(Source: CDC)
From the newsletter
The annual World Health Organization report on Malaria warns that antimalarial drug resistance is a threat to treating rising malaria cases in Africa. This leaves the continent with the option of expanding local manufacturing of preventive therapies that counter resistant mosquitoes like the malaria vaccine, dual insecticide bed nets, spatial repellents and others.
According to the report, there were 282 million cases of malaria in 2024, an increase of about 9 million cases, with 95% of these reported in Africa. Eight countries have confirmed antimalarial drug resistance, including to artemisinin, a WHO recommended treatment.
In July 2025, Gavi secured a deal with Bharat Biotech and GSK to cut the price of the first ever malaria vaccine by half. Despite this milestone, local manufacturing of both preventives and treatments for malaria remain low in Africa.
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Other challenges in the fight against malaria, according to the report, include resistance to insecticides, climate change, new mosquito threats and conflict. To combat this, the report recommends that countries avoid over-reliance on a single drug, while opting for better surveillance and preventive measures. Underfunding is another major challenge. $3.9 billion was invested in the response in 2024, less than half the target set by WHO.
A recent study by the Lancet shows that Africa could face an estimated 13.6 million additional malaria cases and 104,000 deaths due to new challenges. It recommends expanding local drug production to sustain malaria control across the continent. Kenya became the first country in Africa to locally produce sulfadoxine–pyrimethamine plus amodiaquine in 2024. This WHO-approved drug is used for seasonal malaria prevention.
There are at least 5 other pharmaceutical companies with WHO pre-qualification to manufacture antimalarials in the continent. However, with the new challenges like climate change, drug resistance, conflicts and underfunding, the continent needs to invest more in preventives. The new preventives for malaria include RTS,S which is the first ever vaccine for malaria, dual insecticide bed nets, spatial repellents which kill insecticide resistant mosquitoes and more.
Dual insecticide bed nets combine two active ingredients to overcome mosquito resistance. Trials across Africa showed they cut malaria infections in children by 50%. They combine pyrethroids with a second chemical like chlorfenapyr to kill resistant mosquitoes. Between 2019 and 2022, these nets prevented an estimated 13 million cases and saved nearly 25,000 lives.
Spatial repellents are also a new innovation which releases vapours that stop mosquitoes from biting, even outside sleeping hours. They cover gaps left by nets and studies in Kenya showed they cut new infections by 33% even where resistance to pyrethroids was widespread. They use special pyrethroid formulations that remain effective even where mosquitoes have developed resistance to standard bed net insecticides.
A previous report by Unitaid in April 2024 identified several challenges hindering antimalarial drug production in Africa. These challenges include high manufacturing costs, lack of affordable financing, limited infrastructure, weak regulatory systems and inadequate technical capacity. It recommends a coordinated strategy that includes regional production of active pharmaceutical ingredients, investment in bioequivalence and bioanalytical laboratories, technology transfer and quality assurance support.
Our take
Only six pharmaceutical firms on the continent have achieved WHO-prequalification to manufacture antimalarials amid the rising infections fueled by climate change.
The economic burden of malaria in Africa is substantial. In 2022, global expenditure on malaria control was estimated at $4.1 billion, with 80% allocated to Africa.
WHO's target of reducing malaria by 90% by 2030, if successful, could increase Africa’s GDP by $16 billion per year.