What is needed now?

 

Reversing the upward trend in malaria burden requires urgent and coordinated action. Countries must strengthen leadership, governance and accountability mechanisms, building on the Yaoundé Declaration and the forthcoming Big Push framework. The goal remains clear: with the tools and resources available, no one should die from malaria.

Sustained financing is essential to maintain global progress against malaria. History shows that even modest funding cuts can trigger malaria resurgence and increased disease burden. From 2024 to 2025, global malaria financing faced serious setbacks. Total funding in 2024 reached only US$ 3.9 billion, less than half of what is required, and Official Development Assistance (ODA) fell by 21%, largely due to reductions in support from the United States of America. Reductions in ODA have disrupted health systems, weakening routine surveillance. This has led to the cancellation or postponement of most planned surveys and increased the risk of stock-outs and campaign delays, all of which have undermined programme impact and pose a significant risk to sustaining the malaria response. Rapid, coordinated mitigation helped to keep key interventions, such as SMC and ITN campaigns, largely on track with partner support, offering some optimism as United States funding resumed through the Department of State. Nevertheless, major donors signal potential future cuts, highlighting the high ongoing risk. The 2025 funding disruptions have exposed the fragility of external aid. Sustained, diversified and increased domestic funding is therefore vital to safeguard global malaria gains and ensure continued health impact. Under constrained financing, programmes need to prioritize high-impact, data-driven interventions. The new WHO Sub-national tailoring of malaria strategies and interventions reference manual provides countries with guidance to adapt interventions to local contexts. Surveillance systems must be strengthened to close data gaps and enable faster, evidence-based decisions.

Political commitment is essential for sustaining progress in malaria control. The Yaoundé Declaration showcased national and continental leadership, accountability and institutional resilience, highlighting the need for a coordinated, multistakeholder approach to reinvigorate global efforts for prevention and control of malaria. The Big Push framework seeks to strengthen the malaria response through inclusive national leadership, robust data systems, expanded access to quality interventions, rapid adoption of new tools, and increased funding. Communities play a critical role in accessing interventions, ensuring accountability and sustaining momentum. A new governance model is needed – one based on strong national leadership, global solidarity and active community involvement, and supported by programmatic advances, including improved surveillance, vaccines, innovative vector control tools and data-driven decision-making