World Malaria Report 2023 Highlights the Climate Change and Health Nexus

World Malaria Report 2023 at a glance:

• Malaria cases rose to 249 million in 2022, staying significantly higher than the 2019 pre-pandemic levels.
• Malaria deaths in 2022 totalled 608,000, demonstrating a marginal decline since 2021, but the figures remain markedly higher compared to the 2019 pre-pandemic levels.
• 95% of all malaria cases occurred in sub-Saharan Africa and five countries (Pakistan, Ethiopia, Nigeria, Uganda and Papua New Guinea) shouldered most of the burden of the global rise in malaria cases.
• Extreme weather events, humanitarian crises and converging biological threats hinder progress against the disease.
• While a steady pipeline of innovative tools for malaria prevention and control is in place, the malaria financing gap has widened with a 3.7 billion USD deficit in 2022.

Stalled progress against malaria meets a cocktail of threats

The latest report by the World Health Organization (WHO) serves as a stark reminder of the alarming public health toll inflicted by malaria, as it continues to affect thousands of lives, especially in sub-Saharan Africa.

Disruptions due to the COVID-19 pandemic exacerbated an already worrying context with global trends in malaria cases and deaths plateauing since 2017. The concerning figures from this year’s report reinforce the need to urgently vitalise the global malaria response, not just to make progress, but also to sustain the gains achieved thus far. “In terms of both malaria cases and deaths, the world is worse off now than before the pandemic,” explains the WHO report. 

Widespread insecticide resistance, the proliferation of the invasive malaria vector Anopheles stephensi, an increase in malaria parasites with genetic mutations impeding diagnosis, and rising antimalarial drug resistance in Africa are some of the major biological threats that loom over ongoing efforts to prevent and control the disease.

To compound these challenges, non-biological challenges posed by extreme weather events, humanitarian crises, and resource constraints further intensify the complexities faced by malaria programs.

Witnessing the impact of climate change on malaria services

While a comprehensive understanding of the direct impacts of climate change on long-term malaria trends requires further investigation and evidence generation, indirect effects such as reduced access to essential health services and population displacement caused by extreme weather events are quickly becoming evident.

In 2022, Pakistan reported a 5-fold increase in malaria cases following excessive rainfall and flooding. Comprehensive long-term data also reveals that areas in the African highlands, once devoid of malaria, are now grappling with the transmission of the disease.

Given the intersections between populations vulnerable to climate change and those at risk of malaria, the report outlines the need to collaboratively address these shared vulnerabilities, invest in climate-resilient health systems, and take action to mitigate the effects of climate change.

Opportunities to get the global malaria response back on track

Despite numerous challenges, the malaria toolkit has never been as equipped as it is today, with new tools such as dual-ingredient insecticide-treated nets and WHO-recommended malaria vaccines. Furthermore, several countries with a low burden of malaria are making substantial progress toward the goal of elimination, showcasing that with impactful interventions, zero malaria is an achievable reality.

In addition to ramping up much-need malaria financing, the report urges countries to strengthen political will and malaria surveillance systems to act swiftly upon biological threats and offers guidance to countries in the strategic use of data for decision-making for sub-national tailoring of malaria interventions.

ISGlobal’s commitment to malaria research and response

Malaria has consistently been a top priority on the institution’s research agenda. Through collaborations with partners in malaria-endemic countries, ISGlobal is actively responding to several key threats outlined in the WHO report such as gene deletions and invasive vectors.

MESA, a malaria knowledge hub hosted by ISGlobal, has been collaborating with national and global malaria stakeholders to support surveillance for threats like pfhrp2/3 gene deletions and Anopheles stephensi by convening communities of practice and undertaking landscaping exercises to help researchers and practitioners in responding to these challenges.

This World Malaria Report makes it clear that “every day we delay, we expose our hard-won gains to an increasingly volatile future with biological threats, socio-economic challenges and the varied effects of climate change,” expresses Regina Rabinovich, director of ISGlobal’s Malaria Elimination Initiative. "We must swiftly forge new transdisciplinary collaborations for the effective implementation of malaria services and invest in sustainable and climate-resilient health systems."