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World Malaria Day: Children at the Center of the Crisis


‘In Africa, nearly every minute, a child under 5 dies of malaria.’ (UNICEF, 2024)


In an era of rapid technological progress and medical advancement, malaria remains one of the leading yet overlooked causes of child mortality, especially among younger children. This is particularly evident in Africa, where in 2024 children under the age of 5 made up 76% of all malaria-related deaths. Over the past two decades, this proportion has at times been even higher, reaching up to 87%.[1] Although significant efforts have been made so far – particularly through the Global Fund to Fight AIDS, Tuberculosis and Malaria – they remain insufficient to meet the scale of the challenge.

Persistent resource constraints in most malaria-affected countries lead to weak preventive health systems, limited access to primary health care, and shortages of essential medicines. The situation is most severe in Nigeria, followed by the Democratic Republic of the Congo and Niger, which together account for almost 50% of global malaria deaths, of which 75% are among children.[2] In Nigeria alone, in 2018, 84,800 children under the age of 5 lost their lives due to malaria.[3] Compared to adults, this represented a ratio of approximately 9:1. This disproportionately high burden among young children is largely explained by their still-developing immune systems, which make them more vulnerable to infection. The risk is further increased in children whose immune systems are already weakened by parasitic, viral, or bacterial infections, or who suffer from malnutrition and genetic conditions, all of which reduce their ability to fight malaria.[4]

In that sense, prevention plays a key role. Vector control, preventive chemotherapies (such as intermittent preventive treatment of pregnant women, intermittent preventive treatment of infants, and seasonal chemoprevention for children aged under 5 years), and vaccines represent the most powerful preventive tools in the fight against malaria.[5] Vaccines, combined with mosquito bed nets can reduce malaria by up to 75%, however access to them remains limited in some regions.[6] Testing, diagnosis and treatment play no less important role, contributing to better clinical outcomes and reduced mortality. However, UNICEF warns that in sub-Saharan Africa less than 1 in 3 children are tested for malaria and about 6 in 10 febrile children are taken to a health care facility. Children from rural areas and from poorer families are less likely to be taken to the hospital than those coming from urban areas and from wealthier families.[7] All of this, regrettably, continues to result in preventable loss of life. With climate change, the situation may even worsen. It is estimated that by 2050, around 8 times more children will be living in areas at high risk of exposure to extreme heatwaves, which contribute to the growth of mosquito populations – the primary carriers of malaria.[8]

It is therefore essential to take timely and effective action. States and the international community must and can do more. Children’s rights must not remain merely symbolic. A lack of resources cannot serve as a justification. Even in situations where resources are limited, States are ‘required to undertake targeted measures to move as expeditiously and effectively as possible towards the full realization of children’s right to health’.[9] Greater investment is required to strengthen preventive health-care systems, ensure universal access for all children to primary health-care services as close as possible to where they live, and support the implementation of safe, simple, and cost-effective interventions that have already proven effective.[10] Strong coordination between malaria programmes and child health programmes, laboratory services, and regulatory authorities (for diagnostic devices, medicines, and insecticides) is of crucial importance.[11] Improving access to vaccines, bed nets and essential medicines is vital. Increased investment is particularly needed in high-risk areas, with a special focus on the most vulnerable groups of children.

Only then can we speak of a world free of malaria, where no child dies from a preventable and treatable disease – a disease that still claims the lives of around 1,000 children every day.

 

[2] WHO malaria report, 2025, p. 11.

[3] Njoku, 2025, p. 39.

[4] Liu et al., 2021, p. 8.

[5] WHO guidelines for malaria, 2025, p. 102.

[8] UNICEF, 2024; CRC Committte, General Comment No. 26 (2023), para. 39.

[9] CRC, General Comment No. 15 (2013), para. 72.

[10] Ibid., paras. 35 and 36.

[11] WHO guidelines for malaria, 2025, p. 25.


References

Liu, Q., Jing, W., Kang, L., Liu, J., Liu, M. (2021) ‘Trends of the global, regional and national incidence of malaria in 204 countries from 1990 to 2019 and implications for malaria prevention’, Journal of Travel Medicine, 28(5), pp. 1–12.


Njoku, N. (2025) ‘Re-examining malaria disease as a factor in children’s mortality rate and its impacts on the protection of children’s rights to health and wellbeing in Nigeria’, International Review of Law and Jurisprudence, 7(2), pp. 37–43.


UN Committee on the Rights of the Child, General Comment No. 15 (2013) on the on the right of the child to the enjoyment of the highest attainable standard of health (art. 24), CRC/C/GC/15.


UN Committee on the Rights of the Child, General comment No. 26 (2023) on children's rights and the environment, with a special focus on climate change, CRC/C/GC/26.


UN Convention on the Rights of the Child, Official Gazette of the SFRY, No. 15/1990, Official Gazette of the Republic of Croatia – International Treaties, Nos. 12/93, 20/97.


UNICEF, The State of the World’s Children 2024, UNICEF, New York, 2024.


World Health Organization (WHO), World malaria report, 4 December 2025.


World Health Organization (WHO) guidelines for malaria, 13 August 2025.


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