A small southern African nation’s ambitious drive to eliminate malaria is facing growing challenges, as cross-border movement, climate change and shrinking international funding threaten to reverse hard-won gains against the disease. According to a recent report, Eswatini, which has significantly reduced malaria cases over the years, is struggling to contain infections entering from neighbouring regions with far higher transmission rates.
The country recorded just a few hundred malaria cases in 2024, a stark contrast to millions reported in neighbouring Mozambique, highlighting the scale of the cross-border challenge. Health officials say the porous nature of borders allows infected individuals—particularly migrant workers—to carry the malaria parasite into Eswatini, where local mosquitoes can then spread it further. Informal crossings and undocumented travel complicate surveillance efforts, making it difficult to track and contain outbreaks.
Authorities have intensified monitoring and rapid response mechanisms to prevent localised outbreaks from spreading. When a new malaria case was recently detected in a region that had remained malaria-free for several years, health teams swiftly launched door-to-door testing, distributed information and carried out insecticide spraying. Experts say such immediate interventions are critical to maintaining progress, particularly as the country edges closer to elimination.
However, environmental changes are increasingly undermining these efforts. Rising temperatures and erratic weather patterns have expanded mosquito breeding habitats, while flooding has created new pools of stagnant water that serve as ideal breeding grounds. Scientists have also observed malaria-carrying mosquito species appearing in areas where they were previously absent, suggesting a shift linked to climate change.
The malaria transmission season, once relatively predictable, is also lengthening. Health officials note that infections now persist later into the year, overlapping with peak agricultural activity. This increases exposure among farm workers, many of whom sleep outdoors without protective nets, heightening the risk of transmission.
Economic migration is another complicating factor. Workers, particularly those employed in agriculture, often travel from higher-burden regions and may avoid contact with authorities due to fear or lack of documentation. This reluctance can delay diagnosis and treatment, allowing the disease to spread undetected within communities.
At the same time, funding constraints are emerging as a major concern. Cuts in international aid, including reduced contributions to global malaria programmes, have affected training and operational capacity in Eswatini. Experts warn that declining financial support, combined with increasing resistance to insecticides and antimalarial drugs, could significantly hamper elimination efforts.
Despite these setbacks, the government remains committed to eradicating malaria. Officials are exploring measures to strengthen border controls and improve access to travel documentation, aiming to reduce reliance on informal crossings and enhance disease surveillance. Health authorities have reiterated their determination to pursue elimination, even as new challenges continue to emerge.
Global trends suggest that Eswatini’s struggle is part of a broader pattern, with malaria cases rising in recent years due to a combination of environmental, biological and financial pressures.
