Addressing Contemporary Threats to Global Malaria Control: New Tools and Strategies

Annette Elizabeth Kaiser^1*Louisa Messenger²Richard Oxborough³Nancy Stephen Matowo⁴

• ¹Faculty of Medicine, University of Duisburg-Essen, Duisburg, Germany
• ²Department of Environmental and Global Health, Las Vegas,United States, Las Vegas, United States
• ³Parasitology Las Vegas, Las Vegas, United States
• ⁴London School of Hygiene & Tropical Medicine, London, United Kingdom

In view of the World Malaria Day 2025, the WHO and other partnerships started the campaign "Malaria Ends With Us: Reinvest, Reimagine, Reignite" to promote global policy and community action towards malaria elimination. Malaria control efforts have stalled in recent years due to climate changes, wars and economic decrease. Although there is profound knowledge in targeted prevention, treatment and detection in malaria people in endemic countries have limited access to these services. In 2020, people in low -and middle income countries spent 40% of their income in healthcare, a threat in pushing poverty. Malaria is affected by social inequities such as low education, work in agriculture, unprotected housing which exposes people to mosquito transmission (Carrasco-Escobar et al., 2021). Therefore, common global approaches have to be performed to overcome contemporary threats in global malaria control. The WHO has currently listed four main threats which comprise: i) invasive vector species (Singh et al., 2023) (ii) vector insecticide resistance (Suh et al., 2023) (iii) antimalarial drug efficacy and resistance (Rosenthal et al., 2024) iv) Parasite pfhrp2/3 gene deletions (Weiss et al., 2025). The Topical Issue addresses the urgency of novel control strategies either from the side of the parasite or the transmitting mosquito to ameliorate the reoccurrence of upcoming malaria cases.In that context, an alarming signal of global warming and climate change is the detection of four human Plasmodium species by Next Generation Sequencing (NGS) in a river (Heine et al.) West of Johannesburg, an area which is non endemic for malaria. Detection of the four different Plasmodium species might raise the question of accidential or Oddysee movement of the transmitting Anopheles mosquito into a former malaria free area. Hence, these findings illustrate the contemporary threat of endemic area expansion into non-endemic areas.A set of articles in this Topical Issue focuses on novel control strategies of the parasite and its transmission.The assessment of the malaria burden will be an important tool for prevention, control and eradication of the disease. In an integrative study based on retrieved data from the 2021 Global Burden of disease database (GBD), Zhou et al. assessed the malaria burden in the Comoros in 2021 including indicators like incidence, prevalence, and mortality, as well as disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs). Although the malaria burden decreased in the Comoros between 1999 to 2021 mainly due to epidemological changes, the study indicates that women under 40, school-aged children, and adults under 30 in the Comoros still have a higher malaria burden.Although malaria incidences have significantly declined in Indonesia, Lubis et al.recognize the necessicity to develop serum conversion rates to survey low level rates of transmission to immediately start elimination programmes. In a cross-sectional study conducted 2019 in Langkat district, North Sumatera Province, Indonesia, Lubis et al.applied two antigens, i.e. Merozoite Surface Protein-1 (MSP-1) and Apical Membrane Antigen 1 (PfAMA-1) in blood stages of P. falciparum and P.vivax. The seroprevalence for P. falciparum was 10.6% for PfAMA-1, 13% for PfMSP-119, respectively. In contrast, the measured serum conversion rates were 18.6% for PvAMA-1 and 7.4%for PvMSP-119. Based on these data the authors concluded that this assay is suitable for determing epidemological risk factors and surveillance in low transmission settings.Blocking transmission is an important issue to control asymptomatic gametocytemia. At least four articles in this Topical Issue focus on the threat of "insecticide resistance".Apart from the development of insecticides with novel scaffolds for ITNs, educational enrollment of the population (Mrema et al., 2023) is mostly important. In particular, highly endangered groups like children and pregnant women in rural areas have to be informed and convinced to use insecticide treated bednets.One article tackles the threat of invasive vector species i.e. the invasion of the malaria transmitting Anopheles mosquito into a non-endemic malaria free area West of Johannesburg. Six contributions in this Topical issue illustrate the necessity to implement novel control mechanisms to monitor malaria infections at an early stage in areas of low transmission.Conclusively, there are plenty of modern, scientific tools to combat the contemporary threats if we carefully observe and consequently implement them (World Malaria Report, 2025). Moreover, the collection demonstrates the need for direct and coordinated responses and strong quality assurance systems to overcome the current gaps. Apart from the progress in science and surveillance of malaria, reduction in international donor funding since 2025 from the US administration and other stakeholders for multiple years will have a critical impact on all achievements. This scenario has been recently modeled for tuberculosis with substantial impacts on mortality and morbidity due to reduced international donor support (Clark et al.,