Maimuna Musa and her six children live in a cluster of homes with about 300 other family members in the Nigerian town of Lafia. On particularly hot nights, Musa brings her bed net outside for her and her children to sleep under. About 10 people in the extended family are admitted to the hospital with malaria each year. Sometimes they need to sell stored food or get loans from neighbors or other family members to pay medical costs and school fees.
“Malaria is the most prevalent sickness around here. Most likely when admitted [to hospital] they find other sicknesses like typhoid. Malaria is the gateway.” Maimuna Musa, 30
The world has made progress against malaria, but to Accelerate the Fight Against Malaria for a More Equitable World, we must continue to strengthen both global and local networks — including community health workers, doctors and nurses, lab workers, warehouse workers, truckers, local and national governments, and data entry clerks — to prevent and treat the illness.
In this photo essay, we look at the work that Chemonics and its partners conduct in Nigeria and the Democratic Republic of the Congo (DRC), which together shoulder the heaviest burden of malaria in Africa with almost 40% of the continent's cases. Ninety-four percent of the world’s malaria cases occur in Africa, most of them among children under the age of five. At least 245 million Africans came down with malaria in 2022 and 608,000 died.
One of the most effective ways to prevent malaria is by using insecticide-treated bed nets. These nets help to reduce malaria bites and have been shown to reduce deaths in children under five years from all causes by about 20%. Distributing bed nets takes a coordinated effort with both public- and private-sector partners to reach people in malaria-affected areas. Over the past eight years, the Chemonics-led USAID Global Health Supply Chain Program-Procurement and Supply Management (GHSC–PSM) project has achieved the following globally:
The USAID End Malaria Project in the DRC, led by Chemonics, distributed more than 18 million bed nets to nearly 32 million people through mass and school-based campaigns over two and a half years. The project supports the National Malaria Control Program to achieve and sustain its goal of universal bed net coverage through these campaigns in 10 of the DRC’s 26 provinces.
For each campaign, the End Malaria team works with health representatives at all levels of government to troubleshoot challenges, such as stockouts, geographic accessibility, and insecure environments. End Malaria collaborates solely with local partners to strengthen their capacity to support these campaigns.
The GHSC-Technical Assistance Francophone Task Order also works at the national, provincial, and health zone levels to ensure the continuous availability of malaria medicines and commodities and to improve collaboration and coordination within the country. Since 2021, the project has distributed 7 million bed nets, 31 million malaria tests, and 31 million artemisinin-based combination therapies, among other commodities in the DRC.
The contributions of both projects help to ease some of the financial burden that communities may face, such as travel to health facilities to receive treatment, interruptions to work or their business, and hospitalization in severe cases. Since partnering with the U.S. President’s Malaria Initiative in 2010, the DRC has been able to decrease child death rates by 56%.
Malaria is transmitted to humans from dusk to dawn by female Anopheles mosquitoes. Per the World Health Organization’s 2023 World Malaria Report, climate change — which brings about changes in temperature, humidity, and rainfall and extreme weather events — is also having an impact on the incidence and transmission of malaria.
"When there is an attack of malaria there is a lot of pain, plus the financial burden. Since I got this net and have been using it there has been a reduction in the amount of malaria." Mammuda Amadu, 30
Another way to prevent malaria is through seasonal malaria chemoprevention. Chemonics trains community drug distributors in Nigeria to administer the antimalarial doses in four monthly cycles during the rainy season.
“The effect of [chemoprevention] on the children is very significant and has gone a long way to reducing the incidence of malaria during the rainy season in Benue State.” Dr. Iyornenge Ikuren, seasonal malaria chemoprevention coordinator for Benue State, Nigeria
“I’m happy because I go [to the clinic] every time we need care. Since I’ve been giving them chemoprevention they haven’t had malaria.” Destiny Desmond, 20
Health care and lab workers are among the local partners who are essential in the fight against malaria. As soon as malaria is suspected, a health worker will draw blood for a rapid diagnostic test. Results can be available within 15 minutes. Testing and treatment help to prevent further infection in the community by breaking the chain of transmission via mosquitoes. Delays in diagnosis and treatment are a leading cause of death from malaria.
Artemisinin combination treatments are considered the best medications for treating uncomplicated malaria. Being affordable and consistently available are vital for successful malaria treatment.
“Ten years back we had to buy [malaria medication] ourselves. Now that it’s free more clients are coming and we have a steady supply.” Deborah Varuar, officer in charge of Adeke primary health care clinic outside Makurdi, Nigeria
Malaria is a serious threat to global sustainable development that not only impacts the poor. But it is entirely preventable, and it can be defeated. By devoting adequate resources, working together globally and locally, expanding private- and public-sector partnerships, and reaching all of those in need, we can all make it happen and indeed help to create a more equitable world.