The WHO 2025 World Malaria Report marks progress in preventing malaria globally with expansion of programs that include new-generation nets, malaria vaccine, and seasonal as well as perennial chemoprevention, while warning that progress is threatened by recent reduction in funding.1
"There has also been notable progress in providing timely diagnosis and treatment for young children," the report notes."However, coverage of insecticide-treated nets (ITNs) and intermittent preventive treatment of malaria in pregnancy (IPTp) continues to lag, underscoring areas needing further action."
Although more than 3 billion ITNs have been distributed globally, and the usage in sub-Saharan Africa has increased substantially since 2000, the report finds that less than half (47%) of those at risk were sleeping under an ITN in 2024, which was similar to the proportion reported in 2015.The usage in 2024 was slightly higher for young children, girls and pregnant women (53%), but still far from the goal of universal coverage.
Recognizing the increase in mosquitos that are not susceptible to the pyrethroids commonly used to treat the netting, the WHO now recommends supplementing the pyrethroid with piperonyl butoxide (PBO), for synergistic effect.In 2024, according to the report, these dual-treated nets accounted for 84% of the 168 million that were provided to sub-Saharan Africa, up from 10% in 2019.
What You Need to Know
New-generation ITNs (including PBO-treated nets), expanded chemoprevention, and rollout of two WHO-recommended vaccines show meaningful progress, yet fewer than half of people at risk sleep under an ITN and uptake of IPTp in pregnancy remains well below targets.
Vaccination, SMC/PMC for young children, and IPTp for pregnant women are reducing severe outcomes, with hundreds of thousands of low-birthweight cases already averted, but far greater impact is possible if coverage matched routine care access.
Sharp reductions in malaria financing—particularly declines in ODA—are disrupting programs, delaying campaigns, increasing stock-out risks, and weakening surveillance, putting recent progress at serious risk.
Two vaccines are now available and recommended by the WHO for use in malaria endemic regions: RTS,S/AS01 (RTS,S) and R21/Matrix-M (R21).The report notes that these vaccines had been introduced in 17 countries by the end of 2024, and in an additional 7 countries by October 2025. UNICEF had delivered over 10.5 million doses, with an estimated 2.1 million children receiving vaccination in 2024.
Seasonal and perennial malarial chemoprevention programs (SMC, PMC) were also recognized as effective strategies to control malaria in Africa.The former involves monthly doses of antimalarials during the peak infectious season to children under 5 years of age—the most vulnerable group to severe malaria.PMC (previously known as intermittent preventive treatment in infants [IPTi]) is dosing that coincides with routine immunizations throughout the first year of life, and is recommended by the WHO for regions with moderate-to-high year-round malaria transmission.
IPTp programs were also found to have modestly increased, albeit well short of targets, with the proportion of eligible pregnant women and girls in 34 African countries receiving a third dose of IPTp rising from 43% in 2023 to 45% in 2024.The report estimates that malaria infection complicated 36% of 36 million pregnancies, or 13 million in the WHO African Region in 2024.
"Current levels of IPTp would result in low birthweight being averted in an estimated 530,000 neonates," the report indicates."If coverage of three doses of IPTp matched coverage of first antenatal care visits, low birthweight would be averted in an additional 161,000 neonates.
Recent reductions in funding are identified as key factors in missing the targets for scope and effectiveness of the malaria prevention programs. The report highlights serious financial setbacks incurred from 2024 to 2025, with the total funding of US$ 3.9 billion representing less than half of the amount required. Official Development Assistance (ODA) fell by 21%, largely due to reductions in support from the United States, which the report links to disrupted health systems and weakened routine surveillance.
"This has led to the cancellation or postponement of most planned surveys and increased the risk of stock-outs and campaign delays," the report indicates, "all of which have undermined program impact and pose a significant risk to sustaining the malaria response."
Read the first installment of this 2-part article.
Reference
