Malaria Remains Endemic in 83 Countries by Robert Carlson MD , 29th April 2028

Malaria Vaccines are available in Africa in April 2025

When we talk about the global fight against malaria, it’s easy to focus on the staggering achievements of the last quarter-century: Since 2000, global efforts against malaria have successfully prevented over 2 billion cases and protected nearly 13 million lives. Despite significant progress made against malaria it remains a persistent threat across large sections of the globe. The World Health Organization (WHO) recognized 45 countries and one territory as malaria-free by April 2025. That’s cause for celebration. The fight against malaria remains challenging because 83 countries still face endemic transmission and among them 25 nations reported less than 10 malaria cases in 2023.

A Glimpse at Global Progress : Malaria’s reduction resulted from combined focused actions, technological developments, and local community participation. The revamped WHO Global Malaria Programme joined forces with substantial financial support from the Global Fund and the U.S. President’s Malaria Initiative to drive malaria interventions throughout Africa, Asia, and Latin America at the beginning of the 21st century. The deployment of high-impact tools including insecticide-treated nets (ITNs), indoor residual spraying (IRS), and timely effective treatment led to reductions in both case counts and mortality rates.

Yet success has been uneven. Despite complete malaria eradication in Europe and parts of Asia and the Americas, sub-Saharan Africa remains the primary region affected by the disease. The persistence of malaria transmission worldwide occurs because of socioeconomic challenges and weak health systems combined with variable funding and insecticide resistance along with Plasmodium parasite biology complexity.

What’s Possible: Lessons From the Malaria-Free

The alignment of political determination and adequate resources demonstrates through history what achievements can be realized. Nations that have eliminated malaria invested heavily in surveillance and response: Health systems must detect all cases while tracking how transmission spreads and then implement rapid containment measures. Cross-ministry partnerships between health services and departments of agriculture, environment, education and tourism established reliable vector control practices while maintaining community involvement in preventative actions.

Through establishing robust connections between research organizations, government agencies and civil society these nations developed health systems capable of effectively preventing outbreaks and rapidly responding to new cases. Through this approach they revealed an undeniable route towards malaria eradication.

A New Generation of Insecticide-Treated Nets

The implementation of next-generation insecticide-treated nets stands out as one of the most transformative recent developments. Mosquitoes developed resistance to pyrethroids which were the sole insecticide used in traditional ITNs. Research teams redesigned ITNs by adding a second active substance that could be a synergist or an alternative insecticide to tackle the challenge of growing pyrethroid-resistant mosquito populations.

The 2024 World Malaria Report shows that dual-action nets represented about 80 percent of the total nets distributed to sub-Saharan Africa in 2023 which marks an increase from 59 percent in the prior year. Initial research data shows that communities who use enhanced nets experience more significant reductions in mosquito numbers and malaria cases in comparison to communities with traditional nets. The combination of new-generation ITNs with complementary tools like seasonal malaria chemoprevention for children promises to deliver a powerful effort toward disease control and elimination.

Vaccines: A New Frontier

The creation of a successful malaria vaccine represented an unattainable objective for many years. The RTS,S/AS01 (Mosquirix) vaccine achieved a major WHO endorsement for expanded use among children in regions experiencing moderate to high malaria transmission in 2021. The R21/Matrix-M vaccine demonstrated similar effectiveness during large-scale clinical tests and received WHO approval by early 2025. The vaccines work by preparing the immune system to respond during the parasite’s pre-erythrocytic phase before it multiplies in the liver. Countries including Nigeria and Ghana implemented pilot vaccination programs which produced encouraging results in reducing severe malaria cases and hospital visits among young children.

Although both Mosquirix and R21/Matrix-M vaccines show potential, they remain unavailable for distribution in the United States. U.S. travelers who visit high-transmission regions in Africa should avoid mosquito bites by using repellents and protective clothing along with bed nets while following CDC-recommended chemoprophylactic regimens.

A Dual-Track Approach in the U.S.

The majority of malaria cases reported in the United States as of April 28, 2025 originate from travelers returning from endemic areas with Florida appearing most frequently on the list. Healthcare facilities and public health agencies monitor imported cases through systematic screening and fast diagnostic testing which enables quick treatment of patients and prevents local spread of the disease. Meanwhile, public health messaging emphasizes layered prevention: Effective malaria prevention requires environmental strategies such as eliminating standing water together with protective measures including long-sleeved clothing and window screens and medication options like atovaquone–proguanil and doxycycline. The U.S. expects to approve malaria vaccines for travelers while current research efforts could soon provide additional protective measures for residents traveling to high-risk malaria areas.

The Road Ahead: Collaboration and Commitment

Despite the substantial achievements of preventing 2 billion cases and 13 million deaths malaria continues to require significant effort to eradicate. The key objective is to maintain progress in the 83 endemic countries while focusing on those nearing malaria elimination.

Key priorities include: Surveillance Strengthening. Nationwide case reporting systems need immediate functionality so data can move smoothly from community health workers to national health authorities. Insecticide and Drug Resistance Monitoring. Effective control of malaria vectors and treatment requires proactive management strategies that include rotating insecticides and using combination therapies to maintain their effectiveness. Vaccine Scale-Up and Optimization. Expanded vaccine production requires that routine vaccination for children and pregnant women becomes essential in regions where malaria persists.

Community Engagement and Education. Local leaders together with schools and health volunteers should lead prevention initiatives to ensure interventions gain cultural acceptance and proper use.

Sustainable Financing. Funding pipelines face donor fatigue while endemic nations and development partners need to examine alternative financing methods like malaria bonds or blended finance to ensure steady investment.

Malaria presents significant challenges yet historical evidence confirms its eventual defeat. Through political determination and continuous financial support along with multisectoral efforts and community involvement the goal of eradicating malaria becomes achievable. The success of the last 25 years offers both a roadmap and a warning: We will face inevitable defeat if we continue to falter since progress can unwind but failure becomes guaranteed if we sustain our current course.

OurWorldInData.org’s 2025 malaria overview draws to a close with a renewed pledge to eliminate an age-old affliction that has tormented humanity throughout history. The route ahead stands clear yet our united determination to follow that path is what remains essential.

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