Malaria remains one of the deadliest diseases in Africa, a continent that bears the brunt of global malaria deaths. According to the World Health Organization (WHO), approximately 597,000 people died from malaria worldwide in 2023, with Africa accounting for 95% of these deaths. Malaria disproportionately affects children, pregnant women, and vulnerable populations, making it one of the most persistent health challenges in the region.
As Africa enters the malaria season, which typically begins in March in many parts of the continent, the ongoing struggle to combat this deadly disease is being exacerbated by significant cuts to international aid. Specifically, the Trump administration’s decision to slash U.S. foreign aid, including funding for malaria control programs through USAID (United States Agency for International Development), has created a severe challenge in the fight against malaria. Health experts and local officials are sounding the alarm that these cuts are likely to lead to a catastrophic rise in malaria cases and deaths.
Malaria in Africa: A Persistent Threat
Malaria is caused by the Plasmodium parasite, which is transmitted through the bites of infected Anopheles mosquitoes. The disease manifests with symptoms such as fever, chills, headache, and body aches, and if not treated promptly, it can lead to severe complications, including organ failure, and death. Despite significant progress in reducing malaria-related deaths globally over the past decades, Africa remains the epicenter of the malaria burden.
In Uganda alone, there were 12.6 million malaria cases and nearly 16,000 deaths in 2023, many of them among children under 5 years old and pregnant women, who are especially vulnerable to the disease. According to Dr. Jimmy Opigo, who heads Uganda’s malaria control program, malaria is so pervasive in the country that the distribution of anti-malarial medicines and insecticide-treated bed nets has become as essential as groceries. Without consistent supply chains, the fight against malaria could be set back for years.
The situation in Uganda is far from unique. In other high-burden African countries like Nigeria and the Democratic Republic of Congo (DRC), malaria continues to take a devastating toll. In fact, Nigeria records a quarter of all malaria cases globally. Yet, thanks to extensive efforts over the years, the country has been able to reduce malaria-related deaths by over 55% since the year 2000, with substantial support from international organizations and governments, especially the U.S.
The Impact of USAID Cuts
The U.S. government has long been one of the largest contributors to malaria control in Africa, particularly through the President’s Malaria Initiative (PMI), which has funded malaria prevention and treatment programs in many African nations. PMI has provided essential resources such as insecticide-treated bed nets, rapid diagnostic tests, preventive treatments for pregnant women, and medicines to treat malaria. In 2023, the U.S. allocated hundreds of millions of dollars annually to malaria control efforts in Africa. In Uganda alone, USAID had been contributing between $30 million and $35 million annually to fund mosquito spraying operations, purchase insecticides, and supply anti-malarial medicines.
However, following the decision to cut 90% of USAID’s foreign aid contracts in January 2023, malaria control programs have been severely disrupted. Dr. Opigo mentioned that the termination of these contracts has forced health officials to shift their focus from ongoing malaria prevention efforts to disaster preparedness. For example, mosquito-spraying operations that were supposed to begin in February ahead of the rainy season have been suspended. This is particularly concerning, as stagnant water during the rainy season provides the perfect breeding ground for mosquitoes, increasing the risk of malaria transmission.
The cuts have also affected field research and surveillance programs that help track malaria outbreaks and guide response efforts. Dr. Opigo warned that without the necessary resources, there could be a significant rise in cases of severe malaria, which often leads to complications such as organ failure and death.
Malaria No More’s Warning
Malaria No More, a Washington-based advocacy group, has raised alarm over the long-term consequences of the funding cuts. According to new modeling from the organization, just a one-year disruption in the malaria-control supply chain could result in an additional 15 million malaria cases and 107,000 deaths globally. The group has urged the Trump administration to reconsider its decision and restore funding to prevent outbreaks from spiraling out of control.
Health workers in Africa have expressed concern that without immediate action, the situation will worsen. While some hope remains that other global health organizations, such as the Global Fund to Fight AIDS, Tuberculosis, and Malaria, will continue to support malaria control efforts, the lack of clarity on U.S. funding for these initiatives has left many uncertain about the future.
The Ripple Effect on Other African Countries
The ripple effect of USAID cuts is being felt in other countries as well. In Nigeria, malaria accounts for a significant portion of outpatient visits, with up to 40% of the population diagnosed with the disease. The U.S. has provided billions of dollars in aid to Nigeria through PMI, contributing to significant progress in malaria control. However, health experts warn that without this vital support, efforts to reduce malaria deaths and cases in the country could be reversed.
Similarly, in the Democratic Republic of Congo, U.S. support has contributed approximately $650 million toward malaria control programs since 2010. The reduction in funding could undo the gains made in recent years, especially in the conflict-ridden eastern region, where health workers have been fleeing due to violence. The U.S. funding had helped establish better infrastructure for diagnosing and treating malaria, and its absence could severely hinder efforts to track and respond to disease outbreaks in this region.
The Need for Continued Global Support
Despite the setbacks caused by the funding cuts, there is still hope that the fight against malaria will continue. Local governments, non-governmental organizations, and faith-based organizations are stepping in to fill the gaps left by the loss of U.S. funding. However, these groups often lack the resources and infrastructure needed to replace the extensive support provided by USAID.
Dr. Opigo remains optimistic that some U.S. funding will continue to flow through alternative channels, such as the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), which have long supported malaria research and prevention efforts. But the situation remains fragile, and the need for a sustained, coordinated global response has never been greater.
Health experts emphasize that a multi-pronged approach is essential to fight malaria effectively. This includes not only increasing access to life-saving medicines and bed nets but also investing in malaria research, improving diagnostic tools, and strengthening healthcare infrastructure in high-burden countries. Moreover, greater international collaboration is required to ensure that no one is left behind in the fight against this deadly disease.
Malaria remains one of Africa’s deadliest diseases, claiming hundreds of thousands of lives every year, primarily among children and pregnant women. The Trump administration’s decision to cut U.S. foreign aid for malaria control programs has created a dire situation in some of Africa’s poorest countries, where resources and healthcare infrastructure are already stretched thin. Health workers warn that these cuts could lead to a catastrophic increase in malaria cases and deaths if immediate action is not taken.
While there is still hope that other international organizations and governments will step in to fill the gap, the fight against malaria requires sustained funding, coordination, and commitment from all stakeholders. As Africa enters the malaria season, the world must recognize the urgency of the situation and act swiftly to prevent a public health disaster. The time to act is now.
