Malaria cases are rising for a fifth year as disasters and resistance hamper control efforts

Malaria killed nearly 600,000 people in 2023 as cases rose for the fifth consecutive year, according to a new report of the World Health Organization (WHO).

Biological threats such as rising resistance to drugs and insecticides, and climate and humanitarian disasters continue to hamper control efforts, world health leaders warned.

Globally, there were 263 million cases last year, 11 million more than the year before; the vast majority (94%) occurred in Africa.

Officials said an annual funding gap of $4.3 billion (£3.4 billion) was among further challenges, including the spread of a new insecticide-resistant mosquito strain. genetic mutations in the malaria parasite, making tests ineffective, and the emergence of a new type of malaria parasite in Southeast Asia.

Dr. Tedros Adhanom Ghebreyesus, Director-General of WHO, said: “No one should die from malaria; yet the disease continues to disproportionately harm people in the African region, especially young children and pregnant women.”

There was now “a comprehensive package of life-saving tools” protecting against the disease, he said, but there was a need for more investment and action in the African countries with the highest rates.

Last year, around $4 billion went to the fight against malaria worldwide, less than half of the $8.3 billion officially spent control plans are deemed necessary. That has led to gaps in the supply of resources such as medicines and insecticide-treated bed nets, often leaving the most vulnerable groups shortchanged, the report said.

Only half of those at risk of malaria in sub-Saharan Africa slept under insecticide-treated nets, and only 45% of pregnant women in the region received the recommended three doses of preventive malaria therapy. About 80 million people in countries where malaria occurs are refugees or displaced persons, making it more difficult for them to access prevention and treatment services.

Meanwhile, the climate crisis is increasing the number of extreme weather events that cause flooding, create mosquito breeding grounds and disrupt access to healthcare in countries like Pakistan and Madagascarthe report said.

Earlier this month, British health officials warned that they were seeing rising numbers of malaria cases of travelers returning to Britain. In 2023, there were 2,106 cases of imported malaria, a 26% increase from the 1,555 reported in 2022. Six people died from the disease. Preliminary figures recorded 753 cases in the first half of 2024.

A separate report published last month by the Malaria Atlas Project and Boston Consulting Group, with funding from the Gates Foundation, predicts that Africa will see more than 550,000 additional deaths from malaria in Africa between 2030 and 2049 due to extreme weather events such as floods and cyclones.

Resistance to drugs that have been the gold standard treatment for malaria is spreading, report says, and mosquito numbers are increasing resistant to the insecticides used to treat mosquito nets.

However, the report contained reasons for optimism, including the introduction in 17 countries so far of malaria vaccines for young children who reduce mortality rates by 13%. And the development of new mosquito nets, made more effective by using more than one type of insecticide to combat resistance, accounted for 78% of the nets supplied to sub-Saharan Africa last year.

The WHO has certified 44 countries and one territory as malaria-free, including Egypt in October. There are 83 countries where malaria is considered endemic and 25 of these now report fewer than 10 cases per year.