By Iroyin Yoruba Television
Africa's fight against malaria is facing a renewed financing challenge, with health leaders warning that a major reduction in funding could reverse progress made against the disease and result in millions of additional infections and hundreds of thousands of preventable deaths by the end of the decade.
The African Leaders Malaria Alliance has warned that a 30 per cent reduction in malaria financing could lead to an estimated 146 million additional malaria cases and 397,000 additional deaths across Africa by 2030, while the continent could also lose approximately US$37 billion in gross domestic product.
The warning was issued during a high-level meeting on sustainable malaria financing held on the sidelines of the 81st United Nations General Assembly in New York.
African leaders, health organisations and development partners used the meeting to call for stronger domestic financing, greater coordination across sectors and more predictable international support for malaria programmes.
For Nigeria, which continues to carry one of the world's largest malaria burdens, the discussion has particular significance.
The Federal Government has already launched a new National Malaria Strategic Plan covering 2026 to 2030 and says malaria prevalence in the country declined from 42 per cent in 2010 to 15 per cent in 2025.
The latest warning, however, suggests that progress cannot be assumed to continue automatically.
AFRICA REMAINS THE CENTRE OF THE GLOBAL MALARIA BURDEN
Malaria remains overwhelmingly concentrated in Africa.
According to the African Leaders Malaria Alliance, African Union member states accounted for about 94 per cent of global malaria cases and 95 per cent of malaria deaths at the time of its latest September 2026 assessment.
The World Health Organization has also described the continent as carrying the overwhelming majority of the global malaria burden.
At the UN meeting, WHO Director-General Tedros Adhanom Ghebreyesus said African countries accounted for 96 per cent of malaria cases and 97 per cent of malaria deaths worldwide, highlighting the scale of the challenge facing the continent.
The slight differences between the figures reflect differences in reporting periods and datasets, but they point to the same broader reality: Africa remains the principal centre of the malaria epidemic.
That means changes in malaria financing on the continent can have consequences for millions of people.
WHY FUNDING HAS BECOME A MAJOR CONCERN
Malaria control depends on a range of interventions that must be delivered continuously.
These include insecticide-treated mosquito nets, indoor residual spraying in appropriate settings, preventive medicines, rapid diagnostic testing, effective antimalarial treatment, surveillance and public education.
Vaccines are also becoming an additional tool in countries where they are being introduced.
None of these interventions can be delivered at scale without sustained financing.
Health programmes require money not only to purchase commodities but also to transport them, train health workers, maintain supply chains, monitor effectiveness and reach communities that are difficult to access.
The African Leaders Malaria Alliance says international health financing has come under increasing pressure, while recent replenishment efforts for major global health mechanisms have fallen short of their targets.
This creates concern that countries dependent on external assistance could face shortages or be forced to reduce the scale of malaria interventions.
THE 146 MILLION-CASE PROJECTION
The figure of 146 million additional cases is a projection rather than a prediction that those cases will definitely occur.
It represents an estimate of what could happen if malaria financing falls by 30 per cent and programmes consequently lose the resources required to maintain current levels of prevention and treatment.
The same modelling estimates that nearly 400,000 additional deaths could occur and that African economies could lose approximately $37 billion in GDP by 2030.
ALMA has previously warned that children under five would bear a substantial proportion of the additional deaths.
The organisation's 2025 malaria progress report estimated that 75 per cent of the additional deaths associated with the funding reduction could occur among children under five.
The projection therefore illustrates why malaria financing is being treated as an economic and social issue rather than solely as a medical concern.
WHY CHILDREN ARE PARTICULARLY VULNERABLE
Young children are among the groups most vulnerable to severe malaria.
An infection that might be manageable in some adults can become life-threatening in a young child, particularly when diagnosis and treatment are delayed.
Pregnant women are also an important population in malaria-control programmes because malaria infection during pregnancy can affect both the mother and developing baby.
This means that malaria programmes need to reach communities before people become seriously ill.
Mosquito nets, preventive treatment during pregnancy, early diagnosis and effective medicines all form part of a wider protection system.
When funding declines, the first consequences may not immediately appear in national statistics.
They may instead appear as fewer preventive commodities reaching communities, delays in diagnosis, interruptions in medicine availability or reduced ability to conduct outreach.
Over time, those gaps can translate into increased transmission and more severe disease.
