The WHO 2025 World Malaria Report recognizes 47 countries and one territory as malaria free, with Egypt, Georgia, Suriname and Timor-Lest the most recently certified.The report emphasizes, however, that malaria persists as a serious global health challenge, with mosquito resistance to pyrethroids and the malaria parasites resistance to antimalarial drugs remaining widespread.1
The report credits "strong national leadership, targeted use of effective treatments, robust surveillance and sustained community engagement," for the substantial reduction in cases in the Greater Mekong subregion (GMS), with Cambodia, the Lao People's Democratic Republic and Viet Nam nearing the elimination of indigenous cases.
The report notes that the emergence of antimalarial drug resistance in the GMS served as the impetus for large-scale investment, coordinated surveillance and rapid data sharing and policy change.The efforts brought those countries, "once the epicenter of resistance", to near elimination of cases.
It is the WHO Africa Region which has remained hardest hit by malaria, however, accounting for 94% of cases and 95% of deaths globally.The report identifies five countries which were afflicted by more than half of all global cases in 2024: The Democratic Republic of the Congo, Ethiopia, Mozambique, Nigeria and Uganda.
There was a 2% reduction in case incidence and a 17% decline in mortality rate in this region between 2015 and 2024, but the report points out that each was more than double the target levels set by the Global Technical Strategy (GTS) for Malaria 2016-2030. The GTS targets reductions in case incidence and mortality rates of at least 75% by 2025 and 90% by 2030 compared to 2015 baseline levels.The report finds the 2024 malaria incidence of 64 cases per 1,000 population at risk in this region was more than 3 times the 18 cases per 1000 targeted.
What You Need to Know
While 47 countries and one territory are now malaria free—highlighted by recent certifications in Egypt, Georgia, Suriname, and Timor-Leste—global progress is increasingly threatened by widespread insecticide resistance in mosquitoes and growing antimalarial drug resistance.
The Greater Mekong subregion shows that strong national leadership, coordinated surveillance, rapid data sharing, and focused investment can reverse even severe drug-resistance challenges, bringing countries once considered resistance epicenters close to eliminating indigenous malaria.
The WHO Africa Region still accounts for the vast majority of malaria cases and deaths, remains far off Global Technical Strategy targets, and faces compounding risks from emerging artemisinin resistance, invasive insecticide-resistant mosquitoes (Anopheles stephensi), and limited treatment options—underscoring the need for broader health system and social interventions beyond malaria-specific tools.
In Africa, the report indicates, P falciparum Kelch13 (PfKelch13) gene mutationsassociated with artemisinin partial resistance are emerging from multiple independent origins.Although artemisinin-based combination therapies are still effective for most infections across Africa, the report warns that the repeated emergence and spread of artemisinin partial resistance presents a challenge to such combinations as lumefantrine and amodiaquine, "in a context where treatment depends on a limited number of combinations".
In addition to the parasite evidencing resistance to antimalarials, the report documents a new, invasive mosquito species that is resistant to many of the commonly used insecticides. Anopheles stephensi, originally native to southern Asia and the Arabian Peninsula has been expanding its range, with detection in 9 African countries. In 2022, the WHO launched an initiative targeting An Stephensi, which it characterizes as thriving in urban settings, and in the high temperatures associated with climate change.
Besides the P falciparum parasite and mosquito vector, the report also notes cases of malaria from the P knowlesi parasite which was initially found in monkeys.The illness is characterized by rapid and severe onset, with a 1-2% human fatality rate. Although there were over 2,000 reported cases of P. knowlesi infection in 2024, this was a 34% decrease from cases in 2023.The cases were predominately in Malyasia (89%), followed by Indonesia (6%), Thailand (4%) and Cambodia (0.5%).
To confront the global health challenge of malaria, reduce exposure to malaria vectors and improve survival after infection, the report encourages broad public health efforts go beyond core malaria interventions, to include improved housing, nutrition, education and access to primary care.
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