By Frank Okello
Malaria continues to kill nearly 600,000 people every year, mostly African children, but experts say progress made over the last two decades is at risk. It is against this backdrop that scientists and public health leaders are pushing for new solutions to combat the disease.
“We are looking at ways to leverage technology and innovation to make a measurable impact in people’s lives,” said Dr. Jennifer Gardy, Deputy Director for Malaria Surveillance, Data and Epidemiology at the Gates Foundation. “The fight against malaria requires solutions that keep pace with resistance, climate change, and shifting patterns of transmission.”
She was speaking during a Gates Foundation webinar titled “State of Malaria Innovation Expert Briefing: Spotlighting the innovations that could help end malaria in our lifetime.”
For years, insecticide-treated nets (ITNs) have been one of the most effective tools in reducing global malaria cases and deaths over the past two decades. Their main advantage lies in providing widespread, low-cost protection, especially at night when mosquitoes bite most. However, a major challenge has emerged as mosquitoes have developed resistance to commonly used insecticides such as pyrethroids. This resistance reduces the nets’ effectiveness, showing how adaptable and “clever” mosquito populations can be in surviving control measures.
Researchers are now pushing dual-active ingredient (dual-AI) nets, which combine pyrethroids with a second chemical, restoring their ability to kill resistant mosquitoes. Field trials in Africa have shown these nets deliver higher mosquito mortality and are already being deployed at scale through the Global Fund’s New Nets Project.
The experts also highlighted spatial repellents, recently given a conditional recommendation by the World Health Organization (WHO). These repellents, such as transfluthrin devices, protect people in settings where nets do not, like outdoor gatherings and refugee settlements. For instance, the common mosquito coil used in many African homes works by slowly burning and releasing smoke laced with insecticides. As the smoke fills the room, it drives away or kills mosquitoes, creating a protective barrier for families sitting or sleeping nearby.
“The coil reduces the chances of mosquito bites and helps cut the risk of malaria transmission”, Dr. Eric Ochomo, deputy director, Kenya Medical Research Institute (KEMRI), emphasized. In Kenya’s Busia County, a study found spatial repellents significantly reduced mosquito bites, particularly outdoors. Ochomo stressed that repellents are not replacements for nets but complementary tools to close protection gaps.
Another area of innovation is gene drive technology, which genetically modifies mosquitoes to either reduce their population or block malaria transmission. Because mosquitoes are difficult to control and a single female can lay up to 300 eggs in her lifetime, traditional tools often fall short. Gene drive uses genetic modification to pass on traits that either kill mosquitoes or stop them from transmitting malaria. Though not yet released for field use, trials in Burkina Faso have tested early-stage genetically modified mosquitoes.
Krystal Birungi, Field Entomology Coordinator, Uganda Virus Research Institute, Research and Outreach Associate, Target Malaria Uganda, noted that gene drive could be a “game-changing intervention” but highlighted the importance of community engagement. Target Malaria, the group leading research, is working with linguists and local communities to translate complex genetic concepts into understandable terms, ensuring transparency and trust.
The panel also underlined the importance of surveillance, as mosquito species and behaviors shift with climate change and urbanization. The recent spread of Anopheles stephensi, an urban-adapted vector now found in several African countries, poses new challenges for malaria control. Continuous monitoring of mosquito populations, biting patterns, and resistance profiles will be vital to guide which interventions nets, repellents, spraying, or larval control, are most effective in different regions.
Funding emerged as a central concern. Much of the success in malaria control has been fueled by the Global Fund, which has underwritten large-scale net distribution and innovation uptake. Experts cautioned that declining funding could reverse hard-won gains, undermining confidence in new tools and slowing their rollout.
“Progress is real but fragile,” Gardy said, adding that scaling next-generation nets, spatial repellents, and vaccines will require not only scientific breakthroughs but also strong community trust and sustained financial commitment.
Looking ahead, experts say the future of malaria control lies in wider adoption of dual-active ingredient bed nets, which are already proving effective in areas of high insecticide resistance. If rolled out across more countries, these nets could help restart progress that has recently stalled in the fight against malaria.
Still, special repellents are being used in several African countries with a high burden of malaria, filling protection gaps where nets alone are not enough. Importantly, much of this innovation was proposed to be driven by African scientists and produced locally, strengthening both trust and sustainability. Dr. Ochomo summed it up by saying, “We are aspiring to see African scientists charting the path in developing and testing new malaria tools, and in some cases even producing them locally in the next 5-10 years.”
