from global stakeholders, vital programmes and key interventions – from vector control and surveillance to research and the development of new malaria-fighting tools – face significant disruptions, placing pressure on already overburdened health systems across South Africa and the broader SADC region.

Research – the cornerstone of progress

One of the most essential components in the fight against malaria is continuous research. The past decade has seen remarkable breakthroughs, from improved diagnostic tools to promising malaria vaccine developments. Institutions like the University of Pretoria Institute for Sustainable Malaria Control (UP ISMC) and other academic and research organisations across Africa are pivotal in developing innovative strategies to combat malaria.

The UP ISMC champions eco-friendly, community-oriented, sustainable malaria control alternatives. It advances community-based health interventions, builds leadership capacity in control programmes, explores indigenous plants and existing compounds as potential new drug targets for malaria treatment, and promotes novel vector control strategies, including integrated vector management and public awareness initiatives. The UP ISMC’s transdisciplinary approach places emphasis on health promotion, behaviour change communication and the reduction of harmful chemical exposure, aligning malaria control with broader sustainability and environmental health goals.

Yet research funding is increasingly under pressure. Without reinvestment in innovation, advances in drug development, vector control and vaccines could slow, undermining long-term elimination goals. Now more than ever, it is crucial to invest in research and innovation to ensure that malaria control efforts remain effective and sustainable.

The power of collective action

Ending malaria is not just a health priority; it is a step towards a safer, more prosperous future. The burden of malaria extends beyond health, affecting economies, education and development, especially in Africa. By recommitting to malaria elimination through sustained funding, cross-border collaboration and innovative research, we can ensure a malaria-free future for all. The way forward is clear: we need to reinvest in, reimagine and reignite the fight against malaria before progress slips further away.

For more information about malaria and the UP Institute for Sustainable Malaria Control, go to .