April 25 is World Malaria Day, a time to raise awareness, rally support, and remember those lost to the disease. As the world works to eliminate malaria as a global health threat by 2030, we must look forward to the advancements that will get us there, while also reflecting on the ambitious actions that made this progress a possibility.
Malaria 101
Malaria is spread through mosquitoes that thrive in warm, tropical climates. The disease is prevented through low-cost interventions like insecticides and insecticide-treated bed nets and antimalarial drugs. For the first time in history, there are several advancements that make ending malaria in our lifetime a possibility, including a new malaria vaccine. Thanks to these interventions, forty-seven countries have been certified malaria-free by the World Health Organization.
Although the disease is treatable and preventable, malaria remains one of the world’s most common and serious tropical diseases. About half of the world’s population is at risk of being infected, and the majority of those who die from the disease are young children and pregnant women in resource-poor regions. In 2024, there were approximately 282 million cases of malaria and 610,000 deaths. Much like HIV/AIDS, the malaria burden is highest in sub-Saharan Africa.
The President’s Malaria Initiative (PMI)
One of the greatest efforts to end malaria came from the launch of the President’s Malaria Initiative (PMI) by President George W. Bush in 2005. Much like the President’s Emergency Plan for AIDS Relief (PEPFAR) launched just two years earlier, which has saved more than 26 million lives, PMI sought to use a whole-of-government approach to save lives from malaria, increase productivity, and expand economic opportunity. PMI has workedin 30 countries with the highest burden of malaria, 27 of which are located in sub-Saharan Africa.
Several U.S. government agencies, including the Centers for Disease Control and Prevention (CDC), the Peace Corps, the National Institutes of Health, the Department of War, and the Department of State, implement the program. PMI also works closely with the Global Fund to Fight AIDS, Tuberculosis, and Malaria to ensure those most in need have access to lifesaving prevention and treatment resources.
Together with other organizations and country-led initiatives, PMI has committed to the globally agreed-upon goals to end malaria as a threat by 2030. This includes the reduction of global malaria mortality and cases by 90% compared to 2015 levels, the elimination of malaria in at least 35 more countries, and the prevention of the resurgence of malaria in countries that have been certified as “malaria-free.”
Today, PMI and the Global Fund have contributed to the 14 million lives saved from malaria and 2.3 billion malaria cases prevented across the globe over the last two decades.
PMI and Malaria under the America First Global Health Strategy
The America First Global Health strategy recommits to PMI’s objectives. Much like HIV/AIDS programming, the strategy emphasizes a goal to transition U.S.-financed anti-malaria programming to national governments by 2030. Several bilateral health agreements (or MOUs) have already been signed in PMI partner countries. As of April 6, 2026, 29 agreements have been signed in countries throughout Africa, Latin America, the Caribbean, and Asia. Of those 29, 19 agreements include malaria funding and interventions.
What’s Next?
The inclusion of malaria in the America First Global Health Strategy is a positive step. However, there are several key aspects that must be kept in mind to ensure the strategy’s success. In a report released earlier this year, Malaria No More and partners outlined several recommendations to support a successful implementation of the strategy for malaria.
This includes principles that are critical across disease areas, including ensuring trustworthy mechanisms for integrity, monitoring, and accountability are in place; unlocking domestic financing; harnessing private sector innovation; facilitating global partnerships; and strengthening human and institutional capacity. The George W. Bush Institute’s recent piece, One System, Greater Impact, also emphasizes the need to protect hard-won gains while integrating malaria into broader primary health care.
In 2005, President Bush asked the American public to continue to answer the call to take on the challenge of hunger, poverty, and disease that had started under PEPFAR. President and Mrs. Bush put those words into action, launching PMI and hosting the first-ever White House Summit on Malaria. The event brought together experts, the private-sector, civil society leaders, faith-based organizations, and policy makers to raise awareness around malaria and mobilize efforts to save lives.
That whole-of-society approach definedPMI’s planning, implementation, and oversight for over 20 years. The political will, partnerships, and innovation that launched a moonshot program are just as critical as we near the finish line today.
