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Citizen Posts
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The graveyard in that small northern Ugandan village is a quiet injustice. Tiny graves, each with a single wooden cross, line the red earth. In one of them is Amos, three years old. He did not die for lack of science. He died because a fever that should have been preventable met a health system that was not ready, a house that let mosquitoes in at night, and a family for whom a bed net was a luxury they could not always afford.
Across East Africa, stories like Grace’s, the mother of Amos, a bright 7-year-old boy from northern Uganda, are tragically familiar. Amos’s laughter used to light up his home, but malaria struck him down one rainy season, robbing him of his childhood and leaving his mother in despair.
Malaria is an old enemy we understand intimately: the parasite, the mosquito vector, the tools that work. We have insecticide-treated nets, rapid diagnostic tests, effective drugs, and now even vaccines. Yet in 2023, there were an estimated 263 million malaria cases and nearly 600,000 deaths globally, the overwhelming majority in Africa. This persistence is not a failure of science. It is a failure of systems, financing, and political will.
The contrast with other parts of the world is sobering. In the early 20th century, the United States faced malaria as a major public health challenge. Yet through coordinated government-led campaigns, draining swamps, improving housing, vector control, and steady financing, malaria was eliminated as a domestic threat. Elimination was treated as a whole-of-government enterprise, not a donor project.
In Africa, by contrast, malaria control has too often been approached as a temporary campaign or externally funded project rather than as a permanent national infrastructure. This explains why malaria remains entrenched in Africa while America and much of Europe moved past it decades ago.
A closer look at financing tells an even more troubling story. Uganda allocates less than 0.5% of its annual health budget directly to malaria research, most of it directed at operational studies rather than innovation. Kenya spends approximately 0.6%, with most resources going to donor-supported projects rather than sustained national research programs.
Rwanda, often praised for its strong health systems, still dedicates under 1% of its health research budget to malaria-focused innovation. Compare this with the United States, which invested more than $770 million in malaria research through the National Institutes of Health (NIH) in 2022 alone.
The scale of difference is staggering: Africa, where over 90% of malaria cases and deaths occur, invests only a fraction of what high-income countries that eliminated malaria decades ago continue to spend on malaria science.
This imbalance has profound consequences. Instead of leading with African-driven innovations, we often remain dependent on solutions shaped elsewhere. Multinational pharmaceutical companies thrive on curative markets, selling millions of doses of antimalarial drugs each year, while preventive measures and local research receive little financing. These dynamic risks trap Africa in a cycle where treating malaria is more profitable than eliminating it, even as women and children continue to die unnecessarily.
But malaria elimination in Africa is possible. What is missing is not technology but the prioritization of malaria as a permanent national investment. Governments in Uganda, Kenya, and Rwanda must dramatically scale up domestic financing for malaria research, committing at least 5% of national health research budgets to malaria innovation over the next five years.
This funding should support community-driven solutions, such as locally designed mosquito-control technologies, housing improvements to block mosquito entry, and integration of indigenous knowledge with modern science.
The private sector also has an untapped role. Telecom companies, agribusiness, and local industries can be incentivized through tax breaks or public-private partnerships to invest in malaria elimination. Universities and innovation hubs, where young Africans are already building robots, drones, and AI systems, should be empowered to direct that ingenuity toward malaria surveillance, vector control, and vaccine delivery.
Donors and development partners must also change their approach. Malaria funding cannot remain donor-driven “projects” that rise and fall with grant cycles. Instead, they must align with national strategies, strengthen long-term systems, and invest in African-led research institutions that will own the solutions.
The lesson from the United States and other malaria-free nations is clear: malaria elimination must be treated as a nation-building priority, not a donor-funded program. East African governments must rise to the challenge by committing to sustainable financing, empowering communities to innovate, and building public-private coalitions that see malaria elimination not as charity but as a national imperative.
Grace, like millions of African mothers, does not need another temporary campaign or donor slogan. She needs assurance that her child’s death was not in vain, that Africa, with all its ingenuity and resilience, will finally make malaria not just controllable, but history.
The Writer Is a Global Health & Development Policy Expert
