2024 World Malaria Report: What You Need to Know

Malaria Situation Worldwide

• • There were an estimated 597,000 deaths due to malaria in 2023, the third consecutive year deaths have declined since the pandemic struck in 2020 (622,000).

• • The malaria mortality rate (deaths per 100,000 people at risk) has been cut in half this century — from 28.5 to 13.7 —  and has decreased by 9% since 2020.

• • There were an estimated 263 million malaria cases in 2023, an 11 million (4%) increase from 2022. These additional cases were mostly concentrated in five countries — Ethiopia (+4.5 million), Madagascar (+2.7 million), Pakistan (+1.6 million), Nigeria (+1.4 million), and the Democratic Republic of the Congo (+600 000) — that endured climate-induced disasters, armed conflicts, economic hardship, and other drivers of malaria transmission.

• • Global malaria case incidence (number of cases per 1000 people at risk) has decreased significantly since 2000 – from 79 to 60.4 – but has leveled off over the past decade.

• • Thanks to increased commitments from endemic and donor countries, the global malaria community has averted 2.2 billion malaria cases and prevented 12.7 million malaria deaths since 2000. These figures compare actuals to the estimated malaria burden if rates remained at 2000 levels.

Progress towards Elimination

• • In 2023, 25 countries reported fewer than 10 indigenous malaria cases, compared to 4 in 2000.

• • In 2024, Egypt and Cabo Verde were certified malaria-free by the WHO, for a total of 44 countries who have eliminated malaria (26 countries since 2000); and Georgia and Turkey have submitted their request for malaria-free certification.

• • Several high-burden countries have made remarkable progress against malaria, including Rwanda (85% fewer cases since 2019), India (69% fewer cases since 2017), and Liberia (44% fewer cases since 2017).

• • Latin America, the Caribbean, and the Greater Mekong region have made significant progress towards regional elimination this century. However, malaria hotspots in Venezuela, Haiti, and Myanmar, caused by political instability and other factors, have jeopardized those regional elimination efforts.

Regions and Populations Most At-risk

• • Sub-Saharan Africa carries the heaviest malaria burden, accounting for an estimated 94% of global cases and 95% of malaria-related deaths in 2023.

• • Two countries accounted for 38.5% and 42.2% of all malaria cases and deaths, respectively, in 2023: Nigeria (25.9% and 30.9%) and the Democratic Republic of the Congo (12.6% and 11.3%).

• • Young children, particularly African children with limited access to healthcare, are disproportionately at-risk of malaria: 73.7% (~440,000) of all malaria deaths in 2023 were children under-5. A child dies nearly every minute from this preventable, treatable disease.

• • Pregnant women are also at heightened risk: In 2023, there were an estimated 35.96 million pregnancies in sub-Saharan Africa, of whom 4 million (34%) were exposed to malaria infection during pregnancy.

• • Forcibly displaced populations also face a high malaria risk. In 2023, sub-Saharan Africa had a record number of refugees and internally displaced people (approximately 45 million), per the Internal Displacement Monitoring Centre and UNHCR.

Prevention

• • In 2023, 255 million insecticide-treated bed nets (ITNs) were distributed worldwide in malaria-endemic countries (95% in sub-Saharan Africa). Approximately 59% of young children and pregnant women in sub-Saharan Africa slept under an ITN in 2023.

• • To fight insecticide resistance, countries continue to shift away from traditional pyrethroid-only ITNs. Among the ITNs delivered in 2023, 58% (152.4 million) were pyrethroid–piperonyl butoxide (PBO) nets, and 20% (39.8 million) were dual active ingredient (dual a.i.) ITNs.

• • In 2023, 42 countries implemented indoor residual spraying (IRS) campaigns to prevent malaria. While IRS is widely considered to be highly effective, the relatively high cost continues to constrain its uptake and scalability: overall, only 1.6% (55 million) of the global population at-risk of malaria is protected by IRS, compared to 151 million in 2010.

• • The use of Intermittent Preventive Treatment in Pregnancy (IPTp) has increased dramatically over the past decade. As of 2023, 34 African countries have adopted national IPTp programs to reduce the burden of malaria during pregnancy. In these 34 countries, 44% of pregnant women received a full three-dose regimen of IPTp in 2023 – double the rate from 2017.

• • The average number of children receiving Seasonal Malaria Chemoprevention (SMC) steadily increased from about 200,000 in 2012 to almost 53 million across 19 countries in 2023. Two of these countries (Côte d’Ivoire and Madagascar) implemented SMC for the first time, and 15 countries increased their SMC coverage area.

• • As of December 2024, 17 African countries have introduced a malaria vaccine – RTS,S/AS01 or R21/Matrix-M vaccine – into their childhood immunization program. At least a dozen more countries have expressed interest in rolling out the malaria vaccine, according to Gavi, the Vaccine Alliance. When rolled out at full scale, these vaccines are expected to save tens of thousands of lives each year.

• • Researchers and private sector companies are developing and investing in new vector control interventions, including spatial repellents, genetic engineering of mosquitoes, next-generation vaccines, monoclonal antibodies, and drone-based larval source management.

Diagnosis

• • In 2023, the demand for malaria rapid diagnostic tests (RDTs) reached a record level, with 448.5 million RDTs delivered to malaria-endemic countries – an indicator that more health systems are prioritizing malaria testing of febrile patients.

• • Rates of malaria testing continue to improve. Approximately 48% of febrile patients under the age of 5 received a malaria test between 2017-2023, compared to 30% between 2005-2011, according to WHO study in 26 African countries.

• • Most malaria RDTs target the HRP2 protein produced by the P. falciparum malaria parasite. However, a genetically-mutated malaria parasite that prevents the expression of this protein has been detected in at least 41 countries.

• • With potentially millions of malaria cases going undetected, this issue significantly increases the risk that missed cases will progress to severe disease or death. Among the numerous RDTs in clinical trials are tests that better detect non-HRP2 malaria parasites.

Treatment

• • In the 26 surveyed countries, approximately 71% of children under the age of 5 who tested positive for malaria received a course of artemisinin-based combination therapy (ACT) from 2017–2023, compared to 38% from 2005–2011.

• • However, treatment-seeking rates in those 26 African malaria-endemic countries remain too low: Only 64% sought treatment for their most recent fever between 2017-2023, compared to 65% between 2005-2011.

• • In 2023, 236 million courses of ACT – the most widely used anti-malarial treatment – were delivered to the public health sector.

• • Parasite resistance to ACTs, the mainstay for malaria treatment in most malaria-endemic settings, has been detected in East Africa, the Horn of Africa, and Southeast Asia.

• • A wide range of next-generation anti-malarial treatments are being developed and evaluated, including improvements to existing ACT drugs, drugs that combat ACT resistance, and drugs with lower-dosing regimens.

The Spread of Anopheles Stephensi

• • The spread of Anopheles stephensi, an urban-adapted mosquito species, is posing an added challenge to disease control efforts in Africa – particularly in the Horn of Africa. Thus far, the invasive mosquito species has been detected in eight African countries: Djibouti, Eritrea, Ethiopia, Ghana, Kenya, Nigeria, Somalia, and Sudan.

• •  Unlike other malaria vectors, A. stephensi is most active at dusk – i.e. when families generally are not protected by ITNs – and thrives in urban settings. If uncontrolled, its spread may increase the risk of malaria in African cities.

• • In response, many global partners – including WHO, U.S. President’s Malaria Initiative, the U.S. Centers for Disease Control and Prevention – are working with countries to strengthen mosquito surveillance, educate communities about this emerging threat, and ramp up larval source management in urban areas.

• • Since ITNs are less effective against A. Stephensi, other tools that provide round-the-clock protection – like spatial repellents and outdoor mosquito management – could help mitigate the impacts of this invasive mosquito species.

Rising Displacement

• • In 2023, displacement rates reached record levels: 113.2 million people worldwide were forcibly displaced due to armed conflict and natural disasters. And 70% (79.8 million) settled in malaria-endemic countries.

• • In 2023, 65 malaria-endemic countries were affected by conflict and violence, and 81 were affected by natural disasters.

• • Humanitarian crises often create ideal conditions for malaria outbreaks. Numerous crisis-affected countries – notably Ethiopia, Pakistan, Madagascar, Sudan, and Yemen – saw significant increases in malaria cases and/or deaths in 2023.

• • To curb malaria’s impact on displaced populations, countries must work closely with humanitarian partners to ensure refugee and IDP families have access to malaria and other vital health programs. Learn more: Beat Malaria special report.

Resource Constraints

• • In 2023, global investments in malaria control reached an estimated $4 billion, a slight decrease from 2022 and far short of the estimated $8.3 billion needed to stay on track towards eradication.

• • In 2023, malaria research and product development (R&D) funding reached $690 million, a 9% increase from 2022 but still lower than the previous six years. Most of the increased funding focused on vaccine R&D.

• • In 2025, the Global Fund to Fight AIDS, TB, and Malaria will host its Eighth Replenishment Conference, an opportunity for countries and donors to step up their malaria investments (The Global Fund represents 62% of all malaria funding worldwide).

Underlying Inequalities

• • The 2024 World Malaria Report includes a dedicated chapter emphasizing the need for a more inclusive and data-driven malaria response, with an emphasis on reaching those most vulnerable.

• • A variety of societal and environmental factors make it harder for certain groups – i.e. people living in poverty, Indigenous Peoples, displaced populations, and persons with disabilities – to access malaria services.

• • To make malaria programing more effective and inclusive, countries and partners must commit to primary healthcare that is affordable, high-quality, and culturally-appropriate; tackles the root causes of poverty and gender-based inequalities; and engages marginalized groups in the development and rollout of malaria innovations.

• • We are still facing a critical gap in funding to fight malaria, and we need people like you to contact your members of Congress and urge them to support U.S. funding for vital malaria programs. Click here to raise your voice in support of life-saving programs like the U.S. President’s Malaria Initiative; the Global Fund to Fight AIDS, TB and Malaria; and Gavi, The Vaccine Alliance.

• • Join the global movement to end malaria by becoming a Beat Malaria Champion! Text MALARIA to 833-904-4739 to learn more about the actions you can take to make a difference year-round in the fight against malaria.

• • For non-U.S. supporters who’d like to get involved, take action through the Zero Malaria Starts With Me campaign.

• • You can also lend your support by donating to United to Beat Malaria. This Holiday season, support our Healthy Start for Refugee Children campaign – an effort to provide malaria and other vital health services to 1 million refugee children in East Africa.