Malaria is an immense global health challenge. In 2022, there were 249 million malaria cases, an increase of 5 million as compared to 2021, leading to 608,000 malaria deaths in 85 countries. Yet while these numbers increase, investment and attention to malaria in the past decade has stagnated—and even decreased in areas. Notably, the total spending to eradicate malaria in 2022 was $4.1 billion USD – just over half of the $7.8 billion USD needed to stay on track to reduce new malaria infections and mortality rates by 90% by 2030.

Like other infectious diseases, it has the potential to spread rapidly across borders and continents, especially in regions where it is endemic. Shifting weather patterns caused by climate change, as well as human migration and resettlement, can lead to malaria being introduced, or re-introduced, to previously low-transmission or malaria-free areas.

In a new policy brief, Malaria and Most Vulnerable Populations, the Wilson Center’s Maternal Health initiative looks at the current state of malaria globally. We assess the devastating effects of malaria on maternal, newborn, and child health outcomes, survey improved prevention methods and treatments, and underscore the role of community health workers and global health diplomacy in the fight against malaria. We also provide recommendations to help prioritize malaria eradication in a time of increased prevalence and decreased global attention. 

Malaria and Most Vulnerable Populations | Global Health and Gender Policy Brief March 2024 by The Wilson Center on Scribd

Malaria increases the risk of maternal death before and after childbirth. Studies have shown that in parts of the world where malaria is endemic, it may contribute to almost 25% of all maternal deaths. Women are at highest risk of severe infection during the first trimester, when more than 60% of all malaria infections during pregnancy occur.

The core range of interventions to prevent and treat malaria infection in endemic countries include insecticide-treated bed nets, indoor residual spraying, antimalarial medication, and rapid diagnostic testing.

Advances like the development of two malaria vaccines—the RTS,S and the R21/Matrix-M — provide a valuable new tool in prevention for children under the age of five globally. Both vaccines were shown to be safe and effective at preventing malaria in children, with approximately 75% of malaria cases prevented when administered seasonally in areas of high transmission.

Community health workers (CHWs) are lay community members who support the health and wellbeing of a community they are familiar with through outreach, education, and treatment. With adequate support, these frontline workers play a key role in eradicating malaria globally. CHWs can greatly expand the reach of malaria prevention and treatment services, but these workers should be seen as one part of the health care system, rather than as a replacement for the system itself.

Malaria, like other infectious diseases, poses a current global health security threat. Global health diplomacy addresses global health security issues across borders and that require joint recognition and action.  Ultimately, the goal is to improve global health outcomes, promote equity, and strengthen health systems through joint country commitments. However, it is important to recognize that historical colonialism has left lasting impacts on global health systems, making it imperative that global health diplomacy prioritize principles of equity, transparency, and locally-led leadership.

Protecting those most vulnerable to malaria requires a comprehensive and inclusive approach that prioritizes the needs of women and girls. By implementing the policy recommendations below, significant strides can be made towards achieving the goal of a malaria-free world while promoting gender equality and empowering women and girls to lead healthier lives.

1. Improve health service delivery through ensuring accessibility, integration within maternal and child health services, and support from community health workers.
2. Increase empowerment through education and awareness of malaria prevention methods, including mosquito nets and vaccination.
3. Invest in community and local engagement, research, and storytelling to build community trust and address gendered barriers to accessing care.
4. Develop and implement innovative global health diplomacy policy solutions that are locally-led, gender-transformative, and engage stakeholders from multiple sectors.