Progress Made
What is being done
Progress in expanding access to effective malaria control tools, but gaps in coverage persist
Advances in malaria prevention and treatment amid gaps in coverage
The report highlights positive trends in the scale-up of effective prevention tools, including new generation nets, the malaria vaccine and seasonal malaria chemoprevention.
There has also been notable progress in providing timely diagnosis and treatment for young children. However, coverage of insecticide-treated nets and preventive malaria therapy for pregnant women continues to lag, underscoring areas needing further action.
Recent years have seen significant progress in the deployment of new generation nets
Over the past 2 decades, more than 3 billion insecticide-treated nets (ITNs) have been distributed globally. Most of these nets were treated with insecticides from one class: pyrethroids.
To overcome rising mosquito resistance to insecticides, WHO recommends the use of pyrethroid-PBO and dual-active ingredient nets, which offer greater protection against malaria compared to standard pyrethroid-only nets.
In 2023, these more effective nets accounted for 78% of the 195 million nets delivered to sub-Saharan Africa, a notable increase from 59% in 2022.
Wider vaccine rollout also promises to lower the malaria burden in Africa
Between 2019 and 2023, approximately 2 million children in Ghana, Kenya and Malawi received a WHO-recommended malaria vaccine. As of December 2024, a total of 17 countries had introduced the vaccine in selected areas through routine childhood immunization, with many more to follow. Demand for vaccines is high, and supply is sufficient to meet demand.
The scale-up of malaria vaccines in Africa is expected to save tens of thousands of young lives every year. The highest impact will be achieved when the vaccines are introduced alongside a mix of WHO-recommended malaria interventions that are tailored to the local context.
Expanded SMC access is another bright spot in malaria control efforts in Africa
Seasonal malaria chemoprevention (SMC) has proven to be highly effective in protecting young children from malaria. The intervention involves administering monthly doses of antimalarial drugs during peak malaria season to children under five, the group most vulnerable to severe malaria.
Between 2012 and 2023, the average number of African children treated per cycle of SMC rose from approximately 170 000 to 49 million in 2022 and 53 million in 2023. In 2023, SMC was implemented in 19 African countries, including in 2 countries for the first time: Côte d'Ivoire and Madagascar.
The report also shows improvements in case management for young children
Data show a positive shift towards timely and effective malaria care in this vulnerable population. Across 26 sub-Saharan African countries, the proportion of febrile children who were taken to a health provider and received a diagnosis increased from a median of 30% in baseline studies (2005-2011) to 48% in more recent surveys (2017-2023).
Of the children who reached a health provider and received an antimalarial drug, a median of 71% were treated with an artemisinin-based combination therapy (ACT) in the period 2017-2023 compared to 38% from 2005-2011.
ACTs are the most effective and widely recommended treatment for uncomplicated malaria, especially for infections caused by Plasmodium falciparum, the parasite responsible for most malaria deaths in Africa.
Access to ITNs has improved, but many at risk of malaria remain unprotected
Over the last 2 decades, insecticide-treated nets (ITNs) have been a cornerstone of malaria prevention efforts in sub-Saharan Africa. In 2023, only about half (52%) of the population at risk of malaria was sleeping under an ITN.
ITN use among young children and pregnant women and girls reached 59% in 2023 – up from 55% in 2022 – but fell considerably short of the goal of universal coverage.
Efforts to expand access to preventive malaria therapy for pregnant women and girls should also be accelerated
Intermittent preventive treatment of malaria in pregnancy (IPTp) is used to prevent malaria among pregnant women and girls living in areas of moderate-to-high malaria transmission. WHO recommends at least 3 doses of IPTp starting as early as possible in the second trimester. To date, 34 African countries have adopted IPTp.
Despite some progress, many pregnant women and girls continue to miss out on this critical malaria prevention tool. In 2023, an estimated 44% of pregnant women and girls at risk of malaria received the recommended 3 doses of IPTp, a modest increase from 42% in 2022.
