Since 2000, investments in the global malaria response have prevented more than 2 billion cases and nearly 13 million deaths. Yet efforts to control and eliminate malaria are in jeopardy as communities and programmes face the fallout of recent funding cuts.
Malaria is preventable and curable – but without prompt diagnosis and treatment, it can rapidly escalate to severe illness and death, particularly among young children and pregnant women. In 2023 alone, malaria claimed nearly 600 000 lives, with an estimated 95% of these deaths occurring in the WHO African Region.
The 2025 funding cuts to malaria programmes put millions of additional lives at risk and could reverse decades of progress earned, in part, through longstanding investments from the United States of America and other global partners. Between 2010 and 2023, the USA contributed an average of 37% of global malaria financing through both bilateral and multilateral channels.
The recent experience of the COVID-19 pandemic showed that sudden interruptions to malaria service delivery can be deadly. In 2020, COVID-related disruptions to the provision of malaria prevention, diagnosis and treatment led to an estimated 14 million more malaria cases and an additional 47 000 deaths.
“History has shown us what happens if we let down our guard against malaria,” cautions Dr Daniel Ngamije, Director of the WHO Global Malaria Programme. “In 1969, the global eradication effort was abandoned, triggering a resurgence in cases and deaths. It took nearly 30 years for world leaders to come together and restore momentum.”
Although funding for some USA-supported malaria programmes has been reinstated, the disruptions have left critical gaps. Without the rapid delivery of prevention and treatment services to at-risk populations, the consequences could be fatal.
Findings of a rapid WHO stock take assessment
The impact is being felt across the health sector. Of the 108 WHO country offices that took part in a rapid stock take, nearly three quarters reported disruptions to health services following the pause in overseas development assistance (ODA).
Responses from country offices suggest that budget cuts are already translating into increased out-of-pocket payments for patients, with the poor and vulnerable likely to carry the heaviest financial burden. The survey highlighted job losses for health and care workers as well as disruptions to information systems and to the supply of medicines and health products.
Responses to malaria have been particularly affected. Of the 64 malaria-endemic countries surveyed, more than half reported moderate or severe disruptions to malaria services.
Impact of funding shortfall highlighted at WHO advisory committee meeting
Further information was shared in this week’s WHO Malaria Policy Advisory Group (MPAG) meeting, held from 8–10 April. MPAG members heard updates on current challenges and priority actions taken by countries and their global partners to respond to immediate funding shortfalls.
Insecticide-treated nets (ITNs) have been a cornerstone of malaria prevention efforts in Africa over the past 2 decades. By early April 2025, more than 40% of planned ITN distribution campaigns designed to reach 425 million people were either delayed or at risk of being derailed, according to data provided by national malaria programmes.
Nearly 30% of seasonal malaria chemoprevention (SMC) campaigns to protect 58 million children were also off track. In many African countries, stocks of rapid diagnostic tests and medicines have reached critically low levels.
Reductions in funding also threaten to undermine critical investments in scientific innovation, including in new and improved preventive, diagnostic and treatment interventions as well as in new tools to address drug and insecticide resistance.
“We must not allow funding setbacks to derail the global malaria agenda,” noted Dr Jérôme Salomon, WHO Assistant Director-General, in his opening remarks at MPAG. “We urge all stakeholders to sustain their commitments, safeguard national plans, and coordinate adaptation strategies in response to the shifting funding landscape.
Country leadership and partner support critical to response
In Nigeria, lawmakers have approved an additional US$ 200 million for the health sector as part of a 2025 spending plan – an effort to mitigate the impact of the recent suspension of USA foreign aid (AP News). Across Africa, other countries are strengthening coordination mechanisms and taking steps to close critical gaps through the use of domestic resources.
WHO and partners remain committed to supporting national governments and civil society in securing sustained funding and delivering integrated solutions to protect those most at risk. Achieving resilient and self-financed health systems will require increased domestic investment in health and a strategic use of available resources to maximize impact.
“This is the moment for data-driven decision making – for ensuring every dollar is used wisely,” said Dr Dyann Wirth, MPAG Chair. “People and communities already facing poverty and vulnerability will bear the brunt of these funding cuts. We must embrace equity-focused action and stand up for sustainable solutions that leave no one behind.”
In March 2025, WHO and the RBM Partnership to End Malaria launched a cross-partner working group of technical experts and donor agencies to ensure rapid, aligned support for countries where it is most needed.
“It is critical, now more than ever, to ensure that our malaria interventions are fully integrated within broader health systems,” noted Dr Michael Charles, CEO of the RBM Partnership to End Malaria. “Our collective efforts must continue to focus on streamlining, on coordination and on sustainable financing. And, at the end of the day, we must ensure that we are putting countries first.”
Sustained investment in primary health care and delivering integrated, life-saving services – particularly for vulnerable populations – must remain a priority.