Malaria deaths edged up again in 2024. WHO's 2026 message is unusually anxious.

By David Ogilvy, Chief Marketing Officer at Mosticare Global | Published 2026-05-06

The World Health Organization has chosen "Driven to End Malaria: Now We Can. Now We Must." as the slogan for World Malaria Day 2026, which fell on 25 April. It is a confident sentence on the surface and an anxious one underneath. The first half — "now we can" — is unambiguous: there are vaccines, long-lasting nets, new diagnostics, and pre-clinical antimalarials that did not exist when the global community last took malaria seriously in the early 2000s. The second half — "now we must" — is the kind of sentence public-health bodies write when they are quietly worried that the world is about to look away.

The numbers behind the worry are these. WHO's current estimate is 282 million malaria cases globally in 2024 and 610,000 deaths, a small increase on 2023 and well above the trajectory the world set itself a decade ago. Of those deaths, the overwhelming majority are children in sub-Saharan Africa. The endemic country count has fallen — from 108 in 2000 to 80 in 2024, with 47 countries now formally certified as malaria-free — but the total caseload has stopped its long decline and started to drift upwards.

Four reasons the curve has flattened

Read the WHO's own briefing material and four threats keep recurring. None is new. All are getting worse.

First, drug resistance. Artemisinin-based combination therapies have been the workhorse of malaria treatment for two decades. Partial artemisinin resistance is now confirmed in four African countries and continues to spread; the genetic markers (the kelch13 mutations) have been documented in patients who clear parasites more slowly than the drugs were designed to manage. There is, today, no equivalently cheap, equivalently effective replacement waiting in the wings.

Second, insecticide resistance. Pyrethroid resistance — the class of insecticide on which most long-lasting nets have relied — is now widespread in 48 of the 53 countries that report into WHO's monitoring system. The response, in the form of dual-active-ingredient nets that pair pyrethroids with chlorfenapyr, works well in trials. The cost, around twice that of conventional nets, is a problem at scale.

Third, diagnostic failure. The Plasmodium falciparum parasite has, in many places, evolved deletions of the pfhrp2 gene. Rapid diagnostic tests that look for the HRP2 protein simply miss those infections. WHO records this problem in 46 endemic countries. A patient who tests negative on a market-standard rapid test, then presents again two days later much sicker, is a story increasingly told in clinics from Eritrea to the Horn of Africa.

Fourth, and most acutely, money. WHO and the Global Fund put the 2025 funding need at US$9.3 billion. They received US$3.9 billion in 2024. The shortfall — US$5.4 billion — is not a rounding error. It is the gap between current operations and the level of effort that the Global Technical Strategy modelled as the minimum required to stay on track. With major donors trimming aid budgets, the shortfall is widening rather than closing.

Where the campaign is, in fact, optimistic

It would be unfair to summarise WHO's tone as bleak. The 2026 campaign is built around real, recent wins. Twenty-five countries are now vaccinating roughly 10 million children a year against malaria using either RTS,S/AS01 or R21/Matrix-M; the same vaccines that, in 2015, were still the subject of cautious editorials in The Lancet. Long-acting injectable antimalarials are progressing through trials. Genetic-modification and Wolbachia-based approaches to suppress vector populations are graduating from research papers to deployed pilots. The technical case that elimination is reachable, country by country, has never been stronger.

The campaign's calls to action are, as a result, oddly specific. WHO asks for sustained and more efficient funding (rather than more for its own sake), for nationally-led programmes (rather than donor-driven verticals), for accelerated innovation (especially on resistance-proof tools), and for community ownership (rather than top-down delivery). Read between the lines and the message is: we have the tools. We are about to lose them if we don't pay for them, deliver them properly, and get ahead of biological resistance.

The European angle that the campaign does not spell out

For European readers, malaria can feel like someone else's problem. It is not, in two senses. The first is direct: imported malaria cases are rising in EU countries, and Anopheles stephensi, an Asian vector that thrives in cities and breeds in stored water, has now been confirmed in seven African countries, including Djibouti, Sudan, Ethiopia, and Kenya. Spatial models suggest 126 million urban Africans are at new risk. The flight times from those cities to European capitals are short, the diagnostic difficulty for a returning traveller is real, and the public-health systems on this side of the Mediterranean are not particularly practised at recognising malaria quickly.

The second is institutional. Europe's vector science — the work that produced ECDC's surveillance maps, the Karlsruhe climate-malaria model, the dual-active-ingredient nets now stockpiled in WHO depots, and much of the Wolbachia infrastructure — is funded out of the same finite donor pool. When that pool shrinks because of decisions made in Berlin, Paris, London, or Washington, the cost is paid in countries with no representation in those budgets. It is also paid, eventually, in our own. Pathogens move with cargo, with travel, and with climate; surveillance budgets, oddly, do not.

What to watch next

Three indicators will say more than the slogan. The next World Malaria Report, due in late 2026, will reset the global case and death estimates with another year's data; if the line continues drifting upwards, the language at WHO will harden further. The Global Fund's eighth replenishment cycle, with figures expected through 2026, will determine how much of the US$9.3 billion target is actually closable. And the long-tail clinical data from R21/Matrix-M, now embedded in routine programmes in countries including Côte d'Ivoire, will tell us whether vaccination at scale holds up the way trials suggested it would.

Mosticare's reading is plain. The science of malaria is in a better state than the politics of malaria. The slogan on the WHO posters this April was not "we can". It was "now we can. Now we must." The qualifier is the entire message. Whether the world supplies the second half is the question of the next two years.

Sources cited

1. World Health Organization. (2026, 25 April). World Malaria Day 2026: Driven to End Malaria — Now We Can. Now We Must. https://www.who.int/campaigns/world-malaria-day/2026
2. World Health Organization. (2024). World Malaria Report 2024. https://www.who.int/teams/global-malaria-programme/reports/world-malaria-report-2024
3. The Global Fund to Fight AIDS, Tuberculosis and Malaria. (2025). Results Report 2025. https://www.theglobalfund.org/en/results/