Each year, the World malaria report serves as a vital tool to assess global progress and gaps in the fight against malaria. This year’s report provides a critical and up-to-date snapshot of efforts to control and eliminate the disease in 83 countries worldwide. This year’s report introduces, for the first time, a dedicated chapter emphasizing the need for a more inclusive and effective response, with a focus on reaching the populations most vulnerable to malaria. Groups at high risk of a malaria infection include children under five, women and girls, Indigenous Peoples, migrants, persons with disabilities, and people in remote areas with limited healthcare access.
Burden of malaria
Globally, in 2023, the number of malaria cases was estimated at 263 million, with an incidence of 60.4 cases per 1000 population at risk. This is an increase of 11 million cases from the previous year and a rise in incidence from 58.6 cases per 1000 population at risk in 2022. The WHO African Region continues to carry the heaviest burden of the disease, accounting for an estimated 94% of malaria cases worldwide in 2023.
The WHO Eastern Mediterranean Region has experienced a 57% increase in incidence since 2021, rising to 17.9 cases per 1000 population at risk in 2023. The top five countries carrying the heaviest estimated burden of malaria cases in 2023 were Nigeria (26%), the Democratic Republic of the Congo (13%), Uganda (5%), Ethiopia (4%) and Mozambique (4%).
Globally, in 2023, the number of deaths was estimated at 597 000, with a mortality rate of 13.7 per 100 000. The number of malaria deaths and the mortality rate steadily decreased from 622 000 and 14.9 deaths per 100 000, respectively, in 2020. The WHO African Region continues to carry the heaviest burden of mortality, with 95% of estimated malaria deaths worldwide.
Between 2000 and 2023, an estimated 2.2 billion malaria cases and 12.7 million malaria deaths were averted worldwide, with 1.7 billion cases and 12 million deaths prevented in the WHO African Region alone.
In 2023 alone, more than 177 million cases and more than 1 million deaths were averted globally.
In 2023, the 11 HBHI countries (excluding India, and including the Sudan) were responsible for 66% of global malaria cases and 68% of deaths. Between 2017, the year before the inception of the HBHI initiative, and 2023, estimated malaria cases in these 11 countries increased by 13.8%, from 152 million to 173 million, and estimated deaths increased by 2.3%, from 399 000 to 408 000. India exited the HBHI group officially in 2024 due to significant progress in reducing the malaria incidence and mortality observed in its high
endemic states.
In 2023, in 33 moderate-to-high transmission countries in the WHO African Region, there were an estimated 36 million pregnancies, of which 12.4 million (34%) were infected with malaria. Accounting for the current impact of IPTp, it is estimated that low birthweight was averted in about 551 000 neonates. If third dose of IPTp coverage increased to 90%, then low birthweight would be averted in an additional 175 000 neonates.
Elimination status
In 2023 and 2024, notable progress was made in malaria elimination. The number of malaria endemic countries decreased from 85 in 2022 to 83, as a result of Timor-Leste and Saudi Arabia maintaining zero indigenous cases for 3 consecutive years. Furthermore, by 2024, a total of 26 countries that were malaria endemic in 2000 successfully reported zero indigenous cases for 3 consecutive years.
In 2023, Azerbaijan, Belize, Cabo Verde and Tajikistan were certified malaria free. In 2024, Egypt also achieved malaria free status, marking it as the third country in the WHO Eastern Mediterranean Region to do so. Additionally, Georgia and Türkiye have submitted their applications for malaria free certification.
Despite progress in elimination efforts, the countries in the malaria eliminating countries for 2025 (E-2025) initiative experienced an increase in malaria cases, predominantly driven by the Comoros, accounting for one third of all reported indigenous cases, followed by Panama and Thailand.
Within the Mekong Malaria Elimination programme, Myanmar remains the primary contributor of malaria cases, accounting for 95% of all indigenous cases and 99% of P. falciparum infections in the Greater Mekong subregion (GMS).
In 2023, global cases of P. knowlesi increased by 18.9%, totalling 3290 reported cases, with indigenous cases rising by 22% from the previous year. Malaysia remains the principal contributor, accounting for 87.4% of these cases and reporting all 14 indigenous deaths due to P. knowlesi.
The resurgence of malaria in the Islamic Republic of Iran in 2022, after 4 years of zero indigenous cases, highlights the persistent risks of reintroduction and re-establishment. This situation underscores the importance of sustained political commitment, robust surveillance systems, timely responses to detected cases, rigorous intervention strategies and cross-border cooperation, particularly in areas with high transmission risk, to maintain malaria free status and prevent re-establishment.
Vaccines
In December 2023, WHO added R21 to its list of prequalified vaccines, marking another milestone in the global malaria response. R21 is the second malaria vaccine to be prequalified by WHO, following the prequalification of RTS,S in July 2022. The WHO-led prequalification process ensures that vaccines and other medical products meet global standards of quality, safety and efficacy.
In 2024, Ghana, Kenya and Malawi continued to offer the malaria vaccine through the routine childhood immunization platform, with support from Gavi, the Vaccine Alliance (Gavi), WHO and other partners. By early November 2024, an additional 13 countries were offering malaria vaccines subnationally. More countries are planning introductions in the coming months, and others are preparing for scale-up, prioritizing areas of moderate and high transmission. Demand for the vaccine remains high, and supply is sufficient to meet demand.
The scale-up of malaria vaccines in Africa is expected to save tens of thousands of young lives every year. As with all malaria prevention tools, the highest impact will be achieved when the vaccines are introduced as part of a mix of WHO-recommended malaria interventions that are tailored to the local context.
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