NIGERIA'S CURRENT STRATEGY
Nigeria has recognised the continuing importance of malaria control by developing a new National Malaria Strategic Plan for 2026 to 2030.
The Federal Ministry of Health said the plan was developed as part of a broader effort to reshape the country's malaria response and sustain reductions in malaria prevalence.
The government reported that malaria prevalence had fallen substantially from 42 per cent in 2010 to 15 per cent in 2025.
That reduction represents progress, but it does not mean malaria has ceased to be a major health problem.
Nigeria's large population means that even a lower prevalence rate can translate into a substantial number of infections.
The country's geographic size and differences in climate, healthcare access and living conditions also make malaria control a complex national task.
PREVENTION REMAINS ESSENTIAL
One of the most effective ways of reducing malaria illness is to prevent mosquito bites and interrupt transmission.
Long-lasting insecticide-treated nets are an important component of prevention.
However, nets need to reach the people who need them, remain in usable condition and be used consistently.
Other interventions can include indoor residual spraying, environmental management and appropriate measures to reduce mosquito breeding.
The choice of intervention depends on local transmission patterns and other conditions.
This is why malaria programmes require surveillance data.
Authorities need to understand where malaria transmission is highest, which populations are most vulnerable and whether interventions are producing the expected results.
DRUG AND INSECTICIDE RESISTANCE
Financing is not the only challenge.
Malaria parasites can develop resistance to medicines, while mosquitoes can develop resistance to insecticides.
WHO has identified drug and insecticide resistance among the factors making malaria control more difficult. Climate change, conflict and humanitarian crises can also disrupt prevention and treatment programmes.
Resistance means that interventions that previously worked effectively may become less effective over time.
This creates a need for continued research, surveillance and development of new tools.
It also means malaria programmes cannot simply rely on the same intervention indefinitely.
Health authorities need to monitor changes in transmission and resistance and adapt their strategies accordingly.
CLIMATE CHANGE AND MALARIA
Changing environmental conditions can also influence malaria transmission.
Temperature, rainfall and humidity affect mosquito populations and the development of malaria parasites inside mosquitoes.
Climate-related changes can therefore alter where and when malaria transmission occurs.
At the same time, flooding and other extreme weather events can damage health facilities and disrupt access to communities.
When communities are displaced by floods, conflict or other emergencies, people may also lose access to mosquito nets, medicines and routine healthcare.
The result can be increased vulnerability to malaria and other infectious diseases.
This is one reason African health leaders are calling for malaria control to be integrated with broader development and climate-resilience planning.
MALARIA IS ALSO AN ECONOMIC PROBLEM
The estimated $37 billion loss in GDP associated with a major reduction in malaria financing demonstrates the economic dimension of the disease.
When people become sick, they may be unable to work.
Children who experience repeated malaria infections may miss school.
Parents may lose income while caring for sick children or paying for treatment.
Health facilities also spend resources treating preventable illnesses.
At national level, these individual losses accumulate.
A malaria-control programme therefore represents an investment in productivity as well as a public-health intervention.
Reducing illness can help families keep children in school, allow adults to remain economically active and reduce pressure on healthcare facilities.
THE CASE FOR DOMESTIC FINANCING
African leaders meeting in New York called for countries to strengthen domestic financing for malaria rather than relying primarily on external assistance.
The argument is based on sustainability.
International donors can provide important support, but external funding can change because of economic conditions, competing emergencies or shifting priorities in donor countries.
Domestic financing gives national governments greater control over long-term planning.
For Nigeria, this means malaria programmes must remain part of national and state health budgets even when international funding is available.
Domestic resources can also help governments respond more quickly when new outbreaks or local increases in transmission occur.
THE ROLE OF INTERNATIONAL PARTNERS
The call for domestic financing does not mean international partners have no role.
African leaders have also asked development partners to maintain support and honour existing commitments.
The challenge is to develop a financing model in which African countries increasingly take ownership while international assistance helps close remaining gaps.
WHO has supported this approach, saying malaria elimination cannot depend on external aid alone and requires stronger national ownership, wider partnerships and predictable financing.
This balance is particularly important for countries with limited fiscal space.
A sudden withdrawal of international assistance could create a gap that domestic budgets are unable to fill immediately.
A managed transition can allow governments to increase their contributions while protecting essential programmes.
NEW TOOLS PROVIDE AN OPPORTUNITY
The malaria fight is not standing still.
