Several African nations, including Botswana, Namibia, and Zimbabwe, have seen a significant resurgence of malaria cases. Botswana, which recorded 290 cases and one death in 2024, saw 2,223 cases and 11 deaths in the first 23 weeks of 2025. Namibia reported over 95,000 cases in 2025, and Zimbabwe more than 156,000, according to government figures.
This increase is attributed to a combination of factors, including a rapid decline in external funding for malaria, the evolution of mosquitoes resistant to traditional insecticides, and confirmed or suspected partial resistance to frontline medicines in eight African countries. Severe weather events, such as flooding and higher temperatures, are also contributing to increased mosquito populations and malaria cases.
The Africa Centres for Disease Control and Prevention notes a 70% fall in health assistance to Africa since 2021. The Organisation for Economic Cooperation and Development projects a further fall of between 29% and 46% in aid for health by the end of 2026. The Global Fund's latest replenishment raised $12.64bn against an $18bn target, leading to reduced allocations for countries.
In response, African leaders adopted the Accra declaration in July, committing to finance their own health systems and reduce reliance on external funding. They also reaffirmed the Abuja declaration, which pledges 15% of national budgets to health. Modelling by the African Leaders Malaria Alliance and Malaria No More UK suggests a 30% cut in malaria funding could result in 146 million additional cases and 397,000 deaths across sub-Saharan Africa by 2030.
Some African countries are already increasing domestic health spending. Benin raised its malaria budget from $1.7m to $6.3m by 2025, and Ghana expects domestic funds to cover 72% of its health spending in 2026. End Malaria councils and funds in 14 countries have raised over $245m from various sources.
Botswana's President and Chair of the African Leaders Malaria Alliance, Duma Gideon Boko, is urging the World Bank to implement a second Malaria Booster Programme. This would provide bridge financing to support countries in their transition to sustainable domestic funding for health, aiming to prevent further malaria resurgences.