How is malaria transmitted?

Malaria is transmitted to humans through the bites of infected female Anopheles mosquitoes, which bite predominantly between dusk and dawn. Five Plasmodium parasite species infect humans; P. falciparum causes the most deaths. Malaria is not transmitted person-to-person; the mosquito is an essential vector. It can also be transmitted through blood transfusion, organ transplantation and from mother to child during birth.

Who is most at risk from malaria?

Children under five in sub-Saharan Africa face the greatest risk — they account for about 76% of all malaria deaths. Pregnant women are also at high risk, as malaria in pregnancy causes maternal anaemia, low birth weight and premature birth. People without prior exposure (non-immune travellers) can develop rapidly severe disease. People with sickle cell trait have some natural protection against P. falciparum.

What are the symptoms of malaria?

Symptoms of uncomplicated malaria typically begin 7-10 days after an infected mosquito bite and include: fever (often cyclical), chills and rigors, headache, muscle aches, nausea and fatigue. Severe malaria — mainly caused by P. falciparum — can include cerebral malaria (altered consciousness, seizures), severe anaemia, acute respiratory distress, kidney failure and organ failure. Severe malaria can be fatal within 24 hours if untreated.

Is there a vaccine for malaria?

Yes — two vaccines are now WHO-recommended. RTS,S/AS01 (Mosquirix, GSK) was the first-ever vaccine against a human parasitic disease, recommended by WHO in 2021. R21/Matrix-M (Oxford/Serum Institute of India) was recommended in 2023 and is cheaper to produce. Both target P. falciparum and provide approximately 50-75% efficacy against clinical malaria in young children over the first year. They are being rolled out across sub-Saharan African childhood immunisation programmes.

How is malaria treated?

Artemisinin-based combination therapies (ACTs) are the recommended first-line treatment for uncomplicated P. falciparum malaria. ACTs combine a fast-acting artemisinin derivative with a longer-acting partner drug to ensure parasite clearance. Severe malaria is treated with parenteral artesunate (IV or IM). P. vivax malaria is treated with chloroquine plus primaquine (to prevent relapse). Rapid diagnostic tests (RDTs) allow accurate diagnosis in primary care settings without microscopy.

What is artemisinin resistance and why is it alarming?

Artemisinin resistance — reduced parasite clearance with artemisinin treatment — first emerged in South-East Asia and is now documented in parts of sub-Saharan Africa, particularly Rwanda, Uganda and Ethiopia. If resistance spreads and partner drug resistance co-emerges, ACTs could fail — potentially causing a catastrophic return to pre-ACT malaria mortality levels. WHO monitors resistance through its Global Malaria Programme and is accelerating the pipeline of new antimalarial medicines.

How do insecticide-treated nets prevent malaria?

Long-lasting insecticidal nets (LLINs) protect sleeping people by killing or repelling Anopheles mosquitoes that bite predominantly at night. Mass distribution campaigns — delivering nets free-of-charge through health systems and community campaigns — have been among the most cost-effective public health investments in history. LLINs contributed substantially to the 50% reduction in malaria mortality between 2000 and 2015. Pyrethroid resistance in mosquitoes is an emerging challenge, driving development of next-generation nets.

What is the connection between malaria and traditional medicine?

Malaria provides perhaps the most famous example of traditional medicine leading to modern therapy. Artemisinin was isolated in 1972 by Chinese scientist Tu Youyou from Artemisia annua (sweet wormwood), used in Chinese traditional medicine for 2,000 years. This discovery led to the ACT revolution and earned Tu the 2015 Nobel Prize in Physiology or Medicine. Similarly, quinine — used for centuries in South American traditional medicine — became the first effective antimalarial.

How is malaria linked to climate change?

Climate change is altering the distribution, seasonality and transmission intensity of malaria. Higher temperatures accelerate parasite development within mosquitoes; changing rainfall patterns create new breeding sites; and warming expands the altitude range of Anopheles mosquitoes into previously malaria-free highlands in Africa and Asia. WHO projects significant shifts in malaria risk zones by 2050, complicating elimination programmes that have been designed around current epidemiology.

What is the WHO's End Malaria strategy?

The WHO Global Technical Strategy for Malaria 2016-2030 targets a 90% reduction in malaria case incidence and mortality by 2030, and elimination in at least 35 countries. Key pillars are: ensuring universal access to malaria prevention, diagnosis and treatment; accelerating efforts for elimination; transforming malaria surveillance into a core public health function; and harnessing innovation. Progress is severely off-track, requiring roughly doubling of the current $3.3 billion annual investment.

What is the Global Fund's role in malaria?

