Unlocking a transformative malaria response for Africa

Biomedical interventions alone will not eliminate disease in Africa

- CHRISTIAN LUEME LOKOTOLA

WE RECENTLY observed World Malaria Day. The theme for 2025 “Malaria ends with us: reinvest, reimagine, reignite” emphasises the need for a holistic approach to combat this devastating disease. A Planetary Health paradigm offers a possible way forward.

Planetary Health calls for solutions that recognise the interconnectedness of human health, ecological systems, climate change, migration, population dynamics, infrastructure, and governance.

Such an approach could be key in the battle against malaria, which continues to be a significant health problem in Africa, particularly in sub-Saharan regions, where 94% of global cases and 95% of deaths occur. Children under 5 years old are the hardest hit. In South Africa, malaria transmission picks up in summer and autumn (October to May), mainly in Limpopo, Mpumalanga and KwaZulu-Natal.

Malaria transmission is seasonal in the entire continent. Despite decades of success in the control of this communicable infection, progress in many countries is still hampered by rising drug and insecticide resistance, limited resources, lack of funding, and inadequate health services. These challenges intersect with climate change, migration patterns, and changes in vegetation that threaten to reverse hard-won gains.

As a disease that is highly sensitive to climate and vegetation types, malaria can be significantly affected by the migration of both human and mosquito vectors. The extent to which changes in climate and vegetation and migration influence the transmission suitability and population at risk - both in already endemic regions and tropical highlands of Africa - has become a significant concern for public health and healthcare systems. Failure to adapt responses to these challenges will always lead to a resurgence in new and previously controlled areas.

The following five strategic questions should be considered for unlocking a transformative malaria response in Africa: