Addis Ababa: Africa must take full financial and political ownership of the fight against malaria, Tanzania’s president has said, arguing that the continent’s ability to fund its own health priorities will be the ultimate test of leadership and sovereignty.
Speaking at a high-level briefing on sustainable malaria financing convened by the African Leaders Malaria Alliance (ALMA) in Ethiopia’s capital, Samia Suluhu Hassan challenged fellow heads of state to move beyond rhetoric.
“Are we ready to fund, lead and finish this fight?” she asked. “On behalf of the United Republic of Tanzania, my answer is a firm yes.”
Her intervention comes at a precarious moment for global health financing. As donor budgets tighten and competing crises multiply, from conflict to climate shocks, African governments are under growing pressure to shoulder more of the burden for diseases that disproportionately affect their populations.
In 2024, Africa recorded an estimated 270.8 million malaria cases, 96% of the global total, and nearly 600,000 deaths, most of them children under five. The disease remains both a public health emergency and a drag on economic productivity across large parts of sub-Saharan Africa.
For Hassan, malaria financing is no longer simply a technical health issue but a question of national development and “health sovereignty”.
“When Africa chooses to lead, Africa must also build strong institutions that make that leadership meaningful,” she said.
Tanzania as test case
Tanzania, which hosts ALMA’s secretariat, has sought to position itself as an example of what domestically anchored leadership could look like.
Hassan pointed to investments in advanced research at the Ifakara Health Institute, where scientists are developing technologies including gene-drive approaches aimed at interrupting malaria transmission by altering mosquito populations.
At the same time, the government has scaled up next-generation insecticide-treated bed nets, expanded malaria vaccine rollout and strengthened community-level case management. A cross-ministerial coordination framework now aligns malaria control with broader primary healthcare and universal health coverage goals.
Tanzania has also established End Malaria Councils on both the mainland and in Zanzibar, bringing together government, private sector actors, faith leaders and civil society to mobilise domestic resources. Across the continent, similar platforms have raised more than $209m to support national responses.
Hassan urged other governments to institutionalise such mechanisms, arguing that predictable domestic financing is the foundation for long-term elimination.
The global equation
Following her remarks, Botswana’s president and ALMA chair, Duma Boko, reinforced the call for scaled-up financing and political will.
“Malaria can be eliminated. The economics are clear. The tools exist,” he said, warning that any slowdown in momentum could reverse years of progress.
Yet leaders were equally blunt about Africa’s structural vulnerabilities. The continent imports roughly 99% of its vaccines and 95% of its medicines, leaving countries exposed to supply chain disruptions, price volatility and geopolitical shocks, lessons underscored during the Covid-19 pandemic.
Expanding local pharmaceutical and vaccine manufacturing, they argued, is not only a matter of industrial policy but of resilience and autonomy.
At the same time, speakers stressed that domestic ownership does not negate the need for international solidarity. Fully replenishing the Global Fund and leveraging the World Bank’s International Development Association for malaria-focused programmes remain critical to sustaining gains.
“No single country can win this fight alone,” Hassan said. “Our collective success depends on sustained partnership.”
With Africa carrying the overwhelming global burden of malaria, the challenge now is whether the continent’s stated determination to lead will translate into sustained, accountable investment, and whether international partners will match that resolve.
“This is a fight Africa can and will win,” Hassan said, framing malaria elimination not as aspiration but as obligation, to a generation still at risk.
