Malaria is a terrible disease in Malawi. It kills thousands of people each year, disproportionately affecting infants and young children. Millions of Malawians come down with malaria every year, bringing misery and incapacitation. Typical symptoms include fever, chills, vomiting, weakness, headaches, and muscle aches. Without effective treatment, an infection can persist for weeks—and severe malaria can become life-threatening very quickly.

Individuals suffer from malaria, but so does the country as a whole. In 2024, malaria accounted for 32% of outpatient visits and 16% of hospitalizations in Malawi—an extraordinary burden on an already stretched health system. And someone sick with malaria often can’t work, go to school, farm, or take care of a household. One analysis estimated the overall economic burden of malaria in Malawi at the equivalent of roughly 1.7% of GDP.

Fortunately, over the last twenty years, there has been impressive progress in combating malaria on multiple fronts.

• Diagnostics and medicines have become much more effective, affordable, and widely available. A simple rapid diagnostic test can now confirm malaria in minutes, and modern antimalarial drugs can usually treat an uncomplicated case in just a few days.
• The distribution and use of insecticide-treated bed nets has become widespread, protecting people during the nighttime hours when malaria-carrying mosquitoes are most likely to bite.
• Indoor residual spraying—carefully applying insecticide to the interior walls of homes in high-risk areas—has also proven effective at reducing transmission.
• And most recently, after decades of research and failed attempts, malaria vaccines for young children have become a reality and are being rolled out in Malawi.

GAIA’s mobile clinics help bring these advances to some of Malawi’s most remote, high-burden communities. Our teams routinely test patients for malaria and provide immediate treatment. They also provide malaria prevention and care during pregnancy. This is particularly important because malaria in pregnancy can contribute to severe anemia, low birth weight, premature delivery, and other serious complications for both mother and baby.

This “all hands on deck” approach is producing results. Over the past two decades, malaria deaths in Malawi have fallen by more than half, even as the country’s population has grown substantially. Parasite prevalence has also declined significantly.

The most recent numbers are particularly encouraging. Malawi reported a steep decline in malaria incidence between 2024 and 2025. The Ministry of Health and WHO point to the massive distribution of insecticide-treated bed nets in 2024–25, along with other malaria-control measures, as important contributors. Malaria can fluctuate substantially from year to year, however, and rainfall, temperature, nutrition, access to treatment, and other factors can also affect transmission and outcomes. We will need more time to know how much of the recent improvement will be sustained.

So while malaria remains a major problem in Malawi, real progress is being made in the battle against the Anopheles mosquito and the parasite it carries. Mosquitoes are sometimes called the “world’s deadliest animal,” and the comparison is startling: shark attacks kill roughly six people globally in an average year, while mosquito-borne diseases kill more than 600,000.

There is an encouraging historical precedent. The United States once suffered extensively from malaria, particularly in the South. When the Centers for Disease Control and Prevention was established in 1946, malaria control was one of its principal missions. By 1951, malaria had been eliminated as a significant public health problem in the United States.

Today, Americans mostly encounter domestic malaria in the history books.

Someday, we hope in the not-too-distant future, Malawians will be able to say the same thing.

We have better tools than ever before: effective medicines, rapid diagnostics, insecticide-treated bed nets, targeted mosquito control, preventive treatment, and now vaccines. The challenge is getting those tools to every community that needs them.

That is a challenge we can solve.