For decades, global efforts towards the eradication of malaria, especially in sub-Saharan Africa, have focused essentially on West and Central Africa, where the disease is most endemic.
The WHO African Region accounts for about 95% of global malaria cases and deaths. More than half of all malaria deaths in the region occur in Nigeria (31.9%), the Democratic Republic ofย Congo (11.7%) and Niger (6.1%). Children under 5 years of age account for about 76% of malaria deaths in the region.
To stem the tide of malaria cases across Africa, the global health body has recommended a wider use of the RTS,S/AS01 malaria vaccine among children living in regions with moderate to high malaria transmission by the Plasmodium falciparum โ a parasite that causes 95% of all malaria infections in Africa. It’s transmitted to humans through the bites of infected female Anopheles mosquitoes.
The WHO warned in April 2025 that recent funding cuts were jeopardising malaria control efforts, with more than half of malaria-endemic countries surveyed reporting moderate or severe disruptions to malaria services.
A study published in The Lancet found that the RTS,S/AS01 malaria vaccine reduced all-cause mortality among vaccine-eligible children by 13.2% in pilot programs in Ghana, Kenya and Malawi.
A changing disease landscape
Malaria transmission is most efficient within temperature ranges common across many tropical regions of West and Central Africa, according to a new study published in the journal Nature.
Malaria transmission by mosquitoes usually peaks at temperatures of around 25 degrees Celsius (77 Fahrenheit) and becomes much less likely when temperatures drop below 16 degrees or rise above 34 degrees Celsius, largely because the malaria parasite must complete part of its life cycle inside the mosquitoย โย a process that is highly temperature-dependent.
Because of this, malaria transmission has historically been most favourable across many tropical parts of West and Central Africa, where temperatures frequently fall within the range most suitable for transmission.
In contrast, some parts of Southern Africa and the highlands of East Africa have historically remained cool enough to keep the spread of malaria at bay, preventing the disease from becoming a major public health burden.
That, however, is beginning to change. The Nature study found that rising temperatures are making parts of southern Africa and high-elevation areas of East Africa increasingly suitable for malaria transmission, while parts of West Africa are becoming too hot for optimal transmission.
What does this mean for the continent?
Climate change is not only heating up the continent, it’s redistributing risks, says Olugbenga Mokuolu, professor of pediatrics at Nigeria’s University of Ilorin.
Although West African countries like Nigeria fall under areas that are “too hot for malaria to thrive, this is not good news to celebrate either, because a world that’s too hot for malaria is not a good world for children’s health overall,” Mokuolu, who also serves as an advisor to the Nigerian Minister of Health on malaria elimination, told DW.
“The same heat that’s inconvenient for mosquitoes is dangerous for people,” he added, noting that climate is “not the primary driving factor of malaria. Funding, drug and insecticide resistance, and health system strength still matter more.”
Olugbenga continued that the elimination and prevention of malaria on the continent could become “a story of two very different regions: West and Central Africa may get a small, unplanned assist from climate, while East and Southern Africa, historically lower-burden areas, face a growing new threat that could undo hard-won gains.”
Are African health systems keeping pace?
Climate change is fundamentally changing the geography of disease on the continent, Olumide Idowu, founder of the International Climate Change Development Initiative, told DW.
Idowu added that many African countries have developed adaptation plans but implementation has lagged behind the pace of climate change.
Although Africa is one of the lowest contributors to greenhouse gas emissions, it remains one of the most vulnerable regions to climate change โ posing systemic threats to the economy, infrastructure, and even its fragile health systems.
Idowu mentioned that without a significant increase in “investment at home, reinforcement of local institutional capacity and embedding health as a core pillar of climate resilience, many African countries risk being unprepared for the changing epidemiological landscape that climate change is creating.”
The regions expected to be hardest hit are also regions less accustomed to fighting malaria today, the study revealed.
“Governments, health systems and communities must adapt to this evolving threat, including getting ready now to run more aggressive anti-malaria programs in cooler areas where risk is rising,” Olugbenga said.
He also urged countries in West and Central Africa to sustain malaria elimination efforts, warning that resistance to insecticides and drugs, funding gaps and weak health systems could easily negate any reduction in malaria transmission associated with rising temperatures.
Edited by: Keith Walker