Malaria: Global Situation, US Efforts & Funding (2024 Update)

About half the world’s population faces the risk of malaria infection, with an estimated 282 million cases and 610,000 deaths reported globally in 2024. Sub-Saharan Africa remains the region most severely impacted. While significant progress has been made in increasing access to prevention and treatment over the past two decades, challenges such as drug and insecticide resistance, and the growing impact of climate change continue to complicate control efforts. Still, recent developments offer hope, including the integration of dual-ingredient insecticide-treated nets and the world’s first malaria vaccines into broader health systems.

A Longstanding U.S. Commitment

The United States government has been involved in global malaria activities since the 1950s and currently stands as the largest governmental donor to these efforts. Historically, U.S. Involvement centered around the President’s Malaria Initiative (PMI), overseen by the U.S. Global Malaria Coordinator, alongside other U.S. Activities reaching approximately 30 countries. In fiscal year 2026, U.S. Funding for malaria control and research is estimated at $1 billion, a slight increase from the $963 million allocated in 2017. The U.S. Also remains the largest contributor to the Global Fund to Fight AIDS, Tuberculosis and Malaria, which is the largest overall funder of malaria programs worldwide. The Global Fund plays a critical role in coordinating and financing malaria interventions globally.

The Complexities of a Global Threat

Malaria, caused by Plasmodium parasites transmitted through Anopheles mosquitoes, is a serious tropical disease. The mosquito thrives in warm climates, and infection can lead to fever, chills, anemia, and even death, particularly when the parasites affect the brain, causing cerebral malaria. Despite being preventable and treatable, malaria continues to cause significant illness and mortality, disproportionately affecting resource-poor regions and young children.

Global strategies to combat malaria have evolved over time. Initial eradication efforts in the 1970s faltered, leading to rising rates. Renewed attention emerged in the late 1990s with the creation of the Roll Back Malaria Partnership (now the RBM Partnership to End Malaria). In 2000, global targets were established as part of the Millennium Development Goals. Expanded efforts by the U.S. Government, other donors, and affected countries have increased access to prevention and treatment, reducing cases and deaths, and sparking discussions about potential eradication.

However, progress has stalled in some areas. Challenges include poverty, poor sanitation, weak health systems, limited disease surveillance, natural disasters, armed conflict, migration, climate change, and the presence of counterfeit or substandard antimalarial drugs. Increasingly, drug and insecticide resistance pose significant threats. Multidrug-resistant malaria is widespread, and resistance to artemisinin-based combination therapies (ACTs) is emerging in parts of Asia and Africa. Similarly, insecticide resistance is a growing problem across multiple regions. Recent reports highlight the need for continued vigilance and innovation in malaria control.

Vulnerable Populations

Certain groups are particularly vulnerable to malaria, including pregnant women and children under five, who lack fully developed immune systems. People living with HIV/AIDS, travelers, refugees, displaced persons, and migrant workers entering endemic areas also face increased risk.

Interventions and Emerging Tools

Malaria control relies on a combination of prevention and treatment strategies. These include insecticide-treated bed nets (ITNs), indoor residual spraying (IRS) with insecticides, diagnosis and treatment with antimalarial drugs (particularly ACTs), intermittent preventive treatment in pregnancy (IPTp), and seasonal malaria chemoprevention (SMC).

A significant breakthrough has been the development and rollout of malaria vaccines. In 2021, the World Health Organization (WHO) recommended the RTS,S/AS01 vaccine, and in 2023, the R21/Matrix-M vaccine was also recommended. As of February 2026, 25 countries are offering these vaccines through routine immunization programs, targeting over 10 million children annually. The rollout of these vaccines depends on continued financing and country-level decisions.

Global Goals and the Road Ahead

Current global malaria activities focus on sustaining, improving, and expanding control efforts. Key goals include reducing malaria incidence and mortality by at least 90% by 2030, eliminating the disease in at least 35 new countries, and preventing re-establishment in malaria-free countries. As of 2024, 26 countries have achieved three consecutive years of zero indigenous malaria cases.

The U.S. Role: Shifts and Uncertainties

The U.S. Government has historically been the largest government donor to global malaria efforts, and also the largest donor to the Global Fund. However, since the beginning of the second Trump administration, the U.S. Global health response has undergone significant changes, including reorganization of foreign assistance, reductions in funding, and cancellation of programs. This has fundamentally altered the global health landscape and impacted both the President’s Malaria Initiative (PMI) and other U.S. Malaria efforts.

The release of the “America First Global Health Strategy” in September 2025 outlined a renewed U.S. Commitment to global health, including malaria, through bilateral health agreements. However, the strategy does not explicitly mention PMI, and the extent of future funding and emphasis on malaria efforts remains uncertain. The America First Global Health Strategy signals a shift in approach, but the practical implications for malaria control are still unfolding.

A History of U.S. Involvement

U.S. Involvement in global malaria control dates back to the 1950s, initially focusing on technical assistance. The launch of PMI in 2005 marked a significant increase in funding and a focused effort in 15 African countries, later expanding to include Southeast Asia. PMI was overseen by a U.S. Global Malaria Coordinator and involved collaboration between USAID, the CDC, and other agencies.

PMI activities historically included expanding access to ITNs, IRS, diagnosis and treatment with ACTs, IPTp, and SMC. The U.S. Also supported malaria research and development through the National Institutes of Health (NIH) and the Department of Defense (DoD).

Looking ahead, the future of U.S. Global malaria efforts will depend on continued funding, effective implementation of new strategies, and strong partnerships with international organizations and affected countries. The evolving global landscape and potential shifts in U.S. Policy will require ongoing monitoring and adaptation to ensure continued progress in the fight against malaria.