African Leaders Demand Sustainable Malaria Financing as AU Report Warns of Looming Resurgence

Nume Ekeghe

African Heads of State and Government have called for a new era of sustainable malaria financing, warning that stalled progress, shrinking international support and emerging threats could reverse decades of gains against the disease.

The call was made at the 39th African Union Summit in Addis Ababa, Ethiopia, where the African Union Malaria Progress Report 2025 was presented by President Advocate Duma Gideon Boko of Botswana, who also chairs the African Leaders Malaria Alliance (ALMA). The report paints a sobering picture of the continent’s malaria burden and cautions that without urgent and coordinated action, Africa risks a significant resurgence.

According to the report, African Union Member States accounted for 270.8 million malaria cases in 2024, representing 96 per cent of the global total, and 594,119 deaths, or 97 per cent of global fatalities. Progress in reducing incidence and mortality has stalled since 2015, with only five Member States achieving the 2025 Catalytic Framework target of cutting malaria incidence or mortality by 75 per cent.

The warning is stark. A projected 30 per cent reduction in malaria funding could result in 640 million fewer insecticide-treated nets, 146 million additional cases, and 397,000 additional deaths three-quarters of them among children under five by 2030. The economic toll could reach $37 billion in lost GDP. In a worst-case scenario, annual cases could exceed 400 million, with deaths surpassing one million each year.

“The perfect storm of converging crises threatening malaria elimination has intensified. Official Development Assistance for health in Africa has declined by 70% in just four years, and the Eighth Replenishment of the Global Fund fell significantly short of its $18 billion target. We cannot allow these challenges to reverse decades of progress that have prevented 1.64 billion cases and saved 12.4 million lives since 2000.”President Advocate Duma Gideon Boko, Republic of Botswana, Chair of ALMA

Against this backdrop, African leaders reaffirmed their commitment to mobilising domestic resources, scaling up innovative financing, and developing national health financing sustainability plans. The report noted that End Malaria Councils and Funds in 12 countries have mobilised over $200 million through public-private partnerships, underlining the importance of multisectoral collaboration.

Leaders stressed that sustainable financing would require a whole-of-society approach, engaging the private sector, philanthropic foundations, high-net-worth individuals and the diaspora, including through a public-private health accelerator model. Countries across the continent are stepping up domestic financing commitments for 2025, while urging global partners to honour existing pledges and renew the World Bank’s Malaria Booster Programme.

The original programme, which ran from 2005 to 2010, committed over $1 billion and delivered transformative results. African leaders are now pushing for a renewed initiative to close funding gaps, deploy next-generation tools, strengthen community health worker systems and build climate-resilient health infrastructure. They argue that investments in malaria will also reinforce primary healthcare systems and enhance resilience against other diseases.

“Our approach has spanned the full spectrum of what it takes to beat this disease. Tanzania has invested in world-class research and is home to the Ifakara Health Institute, where our scientists are working at the frontier of new technologies, including gene drive–an innovative approach that aims to ensure mosquitoes can no longer transmit the malaria parasite. This is African science, conducted by African researchers, addressing an African challenge.” H.E. Samia Suluhu Hassan, President of the United Republic of Tanzania.

Despite the funding headwinds, the report highlights progress in deploying new tools. In 2025, 74 per cent of insecticide-treated nets distributed across Africa were next-generation dual active-ingredient nets, up from 20 per cent in 2023. These nets are 45 per cent more effective against resistant mosquitoes than pyrethroid-only alternatives.

Twenty-four countries have introduced WHO-approved malaria vaccines for children under five, with 28.3 million doses distributed in 2025, compared with 10.5 million in 2024. The World Health Organisation also prequalified two spatial repellent products in 2025, marking the first new vector control intervention in decades. A record 22 countries planned to implement seasonal malaria chemoprevention this year.

Leaders also underscored the strategic importance of health sovereignty through local manufacturing. Currently, Africa imports 99 per cent of its vaccines and 95 per cent of its medicines. The report highlighted Nigeria’s partnerships to locally produce antimalarial treatments and rapid diagnostic tests, alongside plans to establish the first Africa-manufactured next-generation nets.

The African Medicines Agency, now ratified by 31 countries, is working with Regional Economic Communities to harmonise regulatory frameworks and accelerate approval processes for new health commodities across the continent.

“Full deployment of existing and new tools, combined with full funding, could save over 13.2 million lives over the next 15 years and boost African economies by over $140 billion. Every dollar invested in the Global Fund delivers $19 in returns. We have the tools. We need the resources.” Dr. Michael Adekunle Charles, CEO, RBM Partnership to End Malaria

In their final communique, the Heads of State and Government urged Member States to treat malaria as central to health sovereignty and economic transformation. They called for the protection and expansion of both domestic and external funding, full implementation of the Catalytic Framework, and a coordinated “Big Push Against Malaria.”