Emerging trends and insights
Emerging trends in disease prevention and control — from rising drug and insecticide resistance to climate-driven shifts in transmission — are sharpening the need for robust research and evidence. Resistance management demands data-driven strategies as pathogens and vectors evolve, to preserve the efficacy of life-saving tools.
The rollout of malaria vaccines marks a major milestone, with research guiding their optimal use and integration. Meanwhile, climate change is altering disease patterns in complex ways, demanding adaptive, evidence-based and locally informed responses. Research plays a central role in identifying risks, testing solutions and informing policy to ensure that global health strategies remain effective, equitable and resilient in the face of evolving threats.
Climate-driven health threats
Climatic changes are reshaping disease landscapes. Rising temperatures and extreme weather events are expanding mosquito habitats, intensifying the transmission of malaria, dengue and other vector-borne diseases. In addition to longer-term temperature and rainfall effects that impact the geographic spread of vectors, dramatic episodic floods and droughts cause major short-term consequences, placing affected populations at a much higher risk of infection.
The term ‘climate refugees’ has become commonly used for those who are displaced by climate effects and the resulting health consequences. To address climate-driven health threats, strong disease surveillance and early warning systems are vital, enabling early detection and rapid response.
In practice: In Uganda, we are developing predictive models and a risk mapping system to improve early warning of outbreaks of malaria and arboviral diseases, which stem from the intricate effects of climate and extreme weather on disease transmission. Through these efforts, we are enhancing the national outbreak preparedness and response plan. In Asia Pacific, we are working with governments across the region to incorporate climate responses into vector-borne disease policy guidelines.
Read more about how we embed health systems that can continue to reach communities, even in the face of disruptions.
Resistance
Insecticide resistance
Insecticide resistance could undermine decades of progress in malaria control. Mosquitoes are increasingly surviving exposure to pyrethroids — the only insecticide class used in standard mosquito nets — threatening the effectiveness of core interventions. This resistance jeopardises millions of lives, particularly in high-burden regions. Next-generation nets — combining pyrethroids with synergists like piperonyl butoxide (PBO) or new active ingredients — offer hope. But continued investment in innovation, surveillance and resistance management remain critical.
Without decisive action, resistance could reverse hard-won gains in malaria prevention and pose broader risks to global health security. We are carrying out entomological and epidemiological research to understand the impacts of interventions, the spread of insecticide resistance and resistance management, and effects of insecticide-based interventions on malaria transmission.
In practice: In Nigeria, working with national and state malaria elimination programmes in Anambra and Ondo, we distributed more than seven million pyrethroid-PBO nets between 2021 and 2023. We studied the campaign costs, monitored insecticide resistance, vector biting habits, and the physical and chemical durability of the nets over time. We also assessed the coverage and use of nets and evaluated the epidemiological impact. In Papua New Guinea, we are supporting research to understand the shifting malaria epidemiological responses to rising temperatures in the highland regions of the country.
Strong partnerships with governments and national programmes support local ownership of interventions. Find out how we provide technical support to facilitate sustainable, context-appropriate interventions.
Drug and diagnostic resistance
Artemisinin-based combination therapies (ACT) remain the most effective drugs to fight malaria, but artemisinin resistance has emerged in parts of southeast Asia and Africa. Limiting the spread of antimalarial drug resistance is a global health priority. We support the continuous monitoring of drug resistance in malaria-endemic countries, along with research into the various contributing factors. We are also focused on strengthening monitoring, evaluation and surveillance systems to support efforts to control emerging resistance to widely used antimalarial and antibiotic drugs — particularly among at-risk and hard-to-reach populations.
In practice: In Bangladesh and Nepal we have used innovative community engagement interventions such as the Community Dialogue Approach and participatory video to improve understanding of antimicrobial resistance and improve the rational use of antibiotics in both animals and humans.
Local health workers and volunteers are integral to ensuring that health services reach their communities. Find out how we partner with communities to deliver services.
In practice: In East and southern Africa, there is growing evidence of resistance developing towards sulfadoxine−pyrimethamine, which is administered alongside amodiaquine for seasonal malaria chemoprevention delivery. Our research has explored how parasite resistance affects the chemoprevention efficacy of those medicines and how we can routinely monitor parasite resistance to ensure the continued effectiveness of SMC.
What are ACTs?
Successful malaria elimination depends on rapid diagnosis and early treatment with effective antimalarial drugs. Artemisinin-based combination therapies — known as ACTs — are the recommended first-line treatment of Plasmodium falciparum malaria. ACTs combine artemisinin-based compounds with drugs that have different modes of action, including lumefantrine, mefloquine, amodiaquine, sulfadoxine−pyrimethamine, piperaquine and dihydroartemisinin. ACTs are highly effective, fast-acting and reduce the likelihood of resistance developing. It is critical to maintain the effectiveness of ACTs by addressing issues of quality, access and cost.
Resistance develops when the malaria parasites mutate in a way that allows them to override the mode of action of an antimalarial drug, so they can continue to survive and replicate in the patient’s body. Mosquitoes can then transmit the resistant variant to other people.
Life-saving vaccines for a brighter future
As resistance to antimalarial drugs, insecticides and diagnostics grows, vaccines provide a vital tool to reduce the transmission of malaria and other diseases, and save lives. By integrating vaccines into broader malaria control strategies and existing health programmes, national programmes can more effectively tackle emerging threats, strengthen global efforts to eliminate disease and improve child survival.
In practice: We are supporting national programmes to roll out malaria vaccines in Mozambique, Nigeria, Togo and Uganda. In Uganda, this includes strengthening health systems, facilitating community engagement to build vaccine confidence and ensuring equitable access — particularly in hard-to-reach areas. In Chad and South Sudan, our advocacy efforts have strengthened strategies for child survival. We supported health ministries to identify and resolve barriers to integrating PCV and the rotavirus vaccines into routine childhood immunisation programmes and develop strategies for their successful introduction and widespread implementation.
We integrate health services where it is effective and efficient to do so. Learn more.
Sonia Maria Enosse
Country Technical Coordinator for Malaria Consortium Mozambique
Monitoring for evidence of resistance is crucial to catching the problem before it grows bigger and to prevent severe cases or mortality. And this kind of work is needed in Africa now more than ever.