NIGERIA continues to lead the world in malaria cases and deaths, despite decades of global and domestic investments, according to the latest World Malaria Report 2024 released by the World Health Organization (WHO).
The report draws on 2023 data from 83 malaria-endemic countries, including the territory of French Guiana, while also presenting trends in malaria morbidity and mortality globally and by region.
The report, which highlighted the 2023 global malaria incidence, shows that Nigeria accounted for 26 per cent of global malaria cases, again making it the most malaria-affected nation worldwide.
Out of the estimated 263 million malaria cases recorded globally in 2023, Nigeria accounted for 68 million (68,136,000). DRC Congo followed suit with 33 million cases. Uganda had over 12 million people affected by the disease in 2023, while Ethiopia logged 9.5 million of the global reported cases of the disease.
This shows that the four countries are among the 11 ‘High Burden to High Impact (HBHI)’ countries, a group responsible for 66 per cent of global malaria cases and 68 per cent of deaths in 2023.
Others are Mozambique (9.2 million), United Republic of Tanzania (8.5 million), Angola (8.2 million), Mali (8.2 million), Burkina Faso (8.1 million), Niger (7.9 million), and Côte dʼIvoire (7.8 million).
Nigeria also ranked highest in malaria-related deaths, contributing significantly to the 597,000 global fatalities. The WHO African Region, which includes Nigeria, accounted for 94 per cent of the total global malaria burden and 95 per cent of deaths.
Four African countries accounted for just over half of all malaria deaths globally, with Nigeria having 30.9 per cent, and the Democratic Republic of the Congo having 11.3 per cent. Niger (5.9 per cent) and the United Republic of Tanzania (4.3 per cent) are the two other nations that accounted for 10 per cent of the cases.
While mortality from malaria has declined slightly over the past three years globally, from 622,000 in 2020 to 597,000 in 2023, according to the latest WHO report, Nigeria’s data remain high, especially among children under five and pregnant women.
According to WHO estimates, the country also recorded the largest number of under-five malaria deaths.
11 million more global malaria cases between 2022 and 2023
Meanwhile, the 2023 data shows a global increase of 14 million malaria cases compared to 2022. In 2022, the world recorded 249 million cases of malaria, with Nigeria accounting for 26.8 per cent of the cases.
Although Nigeria’s share slightly declined to 25.9 per cent in 2023, the country still recorded 66.7 million cases, representing an increase of over 1.4 million compared to the previous year. WHO noted that this rise might be mainly attributed to population growth.
DRC Congo, Uganda, Mozambique and Angola joined Nigeria as the most hit nations.
“Between 2000 and 2019, the number of annual estimated malaria cases remained stable, varying between 227 million and 248 million across the 108 countries that were malaria endemic in 2000.
“Since 2020, the number of estimated malaria cases has steadily increased, and most of this increase occurred in countries in the WHO African Region (89.7 per cent) and the WHO Eastern Mediterranean Region (15.5 per cent),” the report added.
Nigeria’s health infrastructure, compounded by the impacts of climate change and ongoing internal displacement due to conflict, is said to worsen the malaria crisis.
A missed target
The Global Technical Strategy for Malaria 2016–2030 (GTS), introduced by WHO, seeks a 75 per cent reduction in both malaria case incidence and mortality by 2025. However, the country, among many other African countries, remains far from the target.
The report warned that the 2023 malaria incidence globally was nearly three times higher than what was required to meet the GTS benchmark.
In 2023, 12.4 million pregnant women in 33 moderate to high transmission countries in the WHO African Region were estimated to be infected with malaria.
Despite interventions such as the intermittent preventive treatment of malaria in pregnancy (IPTp), uptake remains critically low, with only 44 per cent of pregnant women in 34 African countries, including Nigeria, receiving the recommended three or more doses of IPTp.
Global investment, local shortfalls
In 2023, global funding for malaria control and elimination totalled US$4.0 billion, with 75 per cent of that directed to the African region.
However, the WHO warned that despite these inflows, a US$4.3 billion global funding gap still existed, with only 48 per cent of the required investment for 2023 being met.
This has translated to under-resourced primary healthcare, delayed or unavailable malaria treatments, and gaps in preventive tools like insecticide-treated nets (ITNS)
The WHO emphasised that an effective malaria response in Nigeria and other affected African countries must address systemic inequities, strengthen health systems, and improve access to prevention and treatment tools for vulnerable populations, including children, pregnant women, indigenous peoples, and people with disabilities.
Usman Mustapha is a solution journalist with International Centre for Investigative Reporting. You can easily reach him via: umustapha@icirnigeria.com. He tweets @UsmanMustapha_M