Stephen I. Feller , 2025-04-25 18:01:00
April 25, 2025
3 min read
Key takeaways:
- Foreign aid cuts in the U.S. threaten malaria elimination efforts globally, experts said.
- Freezing or eliminating aid programs could result in millions more malaria cases and thousands more deaths.
Amid cuts to and cancellation of U.S. public health programs aimed at treating and preventing malaria infection, officials are scrambling to secure funds in order to prevent millions of cases and tens of thousands of deaths.
For World Malaria Day 2025, WHO and its global health partners are promoting the “Malaria Ends With Us: Reinvest, Reimagine, Reignite” campaign to revitalize and accelerate efforts to eliminate the mosquito-borne infection.
The disappearance of U.S. foreign aid for malaria prevention and care has alarmed experts globally. Image: Adobe Stock
“The history of malaria teaches us a harsh lesson: When we divert our attention, the disease resurges, taking its greatest toll on the most vulnerable,” WHO Director-General Tedros Adhanom Ghebreyesus, PhD, MSc, said in a press release.
According to WHO, there were 263 million new cases of malaria globally in 2023, with 597,000 deaths, 95% of which were in Africa.
In the last few years, two vaccines against malaria have been recommended by WHO and are being distributed in 20 African countries, and a new generation of insecticide-treated nets are being distributed across the continent, the agency said.
Nonetheless, experts and officials, including Tedros, are raising concerns about the pullback on funding from the United States and its potential effects on global malaria efforts. We spoke with Jane M. Carlton, PhD, director of the Johns Hopkins Malaria Research Institute at the Johns Hopkins Bloomberg School of Public Health, about the situation.
Healio: What cuts specifically are jeopardizing progress against malaria?
Carlton: The cuts in U.S. public health programs operated by USAID, such as the President’s Malaria Initiative (PMI), are the most devastating for malaria control and elimination. Modeling studies from the Malaria Atlas Project has estimated that a halt of PMI-funded programs for 90 days would result in 1.7 million additional cases and 17,000 additional deaths. A freeze for 1 year would result in 14.9 million additional cases and 107,000 additional deaths.
Healio: What types of projects will be impacted?
Carlton: Distribution of bed nets, insecticide to spray, preventive treatments in pregnancy, rapid diagnostic tests and malaria medicine are all being affected. In addition, training for health workers in malaria diagnosis, clinical care and preventive treatment in pregnancy will be greatly impacted.
Healio: Is there anyone else — private funders, other countries — that can step in to fill the funding gap?
Carlton: Other countries are already stepping up. Nigeria lawmakers approved an additional $200 million (321 trillion Nigerian Naira) for the health sector as part of a 2025 spending plan — an effort to mitigate the impact of the recent suspension of foreign aid from the U.S. Other countries in Africa are taking steps to close critical gaps through the use of domestic resources.
In March 2025, WHO and the Roll Back Malaria Partnership to End Malaria launched a cross-partner working group of technical experts and donor agencies to ensure rapid, aligned support for countries.
Healio: The number of malaria cases in the U.S. has been rising the last few years, and there have been locally acquired cases in each of the last 3 years. How concerning is this?
Carlton: We regularly see roughly 2,000 malaria cases per year in the U.S. from travelers returning from vacation or working in endemic countries. In 2023, there were 10 cases of locally acquired malaria in people who had not left the U.S. and must have acquired the infection from the bite of an infected mosquito — we have mosquito vectors that can transmit malaria parasites in this country.
When this is compared with the 263 million malaria cases worldwide estimated in 2023, it is small. New studies into local Anopheles populations in the U.S. are needed and this is an area we are pursuing at the Johns Hopkins Malaria Research Institute.
Healio: There are now vaccines to prevent malaria. How much of an impact could they have on the spread of malaria in the U.S. and globally?
Carlton: Two malaria vaccines — RTS,S and R21/M — are now recommended by WHO for use in children in African countries. Between 2019 and 2023, roughly 2 million children in Ghana, Kenya and Malawi received RTS,S. An evaluation of impact demonstrated a 13% reduction in mortality and a 22% reduction in hospitalizations of severe malaria among children eligible for the vaccine.
By December 2024, a total of 17 countries had introduced the vaccine through routine childhood immunization, with many more to come. We are hopeful for a significant slowdown in malaria, especially if the vaccine is used in combination with other interventions.
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For more information:
Jane M. Carlton, PhD, can be reached at JaneCarlton@jhu.edu.
