Current State
The malaria situation worldwide
An overview including the number of malaria cases and deaths, the current trajectory of global progress towards targets, milestones and funding as well as the threats to achieving these.
Some global gains in malaria control – but the fight is far from over
This year’s report presents some encouraging data and trends in global malaria control. The period 2000–2023 saw 2.2 billion cases and 12.7 million deaths averted worldwide.
To date, 44 countries and 1 territory have been awarded an official malaria-free certification from WHO, with many more moving steadily towards the goal of elimination. Some higher-burden countries have also achieved notable reductions in their malaria caseload.
Despite these gains, malaria remains a serious global health challenge, claiming 597 000 lives in 2023 alone. The African Region continues to be hardest hit, with about two-thirds of the global burden of malaria concentrated in 11 African countries. Current data suggest that progress towards critical targets of the WHO global malaria strategy is not on pace.
Malaria responses worldwide are preventing illness and saving lives
Since 2000, malaria control efforts have helped avert 2.2 billion cases and 12.7 million deaths worldwide. Alongside targeted interventions, other factors such as improvements in socioeconomic status, nutrition, infrastructure, housing and urbanization have also likely contributed to reducing malaria transmission and disease.
Progress has been reported across many countries
Between 2000 and 2023, the number of countries reporting fewer than 1000 malaria cases per year increased from 13 to 35, while those with fewer than 10 cases per year increased from 4 to 25.
Some high burden countries are also making strong inroads against malaria. In the WHO African Region, Rwanda reduced its malaria caseload by 85% between 2019 and 2023 – from 4.9 million to 749 000 – while Liberia achieved a 44% reduction in cases since 2017, from about 1.8 million to 1 million. In South-East Asia, India lowered its cases by 69%, from 6.4 million in 2017 to 2 million in 2023.
To date, WHO has certified 44 countries and 1 territory as malaria-free – including, most recently, Egypt
The certification is granted when a country can prove, beyond a reasonable doubt, that the chain of indigenous malaria transmission has been interrupted nationwide for at least 3 consecutive years. A country must also demonstrate the capacity to prevent the re-establishment of transmission.
Four countries were certified malaria-free in 2023 – Azerbaijan, Belize, Cabo Verde and Tajikistan – and Egypt achieved this milestone in October 2024. Three more countries – Georgia, Timor-Leste and Türkiye – have submitted requests for a malaria-free certification; an independent WHO advisory group will assess whether they are ready to be certified in the coming months.
List of countries
Disclaimer
Despite progress, malaria remains a serious global health challenge
In 2023, there were an estimated 263 million new malaria cases in 83 countries worldwide, up from 252 million in 2022 and 226 million in 2015. Malaria case incidence, which accounts for population growth, rose in the period 2015-2023 from 58 to 60.4 cases per 1000 population at risk.
The global tally of malaria deaths reached 597 000 in 2023 compared to 578 000 in 2015. In 2020, disruptions caused by COVID-19 led to a sharp increase in malaria-related deaths, with an additional 55 000 fatalities. However, the total number of deaths steadily declined in the post-COVID period, together with the malaria mortality rate.
Progress must be accelerated in the hard-hit African Region
The African Region bears the heaviest burden of malaria, accounting for an estimated 94% of global cases and 95% of malaria-related deaths in 2023. Just over half of these deaths occurred in 4 countries: Nigeria (30.9%), Democratic Republic of the Congo (11.3%), Niger (5.9%) and United Republic of Tanzania (4.3%).
Approximately two thirds of global malaria cases and deaths are concentrated in 11 African countries: Burkina Faso, Cameroon, Democratic Republic of the Congo, Ghana, Mali, Mozambique, Niger, Nigeria, Sudan, United Republic of Tanzania and Uganda.
These 11 countries have adopted the “High Burden High Impact” approach, a targeted effort to reach populations at greatest risk of malaria with tailored packages of interventions informed by local data and disease settings.
Between 2015 and 2023, the African Region as a whole achieved a 5% reduction in case incidence and a 16% decline in mortality rates. However, rates in 2023 for both indicators were more than double the target levels set by the global strategy.
Global targets: progress falling behind
Adopted in May 2015 by the World Health Assembly, and updated in 2021, the WHO global malaria strategy serves as a comprehensive framework for countries working to control and eliminate malaria. The strategy outlines ambitious targets to reduce global malaria incidence and mortality rates by 2030, with interim milestones to track progress.
Progress towards key targets remains substantially off track
The strategy calls for reductions in malaria case incidence and death rates of at least 75% by 2025 and 90% by 2030, compared to 2015 baseline levels.
The 2023 malaria incidence rate of 60.4 cases per 1000 population at risk is nearly 3 times higher than the 21.3 cases per 1000 needed to reach the target. That same year, there were 13.7 malaria deaths per 100 000 population, more than twice the target of 5.5 deaths per 100 000.
