Malaria Surges Despite Vaccines, Experts Warn of Drug and Mosquito Resistance

Malaria cases are rising globally despite the rollout of vaccines, raising concerns among public health experts. According to the World Health Organization (WHO), there were 282 million malaria cases in 2024, a 3 percent increase from 2023, with an estimated 610,000 deaths compared to 598,000 the previous year. Experts warn that vaccines alone will not be sufficient to curb the disease, which remains one of the deadliest infectious illnesses in human history.

Jane M. Carlton, PhD, director of the Johns Hopkins Malaria Research Institute and Bloomberg Distinguished Professor at the Johns Hopkins Bloomberg School of Public Health, highlighted the ongoing challenges in controlling malaria. “Malaria is one of the big three global infectious diseases… one of the deadliest and most burdensome in human history,” Carlton said. She emphasized that drug resistance, mosquito resistance, and evolving parasite strains continue to undermine global malaria control efforts.

The WHO has reported the spread of resistance to artemisinin-based antimalarial drugs, the last effective frontline treatment. Resistance has now been confirmed in at least eight African countries, with early signs that partner drugs combined with artemisinin are losing efficacy. In addition, Anopheles stephensi mosquitoes have developed resistance to common insecticides, while some malaria parasites carry gene deletions that reduce the reliability of rapid diagnostic tests.

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Vaccines, including RTS,S and R21, have provided important protection, preventing tens of thousands of deaths. However, experts note that these vaccines are not fully effective and require four doses to achieve optimal results, creating logistical challenges in rural or resource-limited regions. Carlton stressed that vaccines are most effective when combined with other interventions, including bed nets, chemoprophylaxis, and improved treatment regimens.

Recent advancements offer some hope. WHO reported that the introduction of vaccines and other interventions may have saved around one million lives in 2024. A new antimalarial treatment in development, ganaplacide/lumefantrine (GanLum), represents the first new drug class in over 25 years and could bolster efforts to combat resistant malaria strains.

Carlton called for a continued multi-faceted approach to malaria control. “It’s time to eliminate this disease, and such a goal is within reach,” she said. Experts emphasize that sustained global coordination, innovative tools, and integrated interventions are critical to reducing malaria’s burden and preventing further increases in infections and deaths.

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