Malaria is also posing serious risks of a resurgence in East Africa. Other health experts and organizations have sounded the alarm over a “triple threat” posed by increasing drug resistance, the development of insecticide-resistant mosquitoes, and the arrival of the invasive species Anopheles stephensi. The US government has taken this unfortunate opportunity to abruptly defund malaria programs. This sudden action endangers the hard-fought two-decade-long progress in combating malaria, putting the issue of resurgence at a timelier importance.
Insecticide-treated bed nets and indoor spraying have been essential tools in the fight against malaria. Unfortunately, those mosquito populations have built up resistance to these routinely used chemicals over the years. In East Africa, for example, species like Anopheles gambiae and Anopheles funestus are now more likely to survive exposure to these insecticides. Some mosquitoes have adapted their behavior and now bite earlier in the evening or outside. This dramatic change makes even the most common preventive practices less effective.
In January 2025, the US scaled back funding for malaria programs, most notably during the Trump administration. This decision will cause the world’s most dangerous diseases to return with a vengeance. According to estimates, this funding stoppage will reverse twenty years of progress made in reducing childhood malaria mortality. Since 2000, annual work-related deaths dropped almost in half, down from 839,000 to 438,000 by 2015.
“The US government has been absolutely key to all the successes that we’ve made in malaria. It has been an unprecedented public health success.” – Melanie Renshaw, principal director of the African Leaders Malaria Alliance
Renshaw cautions that pending interventions, malaria cases may more than double by 2025 if we do not act now. As various global partnerships have worked collaboratively over the years, the abrupt funding freeze leaves a significant void that none can fill.
Dr. William Steketee, an expert in malaria control efforts, emphasizes the gravity of the situation: “Each of those challenges alone would be difficult to manage, but their combined impact—exacerbated by the abrupt freeze on funding across the US President’s Malaria Initiative—is setting the stage for a devastating malaria resurgence.”
The threat from the development of drug resistance further complicates this dire situation. Over the past 10 years, resistance to first-line drug treatments has become apparent in East Africa. The arrival of Anopheles stephensi threatens to intensify malaria surges in urban areas where control measures have historically been weaker than in rural regions.
“It’s the worst moment we’ve had in 25 years. We could just lose everything that was accomplished before this.” – Melanie Renshaw
The stakes go beyond COVID, and the impact of stopping prevention work can be deadly. Renshaw notes that malaria can quickly rebound when interventions cease: “The thing about malaria is that it resurges quickly.”
Steketee expresses concern over the rapid undoing of decades of progress: “Watching the rapid undoing of decades of progress is nothing short of devastating.” He notes that critical functions like operational research, advocacy, and monitoring are often the first to go. This occurs when money is pushed into different priorities.
