Malaria Burden Remains High in Sub-Saharan Africa Despite Progress in Vaccines and New Tools
Introduction
Malaria continues to cause serious health and economic problems worldwide. Sub-Saharan Africa accounts for about 95% of all malaria cases and deaths. According to the World Malaria Report 2025, there were an estimated 282 million cases and 610,000 deaths in 2024 across 80 countries. Children under five make up around three-quarters of malaria deaths in Africa. More than half of all deaths in the region happen in Nigeria, the Democratic Republic of Congo, and Niger. Although there have been important advances in vaccines and treatments for children, the overall number of cases and deaths is rising, which shows that progress is slowing down.
Main Body
The current situation is caused by a mix of long-term and new pressures. Funding for malaria control has stopped increasing, while key tools like artemisinin-based combination therapies and insecticide-treated nets are becoming less effective because of resistance in parasites and mosquitoes. Climate change is expected to make transmission worse. A study in Nature predicted that by 2050, Africa could see an extra 123 million cases and up to half a million deaths if adaptation measures are not enough. Floods, in particular, create standing water where mosquitoes breed and disrupt control programmes, as researchers Tiaan de Jager and Taneshka Kruger pointed out. Conflict and mass displacement in the Sahel region also make it harder to deliver prevention and treatment services. At the same time, positive developments have occurred. In July 2025, Swissmedic approved the first malaria treatment designed specifically for infants and young children aged two months to five years, filling a critical gap in paediatric care. Seventeen countries where malaria is common, representing about 70% of the global malaria burden, introduced malaria vaccines into their routine childhood immunisation programmes in 2024. Two vaccines are available: RTS,S, first used in a routine programme in Cameroon in January 2024, and R21/Matrix-M, developed by Oxford University and approved by the World Health Organization in October 2023. Early data from Ghana showed an 86% reduction in malaria deaths among children under five after a subnational rollout of RTS,S. Mali, which introduced the R21/Matrix-M vaccine in April 2025, adapted its delivery by giving booster doses together with seasonal malaria chemoprevention campaigns to improve adherence. Dr. Ngozi Erondu, Technical Director at the Global Institute for Disease Elimination, emphasised that while innovation is promising, the main challenge is scaling up and sustaining these tools. She noted that cross-border data sharing is essential because mosquito populations and transmission patterns do not respect national borders. Initiatives such as the Sahel Malaria Elimination Initiative (SaME) have created regional platforms for sharing epidemiological data and coordinating responses. AI-based mosquito identification tools, like VectorCam tested in Uganda, can speed up entomological surveillance by allowing non-specialists to classify species from images or sound recordings. However, Dr. Erondu cautioned that these technologies need local training data, integration into national systems, and investment in human capacity. She also stressed that data quality at the point of care remains a problem, and that surveillance systems should be combined rather than focused on single diseases to ensure long-term use. The reliance on external funding—nearly half of sub-Saharan African countries depended on outside sources for more than a third of health spending in 2021—makes programmes vulnerable to donor fatigue and changing global priorities. Researchers Taneshka Kruger and Tiaan de Jager argued that prevention is far more cost-effective than treatment, with long-lasting insecticidal nets costing US$4–7 each compared to hundreds of dollars for a single severe malaria case.
Conclusion
The malaria situation in sub-Saharan Africa presents a paradox: new vaccines, treatments, and digital tools offer unprecedented chances to reduce transmission, yet the disease burden is rising because of funding shortages, biological resistance, and climate-related disruptions. Reaching the United Nations target of ending malaria epidemics by 2030 will require sustained investment in health systems, cross-border coordination, and the deliberate scaling up of proven interventions alongside new innovations. Without such efforts, the current momentum may not be enough to reverse the upward trend in cases and deaths.