News and Insights

As part of the fight against malaria in West Africa, national budgets are replacing the suspended international aid

April 25, 2025

Malaria caused nearly 597,000 deaths in 2023, with 95% of these occurring on the African continent, according to the World Health Organization (WHO^[1]). The disease affected approximately 263 million people worldwide that year—11 million more cases than in 2022. Africa remains the hardest-hit region, accounting for 94% of all global cases.

In West Africa, the situation is especially concerning. Nigeria alone accounts for over 26% of global malaria cases and more than 30% of malaria-related deaths. It is followed by the Democratic Republic of Congo, Uganda, and Mozambique^[2]. Although the number of deaths is decreasing, the persistent rise in cases underscores the urgent need to intensify prevention and treatment efforts.

For nearly two decades, the fight against malaria in the region received substantial support from international partners, notably the United States through the Global Fund to Fight AIDS, Tuberculosis and Malaria and the U.S. President’s Malaria Initiative (PMI).  But, in January 2025, President “Trump ordered a 90-day pause in foreign development assistance pending a review of efficiencies and consistency with his foreign policy”^[3].  The decision has sparked significant concern from organizations such as Malaria No More a global nonprofit organization dedicated to ending malaria deaths. In a statement issued on February 27, 2025, CEO Martin Edlund emphasized that halting these programs would lead to outbreaks and an exponential increase in deaths. “New modeling indicates that a year of disruptions could result in nearly 15 million additional malaria cases and 107,000 additional deaths”, says the statement. Edlund urged the administration to restart these life-saving programs before outbreaks worsen^[4].

Opinions in West Africa are divided over the U.S. aid suspension.

“Malaria is one of the main causes of death in healthcare facilities across Africa. Suspending aid weakens local health infrastructure, which often relies on this funding to operate effectively. As a result, efforts to reduce malaria-related mortality are compromised, which could lead to an increase in deaths—particularly among children and pregnant women,” explained Fogue Foguito, Executive Director of Positive-Generation, a Cameroonian organization promoting health and human rights, to FINN Partners.

“Africa was never meant to rely on America or any external source to fight malaria. The malaria scourge is an endemic problem in Africa, and the continent accounts for more than 90% of global malaria cases and deaths. American society does not have as many malaria cases as Africa, nor as many mosquitoes. This is, therefore, an African problem,” said Francis Nwapa, Coordinator of the #EndMalariainNigeria campaign, an advocacy platform promoting a unified approach to ending malaria in Nigeria, to FINN Partners.

A Rise in National Budget Commitments

In response to the international funding cut, several West African governments reacted quickly. Nigeria allocated an additional $200 million to its health budget, with a focus on supplying vaccines and treatments for epidemic diseases. This budget increase, approved on February 14, 2025, aims to offset the impact of frozen U.S. funds, especially in areas already weakened by conflict.

In Cameroon, Health Minister Dr. Manaouda Malachie assured that services for treating malaria, HIV, and tuberculosis would continue uninterrupted. A series of assessments was launched to anticipate the impact of the suspension and to adjust national resources accordingly.

In Ghana, the Finance Minister was tasked with mobilizing new resources to fill the gap left by the suspended aid, prioritizing maternal health, malaria prevention, and HIV/AIDS control programs.

Similarly, in an open letter^[5], Presidents Umaro Sissoco Embaló (Guinea-Bissau) and Duma Gideon Boko (Botswana), outgoing and incoming chairs of the African Leaders Malaria Alliance (ALMA), emphasized the need for strong political commitment and increased national funding to support malaria control programs.

Beyond financial and political responses, some professionals believe that fighting diseases like malaria also requires a structural and environmental approach.

“Malaria is as much an environmental issue as it is a health issue. The vector that transmits malaria is the mosquito. We can fight mosquitoes by interrupting their transformation from larvae to adult. This stage can be disrupted by ensuring water is properly managed,” says Nwapa of #EndMalariainNigeria. He adds: “In Nigeria and other African countries with the highest number of malaria cases, drainage systems are poor. If we ensure our drainage infrastructure is built to prevent water blockage, we will have eliminated a large proportion of mosquitoes by removing their breeding grounds.”

A Glimmer of Hope

Despite budget constraints and reduced international support, there is a glimmer of hope for malaria eradication in Africa. In February 2025, during the African Union General Assembly, the African Leaders Malaria Alliance (ALMA) published a report^[6] stating that Cabo Verde and Egypt were certified malaria-free by the World Health Organization (WHO) in 2024.

Egypt was declared malaria-free on October 20, 2024, after demonstrating that local transmission by Anopheles mosquitoes had been interrupted for at least three consecutive years. Previously, Algeria had been certified malaria-free by the WHO on May 22, 2019, after proving that local transmission had also been interrupted for three consecutive years.

On the occasion of World Malaria Day 2025, themed “Malaria Ends with Us: Reinvest, Reimagine, Reignite”, these achievements take on deeper meaning. They serve as a reminder that while international solidarity remains essential, a sustainable response to malaria also requires strong local political commitment, better mobilized national resources, and enhanced regional cooperation.

^[1] https://www.who.int/teams/global-malaria-programme/reports/world-malaria-report-2024

^[2] https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/world-malaria-report-2024-spreadview.pdf?sfvrsn=3ccb3695_3

^[3] https://www.theguardian.com/us-news/2025/jan/24/foreign-aid-israel-egypt?utm_source=chatgpt.com

^[4] https://www.malarianomore.org/news/malaria-no-more-statement-on-the-administrations-termination-of-usaid-malaria-programs/

^[5] https://www.cabi.org/news-article/presidents-write-for-scidev-net-on-urgent-need-to-eradicate-deadly-malaria-affecting-millions-in-africa/

^[6] https://alma2030.org/fr/chefs-detat-et-de-gouvernement/rapport-detape-de-lunion-africaine-sur-le-paludisme/2024-africa-malaria-progress-report/?highlight=egypte