When a small number of locally transmitted malaria cases were detected in the United States last year, it was a reminder that climate change is reviving or migrating the threat of some diseases. But across the continent of Africa, malaria never left, killing or sickening millions of people.
Take Funmilayo Kotun, a 66-year-old resident of Makoko, an informal neighborhood in the Nigerian city of Lagos. Its dirty water ponds provide breeding grounds for malaria-carrying mosquitoes. Kotun cannot afford insecticide-treated bed nets, which cost between $7 and $21 each, let alone antimalarial drugs or treatment.
With World Malaria Day on Thursday, here's what you need to know about the situation in Africa:
MALARIA IS STILL WIDESPREAD
The malaria parasite is mostly spread to humans through infected mosquitoes and can cause symptoms including fever, headache and chills. It most often affects children under 5 years of age and pregnant women. Vaccination efforts are still in their early stages: Cameroon this year became the first country to routinely give children a new malaria vaccine that is only about 30% effective and does not stop transmission. A second vaccine was recently approved.
Resistance to antimalarials and insecticides is on the rise, while funding for innovation by governments and donors is slowing.
Living conditions play a role, with overcrowded neighborhoods, stagnant water, poor sanitation, and lack of access to treatment and prevention materials in many areas. And the new problem is an invasive species of mosquito that was previously seen mostly in India and the Persian Gulf.
A GROWING PROBLEM
Malaria cases are increasing worldwide. Infections increased from 233 million in 2019 to 249 million in 85 countries in 2022. Malaria deaths increased from 576,000 in 2019 to 608,000 in 2022, according to the World Health Organization.
Of the 12 countries that bear about 70% of the global malaria burden, 11 are in Africa, with India the second. Children under 5 accounted for 80% of the 580,000 malaria deaths recorded in Africa in 2022.
COVID-19 HURT PROGRESS
The fight against malaria has seen some progress in areas such as rapid diagnostic tests, vaccines and new bed nets designed to combat insecticide resistance, but the COVID-19 pandemic and a shift in focus and funding have slowed efforts.
A study published last year in Tropical Medicine and Infectious Disease reported that the lockdowns caused by COVID-19 led to the disruption of 30% of rural community health services across Africa. Malaria cases started to rise again, breaking the downward trend between 2000 and 2019.
This downward trend could soon reverse, according to the WHO.
A WARMING WORLD AND NEW BOUNDARIES
Africa is “at the sharp end of climate change” and the increasing frequency of extreme weather events is wreaking havoc on efforts to fight malaria in low- and middle-income regions, Peter Sands, executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, warned in December .
In 2023, the WHO World Malaria Report for the first time included a chapter on the link between malaria and climate change, highlighting its importance as a potential risk multiplier. Scientists fear that people living in areas that were once inhospitable to mosquitoes, including the slopes of Mount Kilimanjaro and the mountains of eastern Ethiopia, could be exposed.
In Zimbabwe, which has seen some of its hottest days in decades, malaria transmission periods have lengthened in some districts, “and this shift has been attributed to climate change,” said Dr. Precious Andifasi, WHO technical officer for malaria in Zimbabwe.