Combatting malaria through strong health systems

In 2024, there were 282 million malaria cases and 610,000 deaths globally – the vast majority in sub-Saharan Africa, where children under five account for 75% of all malaria deaths (WHO, 2025). In many high-burden countries, drug resistance is spreading and the gap between what is known and what is delivered at the point of care remains large.

Despite the progressive introduction of vaccines into routine immunisation programmes, their impact remains limited as long as the health systems responsible for delivering them stay fragile.

Malaria is both a disease and a health system problem: commodities – insecticide-treated nets, diagnostics, medicines – are necessary but insufficient. Their impact depends entirely on a health system’s capacity to procure, distribute, and use them correctly. In the highest-burden countries, under-supervised frontline workers, fragile supply chains, and incomplete or unused health data directly affect malaria control.

In countries where Enabel has a long-term presence (including Burundi, Niger, the Democratic Republic of Congo, Uganda, Guinea and Benin) malaria control is inseparable from health system strengthening: Enabel supports accessible quality care, well-organised public health services, reliable health data, as well as strengthened action research and surveillance to detect emerging resistance.