New tools saved a million lives from malaria last year, but progress is under threat as drug resistance grows

Wider use of new anti-malaria tools, including two-component nets and WHO-recommended vaccines, helped prevent an estimated 170 million cases and 1 million deaths in 2024, according to the WHO's annual report World Malaria Report.

WHO-recommended tools are increasingly being integrated into broader health systems. Since WHO approved the world's first malaria vaccines in 2021, 24 countries have introduced the vaccines into their routine immunization programs. Seasonal malaria chemoprevention has also been scaled up and is now being implemented in 20 countries, reaching 54 million children in 2024, an increase from around 0.2 million in 2012.

Progress is also being made in eliminating malaria. To date, a total of 47 countries and 1 territory have been certified malaria-free by WHO – Cabo Verde and Egypt were certified malaria-free in 2024, with Georgia, Suriname and Timor-Leste joining in 2025. Despite this significant progress, there were an estimated 282 million malaria cases and 610,000 deaths in 2024 – approximately 9 million more than the previous year.

An estimated 95% of these deaths were in the African region of the World Health Organization, and the majority occurred among children under 5 years of age. The report shows that resistance to antimalarial drugs is increasing and stands in the way of achieving malaria elimination.

“New tools to prevent malaria give us new hope, but we still face significant challenges,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. “The rising number of cases and deaths, the growing threat of drug resistance and the impact of funding cuts threaten to reverse the progress we have made over the past two decades. However, none of these challenges are insurmountable. With leadership from the worst-affected countries and targeted investment, the vision of a malaria-free world remains achievable.”

The World Malaria Report highlights evidence of partial resistance to artemisinin derivatives, which became the backbone of malaria treatment after the failure of chloroquine and sulfadoxine-pyrimethamine. Antimalarial drug resistance is now confirmed or suspected in at least 8 countries in Africa, and there are potential signs that the effectiveness of drugs combined with artemisinin is declining.

Progress in reducing malaria mortality – a key goal Global technical strategy for malaria 2016-2030 – remains far from the track. In 2024, there were 610,000 deaths. This corresponds to 13.8 malaria deaths per 100,000 population, more than 3 times the global target of 4.5 deaths per 100,000.

Complex challenges to progress

This year's report highlights a growing set of risks to malaria elimination efforts with the threat of antimalarial drug resistance.

Malaria parasites with pfhrp2 gene deletions remain prevalent, undermining the reliability of rapid diagnostic tests, while confirmed pyrethroid resistance in 48 countries reduces the effectiveness of insecticide-treated nets. Simultaneously, Anopheles stephensi mosquitoes – resistant to many commonly used insecticides – have now invaded 9 African countries, posing a serious challenge to malaria control efforts in cities.

In addition to biological threats, extreme weather conditions also contribute to increased malaria outbreaks. Changes in temperature and precipitation change mosquito habitats and thus transmission patterns.

Conflict and instability in affected regions also lead to widespread disruptions to health services, limiting access to care and delaying timely diagnosis and treatment.

The challenge has been further exacerbated by the decline in global funding over the past decade, limiting the reach of life-saving interventions. In 2024, US$3.9 billion was invested in the malaria response, but less than half of the 2025 funding target of US$9.3 billion set by the Global Technical Strategy was reached.

Recent cuts in official development assistance (ODA) have severely disrupted health systems, weakening routine surveillance and forcing the cancellation or postponement of most planned malaria research. These cuts also increased the risk of stockouts and delays in malaria intervention campaigns, undermining program performance.

A country-led response, enabled by a partner

“The World Malaria Report is clear: drug resistance is advancing. Our response must be equally clear – new drugs with new mechanisms of action,” said Dr Martin Fitchet, CEO of the Medicine for Malaria Venture. “The development of the first artemisinin-free combination therapy, Ganaplacide-Lumefantrine, is proof that this is possible and marks the beginning of a new chapter in malaria resistance. Together with a global partnership of expertise, commitment and funding, we can stay ahead of the curve and deliver new medicines to ensure malaria is no longer a threat.”

Political commitments should be translated into resources and actions with a sustainable and equitable impact. WHO urges malaria-endemic countries to maintain their political commitments to end malaria deaths as outlined in the Yaoundé Declaration. Unity and action under the Big Push initiative will help the global malaria community mitigate current and future threats to achieve a malaria-free future.