Malaria has long been one of Africa’s toughest health challenges, and while enormous progress has been made over the last two decades, the disease continues to evolve in ways that demand fresh thinking. The latest Annual Report of the WHO Africa Region (2025) reminds us that the continent still carries the overwhelming share of the global malaria burden. In 2023 alone, Africa accounted for 94% of malaria cases and 95% of related deaths worldwide. The most heartbreaking reality is that children under the age of five remain the most affected, representing nearly three-quarters of all malaria deaths.
For many countries, including Ghana, this story is familiar. Tremendous gains have been achieved through the widespread use of insecticide-treated bed nets, better diagnostic tools, effective treatment options, and, more recently, the rollout of malaria vaccines. Yet progress has slowed, and in some areas, the tide is beginning to turn. The WHO notes that climate change, urbanization, and the growing resistance of mosquitoes to insecticides are complicating efforts, threatening to undo years of hard-won success.
Shifting Realities in Ghana
Ghana is often cited as a leader in malaria research and control efforts, but even here, the disease is finding new ways to persist. A recent study conducted in Accra revealed a troubling trend: urban farming, particularly irrigated vegetable farms, is fueling malaria transmission in the city. The researchers found that these small-scale farms, often located in low-lying neighborhoods, create standing water that becomes a breeding ground for mosquitoes.
The data showed that communities near irrigated farms recorded higher numbers of mosquitoes indoors, increased mosquito feeding on humans, and greater infection rates with the malaria parasite compared to non-farming areas. These findings disrupt the common perception that malaria is mostly a rural disease. Instead, they highlight that malaria is also an urban public health problem, made worse by rapid population growth, poor drainage systems, and inadequate urban planning.
A Regional Call to Action
In the annual report, the WHO Regional Director stressed that malaria remains a flagship priority for the African Region. Beyond strengthening the distribution of nets and medicines, the report calls for smarter surveillance systems to track outbreaks in real time, and for countries to invest in integrated vector control that combines multiple approaches to stay ahead of insecticide resistance.
For Ghana, this means going beyond existing measures and taking a closer look at environmental and social factors that shape malaria risk in both rural and urban areas. Addressing malaria in farming communities, informal settlements, and flood-prone neighborhoods will require close collaboration between health authorities, city planners, farmers, and residents themselves.
Looking Ahead
The message is clear: malaria in Africa is not standing still, and neither can the response. While vaccines and medicines remain critical, they are only part of the solution. Climate resilience, urban planning, and sustained investment in health systems are equally important if countries like Ghana are to maintain progress.
