Addressing the threat of Antimalarial drug resistance.

Since 2000, 2.3 billion cases and 14 million deaths have been averted. To date, 47 countries have been certified malaria-free (of which two in 2024 and three in 2025), while 37 countries reported fewer than 1000 cases in 2024. Success is possible, even in tough areas: The Greater Mekong Subregion proves elimination is achievable, with cases falling by nearly 90% despite long-standing drug resistance. Between 2000 and 2024, the number of malaria-endemic countries fell sharply, dropping from 108 to 80. Over the same period:Countries with fewer than 10 000 cases rose from 27 in 2000 to 46 in 2024. Countries with fewer than 100 indigenous cases increased from 6 to 26. Countries with fewer than 10 indigenous cases increased from 4 to 24. But the global situation is stalling: In 2024, there were an estimated 282 million cases and 610,000 deaths—a slight increase from 2023. According to the World Malaria Report 2025, progress is at risk:Biological challenges:

Drug resistance: Artemisinin partial resistance is confirmed in four African countries (Eritrea, Rwanda, Uganda, United Republic of Tanzania,) and spreading. This is a critical danger to the main treatments for malaria.
Insecticide resistance: Resistance to pyrethroids (the main chemical on bed nets) is widespread, confirmed in 48 out of 53 reporting countries.
Diagnostic failure: pfhrp2 gene deletions, which can make rapid diagnostic tests fail, are spreading and now reported in 46 endemic countries.
Invasive mosquitoes: Anopheles stephensi, an urban-dwelling, insecticide-resistant mosquito, is expanding its range in Africa, posing a new threat to cities.
Systemic challenges: A massive funding gap: 2024 funding (US$ 3.9 billion) was less than half of the US$ 9.3 billion 2025 target. A projected shortfall of US$ 5.4 billion leaves the response dangerously under-resourced.
Fragility of aid: Recent cuts in global health aid have disrupted health systems, surveillance, and campaigns, demonstrating how quickly progress can be undone.
Humanitarian & environmental challenges: Climate change, conflict, and humanitarian crises continue to drive malaria resurgence and disrupt essential services. Despite the challenges, several interventions are being successfully scaled up and showing impact.

New-Generation nets: In 2024, 84% of nets shipped to Africa were the more effective PBO or dual active ingredient nets, up from just 10% in 2019.µ