Medecins Sans Frontières (MSF) has long been at the forefront of malaria prevention, diagnosis and treatment, especially in settings with limited access to healthcare. In 2023 alone, MSF treated over 3.7 million cases of malaria worldwide. Despite these efforts, malaria continues to be a significant global health challenge.
The World Health Organisation’s (WHO) 2024 World Malaria Report reveals that in 2023, an estimated 263 million new malaria cases were reported — an increase of 11 million cases compared to 2022, despite progress in malaria control. Sub-Saharan Africa accounted for 94% of the global malaria cases in 2023, with Nigeria, the Democratic Republic of Congo, Uganda, Ethiopia, and Mozambique responsible for 52% of the global burden.
Malaria disproportionally affects children under five, particularly those living in endemic and malaria prone regions. While global child mortality has decreased, the decline has been slow, and in some areas, it has even stalled or reversed. This is particularly true in sub-Saharan Africa, where malaria is endemic.2 In many of these high burden settings, healthcare services are often weakest where they’re most needed, and low coverage of the most needed interventions results in a significant unmet need for treatment of malaria and other childhood killer diseases;1 leaving a significant gap in the delivery of malaria treatment and other essential childhood interventions.
Bringing Care Closer: MSF’s Community-Based Approach to Malaria
While the introduction of new preventive tools such as the malaria vaccines have shown promise in reducing mortality, particularly when integrated with existing strategies, prompt and effective treatment remains critical for both curing and preventing malaria. integrated Community Case Management (iCCM) is one of the most cost-effective tools MSF uses to improve access to malaria care. integrated Community Case Management (iCCM) brings essential primary healthcare services closer to communities in remote areas, improving access to diagnosis and treatment for diseases like malaria.
MSF programmatic experiences with iCCM have proven effective in expanding treatment coverage and providing high-quality care to children in hard-to-reach communities. For instance, in 2024, MSF conducted more than 79,000 iCCM consultations in Central African Republic (CAR), diagnosing and treating more than 62,000 (78%) children for uncomplicated malaria.
This community-based approach relies on Community Health Workers (CHWs) who are trained to diagnose and treat diseases like malaria among children under-five within their communities. This approach ensures that young children get quick diagnosis of malaria. By using malaria Rapid Diagnostic Tests (mRDTs), CHWs can quickly diagnose and provide antimalarial medicines to children with malaria, reducing complications and the need for long travel to health facilities.
Additionally, as a vital link between communities and health facilities, MSF trains CHWs to identify signs of severe malaria and other conditions requiring referral for further treatment. In many of these humanitarian contexts, the distance to the nearest health facility can range from several hours to a full day of travel—often on foot or through unreliable transport means. Without treatment, severe malaria can quickly become fatal. Rectal artesunate (RAS), a vital/key pre-referral treatment for severe malaria, has emerged as an important treatment, bridging this gap by buying time and saving lives. MSF trains CHWs to administer single dose (RAS) to children under five with suspected severe malaria and promptly refer them to a higher-level facility for further management. In 2024, MSF iCCM Projects in the Central African Republic, through trained CHWs, provided pre-referral RAS to over 500 children under five with suspected severe malaria. This significantly contributed to averting malaria deaths and improving child survival in these areas.
Malaria Ends with Us: Investing in Community- Based Strategies.
The theme of World Malaria Day 2025, “Malaria Ends with Us: Reinvest, Reimagine, Reignite,” presents a compelling call to action, urging the global health community to strengthen its resolution and investment in the fight against malaria. Central to this effort is the need to ensure equitable access to effective prevention and treatment strategies, particularly for the last mile population and those underserved communities. ICCM represents a critical component of this strategy. By equipping and supporting community health workers to provide timely diagnosis and treatment for malaria at the community level, iCCM addresses the significant barriers many young children in communities face in accessing vital primary healthcare services.
As we reimagine the path toward malaria elimination, scaling up community-driven solutions like iCCM will be essential in bridging gaps in care and advancing health equity in malaria-prone or endemic regions.