World Malaria Report 2025: Drug resistance and funding gaps underscore need for country-led action

The report stated that since 2000, 2.3 billion cases and 14 million deaths have been averted since 2000, with one million lives saved in 2024 alone — a major achievement. In total, 47 countries and one territory have been certified malaria-free, with Cabo Verde and Egypt gaining the status in 2024, and Georgia, Suriname and Timor-Leste joining them in 2025. New tools against malaria, such as the malaria vaccines and next-generation, dual-insecticide treated nets played a major role in these wins.

However, there was an increase of nine million cases in 2024 compared to the previous year. Dr Tedros Adhanom Ghebreyesus, WHO Director-General warned that “increasing numbers of cases and deaths, the growing threat of drug resistance and the impact of funding cuts all threaten to roll back the progress we have made over the past two decades.” 

The report paints a concerning picture of the fallout attributable to antimalarial drug resistance, which is confirmed or suspected in at least eight African countries. If the problem is not stemmed, the consequences could prove devastating. The report estimates a potential 16 million more annual cases and 80,000 additional deaths if resistance continues to spread. Rising insecticide resistance, with mosquitoes no longer killed as effectively by the chemicals used in mosquito nets and sprays, compounds this resistance, weakening some of the most important tools used to control malaria. 

“This year's World Malaria Report presents us with a moment of reckoning. We have the evidence, tools and the knowledge to protect millions of lives, yet resistance to antimalarial medicines and insecticides threatens to undermine two decades of hard-won progress,” says Malaria Consortium’s Chief Executive, James Tibenderana. “The convergence of resistance, funding gaps and climate impacts means we cannot afford complacency. At Malaria Consortium, we're committed to working alongside governments, communities and partners to ensure that evidence-based interventions reach those who need them most, while strengthening the health systems that will sustain progress for generations to come.” 

A major part of recouping gains lost will be encouraging stronger country leadership. Countries must take ownership of their responses, tailoring interventions to local transmission patterns, strengthening regulatory frameworks and building domestic capacity.  

Catching the development of resistance before it worsens requires robust surveillance systems. However, curtailed funding is forcing many countries to scale back vital surveillance initiatives precisely when they're needed most. Resistance to antimalarial drugs develops when the malaria-carrying parasite Plasmodium falciparum mutates, allowing the parasite to continue to survive in the body, increasing the chance that the treatment will fail. Surveillance helps to understand how parasites and mosquitoes are changing, to track whether drugs are still effective and to spot treatment failures early, enabling vital, timely adaptation. 

The report also points to climate change as a reason behind increased cases and deaths; climate has been altering transmission patterns in complex ways, with extreme weather events leading to increased outbreaks of malaria. The report also attributes the setback in reducing malaria deaths to recent aid cuts, as well as conflict and instability in heavily affected regions.  

Continuing research and development into alternative drug regimens will be critical. Addressing the issue of drug resistance is an integral part of Malaria Consortium’s work. Through the seasonal malaria chemoprevention programme, evidence that resistance was developing towards the drug sulfadoxine-pyrimethamine, which is administered alongside amodiaquine in the delivery of seasonal malaria chemoprevention (SMC), led to work that explored alternative drug regimens. The results of recent research found that the drug dihydroartemisinin- piperaquine (DP) is a potential alternative for use in SMC. The rollout of malaria vaccines will be another transformative tool in the prevention arsenal, especially when deployed alongside tighter and more pervasive surveillance — these will be crucial to prevent and monitor the development of resistance. 

In response to these challenges, the report emphasises that the path towards a malaria-free future will require strong leadership. Particularly in the face of funding shortfalls, political commitment and domestic investment from malaria-endemic countries will prove critical. Malaria Consortium remains committed to supporting this vision, working alongside governments, communities and partners to ensure that interventions reach those who need them most, while strengthening the health systems that will sustain progress for generations to come.  

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