Amid funding cuts to the health sector, experts fear that malaria could hit Malawians even harder, especially children.
Already, latest statistics show that nearly half of Malawi’s 20 million people were infected by malaria in 2024 and deaths from the disease also rose, threatening the country’s goal to eliminate the number one killer disease by 2030.
And that was before the United States of America—hitherto the largest bilateral donor to Malawi’s health sector—closed the United States Agency for International Development (USAid) offices worldwide, cut off funding, and left poor countries such as Malawi in financial trenches.
“We have a lot of work to do because we are continuing to register a lot of malaria cases in our country,” said National Malaria Control Programme (NMCP) senior disease control officer Precious Chinyama at the weekend.
According to the programme’s statistics presented on Sunday at the National Paramedical Private Practitioners Association of Malawi (NAPPPAM) annual general meeting, the number of malaria cases rose from 4.6 million in 2022 to 6.491 million in 2023 and to 9.470 million in 2024.
Presenting the data, Chinyama said in 2022, the malaria incidence was 202 per 1000 population, but it increased to 328 per 1000 population in 2023 and jumped to 467 per 1000 population in 2024.
He said prior to 2022, the numbers were on a steady decrease from 2020, prompting the Ministry of Health to set an ambitious goal of eliminating malaria as a public health concern in Malawi by 2030, as outlined in the National Malaria Strategic Plan covering 2023-2030.
But if recent trends are anything to go by, attaining this goal may be an uphill task. The data, as presented by Chinyama, also indicates that the number of malaria deaths rose from 1 670 in 2023, to 2 252 in 2024.
He said various factors contributed to the rise in malaria cases between 2022 and 2024, including disasters the country experienced during that period, and the wearing out of distributed mosquito nets.
Chinyama feared that the actual number of cases in the country could be more than the recorded figures, saying there are some incidents that are not reported.
The expert added that funding cuts are also a threat to the fight against malaria.
It is estimated that with funding challenges there will be a deficit of about $2 million (K3.6 billion) to buy commodities for fighting malaria by 2026 and a gap of $14 million (K25 billion) by 2027 if there is no improvement in funding.
“Since we had a lot of cases in 2024, we spent a lot of resources on treatment which will also affect availability of resources,” said Chinyama.
The fight against malaria in Malawi is mainly financed by the Global Fund, which is set to inject $87 million (K156 billion) for the 2024-2027 period to support activities in the fight against the disease.
But these resources fall short of what is required to implement the National Malaria Strategic Plan.
The total cost of implementing the strategic plan was estimated at K1.1 trillion in 2023.
But based on indicative funding commitments by major donors for malaria, including the Global Fund, the US President Malaria Initiative/USAid (its funding is now in jeopardy) and Malawi Government, Ministry of Health data shows that implementation of the strategic plan was already facing an average financing gap of 51 percent for the first four years (2023-2027) even before the latest donor pullouts from the health sector.
Donors—who for decades have funded more than half of Malawi’s healthcare—are fleeing the sector, with the most recent withdrawal being the US early in March when Washington terminated contracts worth US$230.4 million (nearly K400 billion) under USAid as part of President Donald Trump’s “America First” foreign policy doctrine.
Other Western donors have also progressively been slashing aid to poor countries.
In the same March, the United Kingdom announced that it would cut its foreign aid to 0.3 percent of gross national product from 0.5 percent to free up money for defence spending amid growing threats from Russia and collapsing security guarantees from the US.
Across Europe, France and Germany have in recent years, also gradually scaled back foreign assistance, hurting budgets of poor countries such as Malawi, especially in the health sector.
At its peak in 2011/2012, donors used to account for more than 60 percent of Malawi’s health budget, but that has now slumped to around 55 percent, which still puts Malawi among the highest donor-dependent countries among low income countries globally when it comes to health financing, against an average of 27 percent for its peer nations.
While Malawi Government’s contribution to its people’s health funding has improved from around 18 percent to 24 percent within the same period, the pace is too slow to compensate for the falling foreign aid.
Chinyama, who was hopeful that the recent distribution of about 11.7 million nets completed in June 2025 will help contain the sharp rise in malaria cases, called on the private sector to support the fight against malaria, saying eliminating the disease requires collaborative efforts.
Yesterday, Ministry of Health spokesperson Adrian Chikumbe conceded that eliminating malaria by 2030 will be a tall order, especially with the recent trends showing an increase in both infections and deaths amid resource limitations.
However, he said government is looking into ways of filling the gap created by US’s aid cuts towards the country’s health sector.
Said Chikumbe: “Funding for malaria is still there, although it has been affected by cuts. We have other sources of funding.
“We also launched the National Health Financing Strategy, which suggests ways to fund the health sector, including paying services, medical schemes, engaging the corporate world to support health services,” he said.
Chikumbe also said the ministry is pushing for resources in the national budget to meet the Abuja Declaration of allocating 15 percent of total expenditure to the health sector.
Meanwhile, health rights activists have urged government to step up efforts in eliminating the disease by 2030.
In an interview, Malawi Health Equity Network executive director George Jobe said achieving the 2030 target will require stronger political will; sustained funding, and intensified community engagement and awareness raising. He added that funding cuts by donors at a time malaria cases are increasing will heavily affect efforts against the disease.
Said Jobe: “While Malawi has strong policies and a National Malaria Strategic Plan, the current surge in cases shows we should do more at the scale and intensity required.
“Prevention methods such as mosquito net distribution, indoor residual spraying, and environmental management are not reaching all households consistently. Community awareness and behaviour change campaigns also need strengthening.”
On his part, Health Rights Education Programme executive director Maziko Matemba described the rise in the malaria cases and resultant deaths as worrisome.
He emphasised that the country needs to invest more in malaria prevention.
President Lazarus Chakwera launched the Zero Malaria Starts With Me Campaign in June 2021 aimed at fighting malaria in the country.
He described the disease as a threat that costs government dearly, saying it accounts for 36 percent of out-patient cases and 15 percent of all hospital admissions in the country.