The Global Fund to Fight AIDS, Tuberculosis and Malaria is the largest multilateral financer of malaria programmes worldwide, disbursing billions annually for insecticide-treated nets, artemisinin-based treatments, rapid diagnostic tests and health system support. The US President's Malaria Initiative (PMI) is the largest bilateral malaria programme. Together, these mechanisms have enabled the massive scale-up of malaria interventions that drove mortality down 50% from 2000 to 2015.

How does GMJ News cover malaria?

GMJ News follows WHO World Malaria Report data, RTS,S and R21 vaccine rollout progress, artemisinin resistance monitoring, and the intersection of malaria with climate change. While Georgia is not malaria-endemic, imported malaria cases and the public health relevance of global disease control to PHIG's international work make this an important area of coverage for the Georgian Medical Journal.

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Malaria

GMJ News knowledge hub · last reviewed September 2026 · Georgian Medical Journal

Summary Statistics Glossary GMJ news FAQ Documents Organizations Research

Malaria still causes about 263 million cases and nearly 600,000 deaths a year — around 95% in Africa, most of them children under five (WHO World Malaria Report 2024). After decades that halved mortality through insecticide-treated nets, rapid tests and artemisinin-based therapy, progress has stalled against funding gaps, insecticide and emerging artemisinin resistance. Hope now rides on the first-ever malaria vaccines — RTS,S and the cheaper, highly effective R21/Matrix-M — rolling out across African childhood immunization programmes, alongside next-generation nets. The artemisinin story itself, from traditional Chinese medicine to Nobel Prize, remains global health's defining tradition-to-therapy translation.

Key messages

Scale

Malaria caused about 263 million cases and 597,000 deaths in 2023 — nearly all in Africa, and more than two thirds of deaths in children under five (WHO World Malaria Report 2024).

Vaccine era

The WHO pre-qualified RTS,S/AS01 (Mosquirix) malaria vaccine in 2021 and recommended the second vaccine R21/Matrix-M in 2023 — the first disease-specific vaccines to protect against a parasitic infection.

Artemisinin resistance

Resistance to artemisinin — the backbone of first-line malaria treatment — is now documented in parts of sub-Saharan Africa as well as South-East Asia, threatening the therapeutic gains of the last two decades.

Climate link

Climate change is expanding the geographic range and seasonality of Anopheles mosquitoes, putting new populations at risk and complicating malaria elimination programmes.

COVID-19 setback

The pandemic caused the worst disruption to malaria services in 20 years — malaria deaths spiked by 15% in 2020 before recovering slowly. Supply chain and health worker disruptions were the main drivers.

End Malaria goal

The WHO Global Technical Strategy for Malaria 2016-2030 targets a 90% reduction in malaria incidence and mortality by 2030. Progress is severely off-track and will require roughly doubling current investment.

Key statistics

263M

malaria cases (2023)

WHO WMR 2024

597K

malaria deaths (2023)

WHO WMR 2024

95%

of cases in Africa

WHO WMR 2024

76%

of deaths in under-5s

WHO WMR 2024

licensed malaria vaccines

WHO 2023

billion at risk globally

WHO

Malaria deaths per year (thousands) 2000-2023 — WHO World Malaria Report

Source: WHO World Malaria Report (annual series). Includes COVID-19 disruption spike 2020.

Glossary of key terms

Plasmodium falciparum
WHOThe most dangerous malaria parasite species — responsible for the great majority of severe malaria and deaths. Predominantly found in sub-Saharan Africa. Now showing artemisinin resistance in Africa.

Artemisinin-based combination therapy (ACT)
WHOThe recommended first-line treatment for P. falciparum malaria — combining artemisinin derivatives (fast-acting) with a partner drug (longer-acting). Backbone of global malaria treatment since the 2000s.

Insecticide-treated nets (ITNs)
WHOBed nets treated with insecticide to kill or repel Anopheles mosquitoes during sleeping hours. One of the most cost-effective public health interventions — responsible for a substantial share of the 50% malaria mortality reduction 2000-2015.

RTS,S / R21
WHOThe two WHO-recommended malaria vaccines: RTS,S/AS01 (Mosquirix, GSK) and R21/Matrix-M (University of Oxford/Serum Institute of India). Both target the P. falciparum circumsporozoite protein and provide partial but significant protection in young children.

Artemisinin resistance
WHOReduced susceptibility of P. falciparum to artemisinin — now documented in parts of Africa (East Africa, Rwanda, Uganda, Ethiopia) as well as South-East Asia. Threatens the efficacy of ACT globally.

IRS
WHOIndoor Residual Spraying — the application of long-lasting insecticide to the walls of homes. Kills mosquitoes that rest indoors after feeding. Used in targeted malaria control and elimination programmes.