AFRICAN REGION - Regional Data and Trends.
The WHO African Region continues to shoulder the heaviest burden of malaria. Globally in 2022, the Region accounted for:
94% of all malaria cases (233 million cases);
95% of all malaria deaths (580 000 deaths). About 78% of all malaria deaths in the Region were among children under the age of five.
In 2022, four countries in the Region – Nigeria (26.8%), the Democratic Republic of the Congo (12.3%), Uganda (5.1%) and Mozambique (4.2%) – accounted for nearly half of all malaria cases globally (Fig. 3.3c).
Four African countries also accounted for just over half of all malaria deaths globally: Nigeria (31.1%), the Democratic Republic of the Congo (11.6%), Niger (5.6%) and the United Republic of Tanzania (4.4%) (Fig. 3.3d). Over the longer term (2000–2022), malaria case incidence and mortality rates in the African Region have declined:
case incidence (cases per 1000 population at risk) fell from 369.3 in 2000 to 222.6 in 2022 (Fig 3.4a);
the mortality rate (deaths per 100 000 population at risk) fell from 142.6 in 2000 to 55.5 in 2022 (Fig. 3.4b).
However, since 2015, the rate of progress in both cases and deaths has stalled in several countries with moderate or high transmission; the situation was made worse, especially in sub-Saharan Africa, by disruptions during the COVID-19 pandemic and other humanitarian emergencies. Between 2019 (pre-pandemic) and 2022, there was a considerable increase in the total estimated number of malaria cases in the African Region, from 218 million to 233 million. Substantial case increases were seen in Nigeria (5.3 million), Ethiopia (2.4 million), Madagascar (1.5 million), Uganda (1.3 million), the United Republic of Tanzania (1.3 million), Mali (1.1 million) and Mozambique (1 million). The African Region as a whole is off track for both the malaria morbidity and mortality GTS 2025 milestones by 52% and 50%, respectively (Fig. 8.4):
Case incidence: there was little change (a less than 5% increase or decrease) in case incidence in 2022 compared with 2015 in 10 countries: Benin, Botswana, Chad, the Congo, the Democratic Republic of the Congo, Gabon, Liberia, Namibia, Nigeria and South Sudan. Case incidence increased by 5% to 25% in Côte d’Ivoire, Guinea-Bissau and Uganda; by 25% to 55% in Angola, Burundi and Madagascar; and by more than 55% or more in the Comoros, Eritrea and Sao Tome and Principe.
The mortality rate increased by 25–55% in Angola and Madagascar and by 55% or more in the Comoros and Eritrea.
The overall regional trend masks progress in individual countries.
Between 2019 and 2022, Rwanda saw a steep decline in malaria cases (3.8 million).
In 2022, Ethiopia, South Africa and Zimbabwe achieved a reduction in the mortality rate of 55% or more. And, although 27 countries are off track to meet the GTS 2025 mortality milestone, they achieved mortality rate reductions of less than 55%.
In 2022, Comoros and Sao Tome and Principe reported zero malaria deaths for the first time. And that same year, Botswana, Eritrea and Eswatini all reported fewer than 10 malaria deaths.
Cabo Verde has reported zero malaria deaths since 2018 and has requested an official certification of malaria elimination from WHO (decision expected in early 2024).














