Malaria control and elimination programs across the Southern African Development Community are facing simultaneous threats from climate shocks and a sudden contraction in international donor support. Over the past two years, case numbers have increased in the region, leading to reversals in hard-earned gains and threatening the World Health Organization’s target to eliminate malaria by 2030.
Four nations in the region—the Democratic Republic of Congo, Mozambique, Angola, and Tanzania—carry some of the world’s greatest malaria burdens, accounting for 22.9% of the global malaria burden combined. While national malaria programs remain overstretched and under-resourced, African malaria programs have largely depended on donor funding, with South Africa standing as one of the few exceptions by funding almost all of its own program.
US Funding Cuts Reduce Global Allocations
The global health funding landscape has grown increasingly unpredictable and rapidly evolving. The sudden end of US government funding in 2025 to support essential malaria control activities made it more difficult for the Global Fund to meet its replenishment target of US$18 billion for Grant Cycle 8.
Kandawe outreach clinic in Chinyonga village 🇲🇼: 5-month-old Ephridah got vaccinated. After the #malariavaccine, she will continue to use bednets as protection from malaria. pic.twitter.com/hcibmrepzX
Consequently, country allocations for the 2026–2028 grant cycle are on average 18% lower than previous allocations. Recipient countries now face difficult choices regarding who to protect, how, and where, as comprehensive coverage is no longer possible. Programs have had to scale back activities such as distributing insecticide-treated bednets, carrying out malaria indicator surveys, and using preventive drugs. While proven interventions for vulnerable populations are prioritized, elimination-focused activities are no longer a priority, driving up case numbers in countries including Mozambique, Nigeria, and Uganda.
Severe Floods Spike Regional Infection Rates
Extreme weather events have grown more frequent in the region, creating heightened risks for infectious disease spread. The La Niña weather system in early 2026 caused severe flooding across several Southern African Development Community countries, damaging infrastructure and displacing communities.
These floods directly spiked infection rates, driving up malaria numbers in Zimbabwe, Mozambique, and South Africa. Mozambique recorded a 55% increase in cases during the first six weeks of 2026 compared to the same period in 2025, while Zimbabwe reported 65,39 cases. Concurrently, the persistence of drug and insecticide resistance continues to challenge public health efforts, as treatments lose efficacy due to parasite adaptation, alongside a pressing need for genomics hubs to monitor parasite responses to interventions.
