A 30 per cent cut in malaria financing could lead to 146 million additional malaria cases in Africa by 2030, nearly 400,000 deaths and $37 billion in lost Gross Domestic Product, the African Leaders Malaria Alliance said Friday.
Who Pays When the Money Stops
That warning came at a high-level side event on sustainable malaria financing, monitored by the News Agency of Nigeria via webinar on the sidelines of the 81st United Nations General Assembly. The event carried the title, “Africa’s Leadership for Sustainable Malaria Financing: A Multisectoral Path to Elimination.” It was hosted by President Advocate Duma Gideon Boko of Botswana, Chair of ALMA, in partnership with the African Union Commission and the RBM Partnership to End Malaria.
The numbers are brutal. Africa currently accounts for 94 per cent of global malaria cases and 95 per cent of malaria deaths, the leaders said. Progress has stalled, they said, with the risk of a resurgence hanging over communities already dealing with major financing shortfalls, extreme weather events, growing resistance to insecticides and medicines, and humanitarian crises. The people at the bottom keep absorbing the damage while the institutions at the top talk about “transition” and “partnership.”
African leaders at the event called for stronger domestic financing, multisectoral action and deeper collaboration to protect gains made in the fight against malaria and accelerate progress towards elimination. They said recent Global Fund and Gavi replenishments had fallen short of their targets, while official development assistance for health in Africa continued to decline. That’s the machinery of dependence in plain sight: promises made, targets missed, and the bill passed down to countries already squeezed.
What They Want From National Budgets
The leaders urged African countries to institutionalise malaria financing within national budgets and development plans, and called on development partners to provide predictable support during the transition. They also called on African countries to include malaria control in their World Bank IDA21 health compacts and urged the World Bank to consider a dedicated Malaria Booster Programme under IDA22. The language is tidy. The reality is a scramble for survival inside systems that keep deciding who gets protected and who gets exposed.
Boko said Africa had the tools, experience and leadership to change malaria’s trajectory but needed sustainable financing and collective action to match its ambition of a malaria-free future. He urged countries to pursue a managed transition towards sustainable domestic financing while strengthening political commitment to malaria elimination. The appeal sounds orderly enough. It still leaves the same question hanging over the room: who pays, and who gets to wait.
WHO Director-General Tedros Ghebreyesus said sustained investment remained critical to preventing a reversal of progress against malaria. “When investment is sustained, malaria retreats. When financing falls, it returns,” Mr Ghebreyesus said. He said National End Malaria Councils and Funds could provide a practical mechanism for bringing different sectors together to support malaria control and elimination. “End Malaria Councils bring government, businesses, civil society, and communities around one plan and one financing platform. Every malaria-endemic country should establish and use such a mechanism adapted to its national context,” he said.
The Same System, New Labels
That model puts government, businesses, civil society and communities around one plan and one financing platform. It sounds collaborative. It also keeps the whole fight inside the same institutional frame, where funding depends on councils, compacts, replenishments and the goodwill of powerful actors.
Boko said Africa was ready to lead the fight but that malaria elimination remained a shared responsibility requiring sustained global partnership. “Let us finance the fight, bring every sector to the table, and deliver the big push to zero malaria,” he said. Muhammad Jallow, Vice President of The Gambia, cautioned that domestic financing alone would not be enough to sustain the level of investment required to achieve malaria elimination. “We must be mindful of the fiscal constraints facing many of our countries. Domestic financing alone can not sustain the level of investment required to reach elimination,” Mr Jallow said.
He called for stronger international partnerships and predictable financing to support countries through the final stages of malaria elimination. Zarau Wendeline Kibwe, Executive Director for the Africa Group 1 Constituency at the World Bank Group, said malaria should remain a priority as countries moved towards negotiations on IDA22. The event also highlighted cross-border collaboration, local manufacturing and innovation as important components of malaria elimination.
The message from the summit was clear enough. The fight depends on money, and the money depends on institutions that keep falling short. Meanwhile, the disease keeps its grip on the people who can least afford another round of delay.