In 2024, 610,000 people died of malaria, the vast majority children under five in Africa. Simultaneously, 47 countries are now officially certified malaria-free by the World Health Organization. Since 2000, 14 million deaths and 2.3 billion infections have been prevented. These figures reveal both how far humanity has come in a quarter century and where the critical gap remains.
From 108 to 80 endemic countries
At the turn of the millennium, malaria was endemic in 108 countries. Today that number is 80. The decline stems from a coordinated global strategy that gained momentum after 2000: insecticide-treated bed nets, artemisinin-based combination therapies, and comprehensive surveillance systems were brought to the poorest regions, funded by governments, the Global Fund, the Gates Foundation, and national health ministries.
WHO certification as a malaria-free country requires that a state record no locally transmitted cases for at least three consecutive years and maintain systems to detect and treat new cases. In 2024, two countries achieved this status, three more in 2025. The WHO now lists 47 certified countries and territories, including large parts of Europe, North Africa, and Southeast Asia.
The Mekong as proof of possibility
The most striking figures come from Southeast Asia. In the Greater Mekong Subregion—Cambodia, Laos, Myanmar, Thailand, and Vietnam—malaria cases fell 77 percent between 2012 and 2022, and deaths by 97 percent. According to the World Malaria Report 2025, this decline continued through 2024, to 70 percent fewer cases than 2012 levels.
Individual country data is even more dramatic: Laos reported just 328 malaria cases in 2024, a reduction of over 99 percent. Cambodia and Vietnam achieved 99 and 98 percent declines, respectively. What works in the region is cross-border coordination: shared surveillance systems, targeted monitoring of artemisinin resistance, and coordinated response to outbreaks across borders. The WHO Mekong Malaria Elimination Programme has documented these steps since 2012 in regular epidemiological reports.
95 percent of the burden lies in Africa
Progress in Asia, Europe, and parts of Latin America masks where malaria still kills. Ninety-five percent of all cases and 95 percent of all deaths occur in the WHO African Region. Of the 610,000 deaths in 2024, the vast majority were children under five. More than half of African mortality is concentrated in three countries: Nigeria accounts for 31.9 percent of deaths, the Democratic Republic of Congo for 11.7 percent, and Niger for 6.1 percent.
The 2025 World Malaria Report identifies three risk factors threatening progress. First, growing resistance of the malaria parasite Plasmodium falciparum to artemisinin therapies, particularly in parts of Africa. Second, climate change, which is pushing vector mosquitoes to new elevations and regions previously unaffected. Third, cuts in international funding that weaken surveillance systems and thin bed net programs. Without reliable financing, even certified malaria-free status can reverse.
In comparison: What smallpox and polio taught
If the elimination strategy succeeds, malaria would be the second human infectious disease to be globally eradicated. The first was smallpox. In 1967, the WHO documented ten to 15 million smallpox cases worldwide. On May 8, 1980, the World Health Assembly declared the disease eradicated—the only time in human history an infectious disease completely disappeared.
Polio demonstrates how near and how distant eradication can be. In 1988, the WHO counted 350,000 polio cases annually across 125 endemic countries. Today fewer than 200 cases remain in two endemic regions, Pakistan and Afghanistan—a reduction exceeding 99 percent. Both examples teach the same lesson. Elimination requires global coordination, reliable funding over decades, and political will even when case numbers are very low and the disease is no longer a priority for wealthy countries.
90 percent by 2030: What this target means
The WHO has set clear targets for 2030: 90 percent reduction in malaria incidence and mortality compared to 2015 levels, coupled with a decline in endemic countries from today's 80 to fewer than 40. According to the 2025 World Report, progress lags behind this pace. Climate extremes and international funding gaps have left shortfalls.
What could close the gap: Since 2024, the first approved malaria vaccine, RTS,S, has been running in 25 African countries' routine immunization programs. A second vaccine, R21, which achieved over 75 percent efficacy in early trials, is being scaled up. The WHO 2026 campaign reads: "Driven to End Malaria: Now We Can. Now We Must." The phrase sounds like a slogan. It is also a question of funding.