Why Ending Malaria Depends on Bold Financing and Global Leadership
Inside View 03/10/2025 •
Tomnjong Thadeus with his 3-year-old daughter Gabriella at their home in Soa, Cameroon. Malaria bed nets – still not accessible enough in Africa’s most endemic countries.
Gabriella’s mother fell ill with malaria while pregnant. Gabriella got sick soon after and spent four days in the hospital. Eventually, Gabriella recovered – but every year, hundreds of thousands of children do not.

The President of the Republic of Botswana and Chair of the African Leaders Malaria Alliance (ALMA), writes on the urgency of mobilising funding to defend the gains and further progress in the fight against malaria. 

Despite decades of progress, we are not on track to defeat malaria in Africa. Without more resolve, innovation, financing, and partnerships, we risk sliding back to the days when malaria killed over a million children each year. 

Malaria remains one of Africa’s leading killers of children. This cannot be our legacy. 

The fight against this disease is threatened by a perfect storm: insufficient funding, extreme weather events linked to climate change expanding mosquito habitats, rising drug and insecticide resistance, and humanitarian crises exposing millions to infection. 

Science has done its part. It has given us the tools: new dual-insecticide mosquito nets, effective medicines, and the world’s first malaria vaccines. Unless we act decisively, malaria will continue to claim lives that should have been saved. 

We know what is needed: strong global commitment, effective financing, and shared responsibility. We must achieve a successful Global Fund replenishment to ensure the effective tools reach everyone who needs them.

The Global Fund replenishment is decisive

People with access to an insecticide-treated mosquito nets In sub-Saharan African countries where the Global Fund invests.

The Global Fund to Fight AIDS, Tuberculosis, and Malaria provides over 60% of all international financing for the fight against malaria.  

Since 2002, the Global Fund has helped cut malaria deaths by nearly a third, distributing hundreds of millions of mosquito nets, treatments, and diagnostic tests. That progress cannot be taken for granted – without a fully funded replenishment, millions of children’s lives hang in the balance. The 2025 replenishment will determine whether we advance or retreat. 

Expert economists calculate that every dollar invested in malaria yields four times that in economic growth. It is also an investment in pandemic preparedness, because the systems strengthened to fight malaria are the same ones that detect and respond to new threats. 

These investments strengthen primary healthcare systems by training community health workers, improving diagnostic capabilities, and enhancing supply chain management. They create a foundation for comprehensive healthcare delivery that extends far beyond malaria treatment.

Africa’s new era of health financing: strengthening domestic resource mobilisation

Twenty African nations rank among the world’s most dependent on U.S. health aid, with several receiving American assistance that exceeds their own government health spending, leaving the continent acutely vulnerable to potential funding cuts.

Africa’s health financing is entering a new era. We must face the reality that official development assistance for health in Africa has fallen by 70% in just four years. Without decisive action, Africa CDC warns that declining aid and rising debt repayments could cost the continent up to four million additional preventable deaths each year by 2030.  

First, we must strengthen domestic resource mobilisation by allocating an increasing proportion of our national budgets to health. We must also tap into public–private partnerships. It makes economic sense for the private sector to operate in a healthy environment. 

We already have proof of concept through innovative platforms such as national End Malaria Councils and Funds, which bring public and private actors together in coordinated action across 11 countries. To date, they have raised more than $166 million in domestic resource commitments to support national malaria strategies. 

These efforts must now be scaled across the continent. We should embrace innovative financing, for example, through solidarity levies on airline tickets, tobacco, or alcohol; diaspora bonds; and community health insurance. We see how possible this is in Rwanda’s Mutuelles de Santé, which covers over 90% of its population.

Next, we need to expand blended finance. This means using public funds to reduce risk and attract private investment, unlocking billions for health infrastructure, supply chains, and local pharmaceutical production. 

The Global Health Investment Fund has used blended finance to bring private investors into funding new vaccines and treatments. With the African health market projected to reach $259 billion by 2030, these investments can build resilience and sovereignty if governed well.

Leveraging World Bank International Development Association financing for a malaria booster

The International Development Association (IDA) of the World Bank has long supported health system strengthening, be it training community health workers in Senegal or upgrading surveillance systems and strengthening supply chains. 

These investments make a real difference. When health workers can diagnose and treat malaria in the community, through integrated community case management, it also significantly improves maternal and child health.

The IDA’s Booster Program for Malaria from 2005 to 2010 showed that front-loading investment can rapidly cut malaria cases and strengthen the primary health care system. We urgently need to bring back this approach through a second Malaria Booster Program, aligned with national plans, which would help Africa close financing gaps while strengthening systems for the long term.

Where should United Nations place its attention?

Global malaria incidence, which accounts for population changes, ticked up last year, translating to 11 million more cases, most of which occurred in the African continent.

In the short term, we must place our emphasis on securing additional financing. 

The Global Fund replenishment, domestic mobilisation, including through the private sector, and World Bank International Development Association financing are not competing choices. They offer a path to close the funding gap, putting Africa back on track to end malaria, and building health systems strong enough to withstand the next pandemic.

But time is not on our side. Donor retrenchment, rising debt, and climate shocks mean that the cost of inaction grows by the day. 

I urge world leaders gathering in New York to see the fight against malaria for what it is: a measure of how committed we are to safeguarding health and human dignity worldwide.

If we fail to finance the fight, history will judge us harshly. If we succeed, millions of children will live, communities will thrive, and Africa will stand stronger against tomorrow’s threats. The choice is ours.

About the author

Duma Gideon Boko is the President of the Republic of Botswana and Chair of the African Leaders Malaria Alliance (ALMA). 

Image Credits: Vincent Becker/ Global Fund.

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