The alarm was sounded during a high-level webinar marking World Malaria Day 2026, where health leaders and development partners gathered to assess the continent’s progress and chart a path forward. The event, organised with support from UNICEF and the RBM Partnership to End Malaria, focused on how stronger primary healthcare systems could accelerate malaria elimination.
At the heart of the discussion was a stark reality: Africa continues to shoulder the overwhelming burden of malaria globally. Despite years of interventions, the disease still accounts for nearly all cases and deaths worldwide, underscoring how fragile recent gains remain.
Dorothy Achu, a leading expert on tropical and vector-borne diseases at WHO’s regional office for Africa, described the continent as the “global epicentre” of malaria. She noted that roughly 270 million cases and about 580,000 deaths occur annually across Africa, with young children bearing the brunt.
“About one billion people across 46 countries in Africa are exposed to malaria, with children under five accounting for 75 per cent of deaths,” she said.
Pregnant women are also highly vulnerable, with an estimated 13 million cases recorded each year. While global efforts since 2015 have prevented millions of infections and deaths, Achu warned that momentum in Africa has slowed due to a combination of financial and structural challenges.
Among the most pressing concerns is the sharp rise in the malaria funding gap.
“The malaria funding gap has widened significantly from $2.6 billion in 2019 to $5.4 billion in 2024,” she explained.
This widening deficit comes at a time when new threats — including climate change, weak health systems, and growing resistance to drugs and insecticides — are complicating control efforts.
Primary Healthcare Seen as Game-Changer
Experts at the forum emphasised that transforming primary healthcare (PHC) systems could be the key to turning the tide. Strengthening frontline services, expanding the community health workforce, and improving access to essential tools were highlighted as critical steps.
Landry Tsaque of Africa CDC outlined a transformation framework built around five pillars: workforce development, infrastructure, supply systems, financing, and governance. He stressed that bringing care closer to communities — supported by digital surveillance tools — would enable faster detection and treatment of malaria cases.
Billions Needed, but Less Than Half Available
The financing challenge remains daunting. Global health strategist Adewale Akinjeji described malaria control as one of the most cost-effective health investments, yet severely underfunded.
“About $9.3 billion is required annually for malaria control and elimination, but only $3.9 billion is currently available,” he said.
“This leaves a gap of over $5 billion, representing more than 58 per cent shortfall.”
Beyond the human toll, malaria continues to weigh heavily on African economies, draining more than $12 billion each year in lost productivity. Akinjeji noted that every dollar invested could generate up to $40 in economic returns, making a strong case for increased domestic funding.
He also cautioned against overdependence on foreign aid, which currently accounts for more than half of malaria financing.
“An externally driven malaria response is not sustainable,” he warned, urging governments to take greater ownership of funding efforts.
Rising Drug Resistance Adds Urgency
Compounding the funding crisis is the growing threat of drug resistance. Yenew Kebede of Africa CDC highlighted concerns about mutations in the malaria parasite, particularly Plasmodium falciparum, which could undermine existing treatments.
“Mutations linked to artemisinin resistance were first identified in Africa in 2014, but surveillance across the continent remained limited,” he said.
Efforts are now underway to strengthen molecular surveillance and build a continent-wide early warning system. However, recent findings showing resistance-related mutations in multiple countries suggest time may be running short.
A Call for Coordinated Action
Across all discussions, one message stood out: without stronger health systems, sustainable financing, and improved surveillance, malaria elimination in Africa will remain out of reach.
Experts called on governments, regional bodies, and global partners to adopt more coordinated and locally driven strategies. Strengthening primary healthcare, closing funding gaps, and investing in innovation were identified as essential steps toward securing Africa’s health future — and finally ending one of its deadliest diseases.