- Severe flooding and changing environmental conditions contributed to increased malaria cases in parts of southern Africa during 2026, highlighting the need for stronger regional surveillance and preparedness.
- Scientific research, environmental intelligence and innovative health promotion can help malaria programmes anticipate risks and improve prevention, diagnosis and treatment.
- Sustainable malaria elimination requires effective leadership, resilient health systems, accessible healthcare services and coordinated regional collaboration.
Earlier this year, severe flooding across parts of southern Africa highlighted the connections between environmental conditions, human movement, and malaria risk. In the months that followed, malaria cases increased in Mozambique, Namibia, and South Africa.
In Gauteng, where malaria isn’t endemic, 414 cases and 11 deaths were reported during the first three months of 2026. Most infections occurred during travel to malaria-endemic areas, showing how changing transmission conditions can have consequences far beyond where infections occur.
Malaria is shaped not only by mosquitoes and parasites, but also by environmental conditions, human behaviour, population movement, healthcare access, and the capacity of health systems to respond. As the Southern African Development Community (SADC) commemorated SADC Malaria Day on 6 November, this year’s call to action – ‘Driven to End Malaria: Now We Can. Now We Must’ – was particularly relevant.
This year’s commemoration preceded the SADC Troika and regional health leadership meetings from 9 to 13 November 2026 in Durban, with South Africa chairing the SADC Ministerial Committee on Health. These meetings are an opportunity to advance shared regional health priorities, including malaria elimination, cross-border surveillance, sustainable health financing, and coordinated responses to emerging health threats.
The University of Pretoria Institute for Sustainable Malaria Control (UP ISMC) also participated in the SADC Malaria Day commemoration, reaffirming its commitment to regional collaboration and advancing malaria elimination through research, innovation, and capacity building.
Understanding an increasingly complex challenge
Southern Africa has made considerable progress in malaria control and elimination, yet sustaining these gains is increasingly challenging. Changing rainfall patterns, extreme weather, population mobility, insecticide and drug resistance, and financial pressures all influence the region’s ability to prevent and control malaria.
The relationship between climate and malaria is complex. Rainfall can create mosquito breeding conditions, while flooding may destroy habitats, disrupt health services, or displace communities. The consequences depend on local circumstances and interacting factors.
Across southern Africa, people routinely travel between areas with different malaria transmission levels for employment, trade, tourism, and family responsibilities. Infections acquired in malaria-endemic areas may only be recognised after travellers return to places where malaria is uncommon, and healthcare professionals may not immediately consider malaria in patients presenting with fever or other non-specific symptoms.
From scientific discovery to informed decisions
Scientific advances in parasite biology, mosquito behaviour, transmission dynamics, drug resistance, and environmental influences continue to create opportunities for malaria prevention and control. At the UP ISMC, researchers integrate biological, environmental, and health sciences to address these challenges.
Research into parasite biology helps identify vulnerabilities that may inform future treatments, while understanding mosquito ecology supports more effective vector control approaches. These insights are increasingly complemented by environmental intelligence.
Through initiatives such as the Remote Sensing for Malaria Control in Africa (ReSMaCA) programme, UP ISMC researchers are exploring how satellite observations, environmental monitoring, and predictive modelling can identify potential malaria risks and support proactive decision-making.
Integrating environmental, biological, and epidemiological information could help malaria programmes anticipate changing conditions, strengthen surveillance, and target interventions. However, sophisticated information has limited value if it does not reach decision-makers or translate into interventions that can be implemented, sustained, and accessed. The challenge is no longer only about generating knowledge, but ensuring that knowledge informs action.
Health promotion must go beyond awareness
Malaria is preventable and treatable, yet people continue to become seriously ill or even die because they do not recognise their risk or seek medical attention in time. The 2026 increase in travel-associated malaria cases demonstrates why communication must extend beyond endemic communities. Travellers need to understand their exposure, while healthcare professionals in non-endemic malaria settings must remain alert to malaria in patients with relevant travel histories.
While traditional awareness campaigns remain important, we must consider whether our approaches reach different audiences and respond to their beliefs, experiences, and realities. The UP ISMC has explored unconventional approaches to malaria awareness, reconsidering how scientific information is communicated and highlighting the importance of a transdisciplinary approach.
A recent collaboration with UP’s School of the Arts saw undergraduate music students develop malaria-inspired compositions, engaging audiences beyond conventional scientific and public health platforms. Two collaborations with the Department of Consumer and Food Sciences (2025 and 2026) demonstrated how food can be used as a creative tool to raise awareness about malaria.
In 2015, a collaboration with the Department of Drama looked at creative ways to communicate health messages to young children, and during the COVID-19 pandemic, Fine Arts provided a platform for communicating malaria awareness and environmental health messages through visual art.
Importantly, awareness must be accompanied by access to services. The regional call for ‘Timely Access to Malaria Services, Everyone’s Right’ emphasises that people cannot act on health information if prevention, testing, or treatment remain inaccessible.
Leadership connects knowledge with implementation
Translating evidence into action requires effective leadership and management. Malaria programmes face competing priorities, limited resources, and changing conditions. Success depends on interpreting evidence, coordinating responses, managing resources and working across disciplines, and institutional and national boundaries.
Over the past five years, the Advanced Leadership Programme for the Elimination of Malaria (ALPEM) – delivered through the UP ISMC and the Gordon Institute of Business Science and other partners – has supported leadership and management capacity development among malaria professionals from nine southern African countries.
The programme recognises that technical expertise must be complemented by practical skills in decision-making, planning, and implementation, alongside regional networks and shared learning. Sustainable elimination also requires institutions that retain expertise, maintain partnerships, and sustain interventions beyond individual projects or funding cycles.
The regional theme ‘Resilient Health Systems and Communities Key to Malaria Elimination’ captures this responsibility. Resilience means anticipating challenges, adapting to changing circumstances, and maintaining essential services under pressure.
Knowing more must lead to doing better
The experiences of 2026 reinforce an important lesson: malaria elimination cannot be achieved through isolated interventions or scientific advances alone. Environmental intelligence must inform preparedness. Research must support practical interventions. Health promotion must connect with communities. Leadership must translate evidence into coordinated, sustained action.
For SADC countries, this requires stronger regional collaboration, recognition of different national and community needs, and a shift towards anticipating risks rather than responding only after crises occur. The Zero Malaria Starts with Me campaign reminds us of individual responsibility. But achieving zero malaria also requires governments, researchers, healthcare professionals, malaria programmes, and communities to work together, supported by accessible services and resilient health systems.
As we commemorate SADC Malaria Day, we should recognise the progress made while questioning whether our approaches are adapting quickly enough to changing realities. We have the knowledge to prevent infections, diagnose disease, and save lives, alongside increasingly sophisticated tools to predict risk.
Now we must ensure that this knowledge reaches the right people, informs the right decisions, and leads to meaningful action. Knowing more about malaria is important, but what makes the difference is how effectively we put that knowledge to work.
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