Global progress considering 2 scenarios: current trajectory maintained (orange) and targets achieved (green)
Global funding reaches less than half of US$ 8.3 billion target
In 2023, global malaria control efforts faced a substantial funding shortfall, with an estimated gap of US$ 4.3 billion.
About 63% of malaria funding came from international sources, while endemic countries supplied 37%. The United States led in international contributions, followed by the United Kingdom, France, Germany, Japan and Canada.
A widening funding shortfall
Globally in 2023, total investments in malaria control reached an estimated US$ 4 billion, falling far short of the US$ 8.3 billion funding target of the WHO global malaria strategy. The funding gap has widened over the past 5 years, increasing from US$ 2.6 billion in 2019 to US$ 4.3 billion in 2023.
Endemic countries gradually increase their share of malaria funding
From 2010 to 2023, international sources provided an average of 67% of total malaria funding, while endemic countries contributed 33%. In recent years, the share of contributions from malaria-affected countries has gradually increased, reaching 37% in 2023.
With a contribution of US$ 1.1 billion, the United States was the top contributor to global malaria control efforts in 2023. Canada, France, Germany, Japan and the United Kingdom collectively contributed nearly US$ 1 billion. An additional US$ 400 million came from other Development Assistance Committee member countries and private sector donors.
Urgent response needed as malaria-endemic countries face mounting threats
In the wake of the COVID-19 pandemic, malaria-endemic countries continue to grapple with persistent challenges.
Fragile health systems, weak surveillance, and chronic funding shortfalls endure as major barriers. Many at risk of malaria continue to miss out on the services they need to prevent, detect and treat the disease. Rising biological threats, such as drug and insecticide resistance, are undermining the effectiveness of core malaria control tools.
Compounding these threats are the overlapping impacts of conflict and violence, climate change, natural disasters and population displacement on malaria transmission, fuelling a complex public health crisis that requires an urgent response.
Mosquito resistance to pyrethroids remains widespread
Resistance to pyrethroids – the most commonly-used chemical on insecticide-treated nets – was confirmed in 55 of the 64 countries where it was monitored between 2018 and 2023. New generation nets, which provide better protection against malaria than pyrethroid-only nets, are becoming more widely available and represent an important tool in global efforts to combat the disease.
List of countries
Disclaimer
Antimalarial drug resistance in Africa is another pressing concern
To date, 4 countries in East Africa have confirmed the presence of partial resistance to artemisinin (Eritrea, Rwanda, Uganda, United Republic of Tanzania) and, based on available evidence, such resistance is also suspected in at least 4 other countries (Ethiopia, Sudan, Namibia, Zambia).
Vigorous measures are needed to protect drug efficacy. Given the heavy reliance on artemisinin-based combination therapies (ACTs) in the region, full-blown treatment failure could have serious consequences.
In 2022, WHO launched a strategy to curb antimalarial drug resistance in Africa. The strategy builds on lessons learned from past global plans and complements existing strategies, including broader efforts to respond to antimicrobial resistance.
Anopheles stephensi presents an added challenge for malaria control in Africa
Originally native to parts of South Asia and the Arabian Peninsula, the invasive mosquito species has been expanding its range over the last decade, with detections reported to date in 8 African countries.
Anopheles stephensi thrives in urban settings, endures high temperatures and is resistant to many of the insecticides used in public health.
In 2022, WHO launched an initiative to raise awareness of this growing threat and catalyse existing efforts by its Member States and partners to stop the further spread of An. stephensi in Africa.
Humanitarian emergencies are heightening malaria risks in many endemic areas
Such emergencies displace populations, alter ecological habitats, and put a strain on healthcare systems. In 2023, an estimated 80 million people in malaria-endemic countries were internally displaced persons (IDPs) or refugees, of which approximately 70% were uprooted by conflict or natural disasters.
IDPs and refugees often lack access to malaria prevention and treatment, leading to higher exposure and transmission rates. Women, children and marginalized communities are disproportionately vulnerable to malaria, often residing in camps or temporary shelters without adequate malaria control.
Climate change also threatens to undermine the gains against malaria
Rising temperatures and changing weather patterns are impacting the health, security and livelihoods of people around the world. Many of the communities impacted by climate change are also at high risk of malaria.
A recent analysis from the Malaria Atlas Project and the Boston Consulting Group suggests that climate change could cause an additional 550 000 malaria deaths between 2030 and 2049, assuming current levels of malaria control. Extreme weather events are expected to drive most of the projected increase in mortality.
The 2022 flooding in Pakistan is just one example of the devastating effects of an extreme weather event on malaria transmission and burden. After the floods receded, pools of standing water created ideal breeding grounds for mosquitoes, leading to a staggering 8-fold increase in malaria cases between 2021 and 2023, from about 500 000 to 4.3 million. These events will likely become even more common, and severe, due to climate change.