New tools, including malaria vaccines, are becoming part of the prevention landscape.
WHO said significant progress has been made over the past 25 years and noted that the world now has its first malaria vaccines.
Vaccines do not replace existing interventions.
Instead, they add another layer of protection.
The challenge is ensuring that new tools are introduced in ways that are affordable, sustainable and integrated into existing health systems.
This again brings the discussion back to financing.
A new health technology can only make a population-level difference if countries have the resources to deliver it effectively.
NIGERIA'S POSITION IN THE BIGGER AFRICAN RESPONSE
Nigeria has increasingly presented itself as an important participant in Africa's efforts to strengthen malaria financing and elimination.
The country's new 2026–2030 malaria strategy is intended to guide national action during the same period in which African leaders are seeking to accelerate progress towards the 2030 elimination targets.
Nigeria's experience is significant because its large population means that progress or setbacks in the country can influence the wider continental malaria picture.
Strengthening Nigeria's primary healthcare system, ensuring continuous availability of diagnostics and medicines, improving surveillance and reaching underserved communities will therefore remain important.
The country also needs to maintain programmes in areas where access to healthcare is difficult because of geography, poverty, insecurity or displacement.
WHAT COULD HAPPEN IF PROGRAMMES ARE INTERRUPTED
Malaria control can be difficult to rebuild once programmes lose momentum.
If prevention campaigns are interrupted, mosquito populations can continue transmitting the parasite.
If diagnostic services become unavailable, people may be treated late or incorrectly.
If medicines become scarce, severe cases may increase.
If surveillance weakens, authorities may not detect changes in transmission quickly.
And if health workers leave programmes because funding disappears, rebuilding expertise can take years.
This explains why health leaders are concerned about funding cuts even before their full effects are visible.
Maintaining continuity can be less costly than rebuilding programmes after transmission has increased.
A CALL FOR LONG-TERM PLANNING
The current warning from African malaria leaders is therefore not simply about raising more money for a single year.
It is about creating predictable financing that allows countries to plan several years ahead.
Long-term planning enables governments and health agencies to negotiate procurement contracts, maintain supply chains, train personnel and establish monitoring systems.
It also makes it easier to introduce new technologies gradually rather than waiting for emergency situations.
The broader message from the September meeting is that malaria elimination requires sustained political and financial commitment.
THE NEXT FOUR YEARS WILL BE IMPORTANT
The period leading to 2030 will be particularly important because that is the target year for many of Africa's malaria-control and elimination commitments.
The continent has made significant progress in some areas but has also experienced periods in which progress stalled.
WHO has warned that malaria is resurging in some settings and that insufficient financing threatens to reverse earlier gains.
For Nigeria, the newly adopted 2026–2030 national strategy provides a framework for continuing the fight.
The success of that strategy will depend partly on whether sufficient resources reach the programmes responsible for prevention, diagnosis, treatment, surveillance and community outreach.
THE MESSAGE FOR NIGERIANS
The latest warning does not mean that Africa is destined to experience 146 million additional malaria cases.
That figure represents a modelled scenario linked to a 30 per cent reduction in malaria financing.
Its significance is that it demonstrates the potential consequences of allowing funding and programme coverage to fall sharply.
For Nigeria, the message is particularly relevant because the country remains one of the world's major malaria-burden countries despite the reduction in prevalence reported by the Federal Government.
Continued progress will require households, health workers, state governments, federal agencies, development partners and communities to remain engaged.
Preventing mosquito bites, seeking testing when symptoms occur, completing prescribed treatment and ensuring vulnerable groups receive preventive interventions remain important parts of the response.
At government level, maintaining financing and ensuring that resources reach communities will be equally important.
The latest discussions among African leaders show that malaria remains far from being a problem that can be considered solved.
The disease can be controlled when effective tools reach the people who need them, but progress can also be reversed when financing, health services and prevention programmes weaken.
As Nigeria implements its 2026–2030 malaria strategy, the wider African financing debate provides a reminder that the fight against malaria will depend not only on medical innovations but also on sustained investment.
The projected 146 million additional cases, nearly 400,000 deaths and $37 billion economic loss are estimates of what could happen under a severe funding-reduction scenario—not inevitable outcomes.
The central issue now is whether governments and partners can maintain sufficient investment to prevent that scenario and continue reducing the burden of a disease that still affects millions of African families each year.