Since the year 2000, the fight against malaria in Africa has mobilized billions of dollars in funding and involved massive deployment of preventative and curative interventions across the continent. It has been ten years since the last effort to comprehensively evaluate the impact of these control efforts, a period of faltering progress. An increasingly complex landscape of new tools, rising threats, and geopolitical uncertainty means there is an urgent need to understand the ongoing impact of malaria control in Africa, why impetus had been lost and to identify if, how and where momentum is being regained.
Here, we present a geotemporal modelling analysis of 25 years of data on malaria disease burden and intervention coverage across Africa. We estimate that malaria control has averted 1.57 billion cases and 6.2 million deaths in Africa since the year 2000, primarily driven by vector control (77% of cases and 58% of deaths averted). Stalled progress since 2015 is largely explainable by plateauing intervention coverage, exacerbated by rising insecticide resistance, although the latter is being strongly counteracted by next-generation vector control tools. Despite flatlining trends, malaria control continues to avert enormous burden each year among a growing population – with more cases averted in 2024 (134M) than any year in history. Sustained funding and ongoing innovation in malaria control can continue to avert substantial loss of life in Africa.