Malaria

This article was first published in November 2015; last revised in December 2017. The content and structure in the current version do not yet cover all the key aspects we intend to cover. We plan to revise and extend the material in the future.

Malaria is a disease that is transmitted from person to person by infected mosquitoes.

Malaria can be fatal. The World Health Organization (WHO) estimates that 438,000 people died because of malaria in 2015; the Institute of Health Metrics and Evaluation (IHME), Global Burden of Disease (GBD) puts this estimate at 620,000 in 2017.

Most victims are children. 57% of malaria fatalities are children younger than 5 years old. It is one of the leading causes of child mortality. Every twelfth child that died in 2017, died because of malaria.1

Empirical View

Deaths Due to Malaria

In the visualisations below we provide estimates of the total number of deaths from the World Health Organization (WHO) from 2000 to 2015, and the Institute of Health Metrics and Evaluation (IHME), Global Burden of Disease (GBD) from 1990 to 2017. These estimates are notably different across various countries which affects the total number of reported deaths. IHME figures, as shown below, tend to be higher; they report deaths of 658,000 in 2015 versus only 438,000 from the WHO. Further information on the confidence intervals of WHO estimates, and a country-level comparison between these two sources is covered in our section on Data Quality & Definitions.

Malaria death estimates from WHO

Since the beginning of the 21st century, the WHO has published global estimates of the number of people that die from malaria. In these 15 years the global death toll has been cut in half: from 839,000 deaths in 2000 to 438,000 in 2015.

Africa is the world region that is most affected by malaria: In 2015, the African continent held 9 out of 10 malaria victims (click on 'Expand' to see this). But Africa is also the world region that has achieved most progress: from 2000 to 2015, African deaths from malaria were reduced from 764,000 to 395,000.

Download this visualization as a static image.

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Malaria death estimates from IHME

The Institute of Health Metrics and Evaluation (IHME) provide estimates of malaria deaths from the year 1990 onwards. Over this period we see a clear rise-peak-fall trend, increasing from around 670,000 deaths in 1990; peaking at around 930,000 in 2004; and then declining (although at varying rates) to around 620,000 in 2017.

These estimates are notably higher than those of the WHO (see Data Quality & Definitions for further details). Although divergent on the total number of malaria deaths, both the IHME and WHO estimate that 90 percent (9 in every 10 deaths) are from the African region.

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Malaria deaths by age group

The visualisation below categories the annual number of deaths by age group. These figures are those published by the IHME, Global Burden of Disease [the WHO does not publish country-level data on malaria deaths by age]. Note that you can view these trends for any country in the chart below.

At a global level, the most vulnerable age group to malaria deaths are children under five years old — in 2017 they accounted for 57 percent of total deaths. The number of deaths from malaria tends to decrease with age; with those over 70 years old accounting for around five percent. When age categories are combined, children under 14 years old account for more than two-thirds of mortality.

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Malaria Death Rates

The visualisation below shows the age-standardized death rate from malaria, measured as the number of deaths per 100,000 individuals.

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Malaria death rates by age

The visualisation below shows the breakdown of death rates from malaria (measured as the number of deaths per 100,000 individuals) by age category.

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Malaria Incidence Today

The map shows the number of new malaria cases per 100,000 individuals across the world. The malaria incidence is highest in the central part of Africa north and south of the equator.

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The history of malaria

Humanity’s fight against malaria has a history of many thousand years.2 For most of that time humanity was exposed to the disease without any defense.

Malaria’s mark on the human body

The history of humanity is so closely entangled with the history of malaria that the disease left its mark on our bodies. Sickle cell disorder is a genetic disease that deforms red blood cells to be sickle-shaped. Carriers suffer from attacks of pain from a young age and their lives are cut short by the condition: it causes around 55,000 deaths every year.3

Why would such a genetic mutation not die out? The reason for the continued existence is that the same disorder hinders the malaria parasite from reproducing so that the carrier is provided with a protective advantage in environments where malaria exists. The prevalence of sickle cell disorder today is testament to the high-malaria environments in our species’ history.4

Malaria’s mark on history

Malaria did not only leave its mark on our body, but in many ways also on our history. Malaria is presumed to have been the secret ally that helped the barbarians bring about the downfall of Rome. The examination of the teeth and bones of the Romans by archeologists has recently brought together more and more evidence that the mosquito-borne fever once thrived in the warm, marshy river valleys of the Tiber and the Po in the Roman empire. The disease enfeebled the mightiest army of the ancient world directly through epidemics and indirectly by reducing the productivity in the agricultural sector and hastened the fall of Rome.5

A disease that is powerful enough to afflict the mightiest armies also left its mark on the fate of societies and the lives in many regions of the world.6

Malaria’s mark on our drinks

One of the first medicines humanity discovered that actually had a beneficial effect was quinine, an extract from the bark of the cinchona tree.7 The quinine powder was either drunk with wine or dissolved in water, a mixture that became known as Tonic Water. But Quinine is so bitter that Tonic Water with concentrations high enough to be effective against malaria were unpleasant to drink. The British colonial officers stationed in malarious India therefore started to add sugar, lime and gin and thereby created a drink that is still popular today: the Gin and Tonic.

Malaria in the US

The map below is taken from the US census from 1870. It shows the share of all deaths caused by malaria in the American Southeast.

America was very prevalent in this region that is free of malaria today. Particularly along the coasts and along the Mississippi malaria killed many Americans.

Proportion of deaths from malaria to deaths of all causes – US Census 18708

Proportion of deaths from malaria to deaths of all causes – US Census 1870

Correlates, Determinants & Consequences

In the first chart on this page, we see that the number of malaria deaths in Africa is now declining. The following chart shows that over the same period the number of people sleeping under insecticide treated nets increased.

Bed nets

Bhatt et al. (2015)9 studied the decline of cases of malaria in Africa between 2000 and 2015. They found that the single most important contributor to the decline were insecticide-treated bed nets. According to their findings bed nets were responsible for the aversion of 68% of the 663 million averted cases in Africa between 2000 and 2015. These are 451 million averted cases.

The second largest factor according to the study was artemisinin-based combination therapy which was responsible for 19% of averted cases. And the third largest factor was indoor residual spraying (IRS) which accounted for 13% of averted cases according to the study.

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Estimated trend in proportion of households with at least one insecticide treated net (ITN) and proportion of the population sleeping under an ITN in sub-Saharan Africa, 2000-2012 – WHO (2012)10

Estimated trend in proportion of households with at least one insecticide treated net (ITN) and proportion of the population sleeping under an ITN in sub-Saharan Africa, 2000-2012 – WHO (2012)

Funding for malaria control

Funding for malaria control has increased dramatically from 2000, but has recently stalled.

Past and projected international funding for malaria control, 2000-2015 – WHO (2012)11

Past and projected international funding for malaria control, 2000-2015 – WHO (2012)

A vaccine against malaria

Alphonse Laveran discovered already in 1880 that the Plasmodium parasite is the cause for malaria.12 But all earlier attempts of developing a vaccines were unsuccessful. Malaria vaccines such as SPf66 were insufficiently effective and until recently none of the scientific efforts led to a licensed vaccine.13

This has changed with the malaria vaccine RTS,S, the world's first licensed malaria vaccine, which has been approved by European regulators in 2015. The vaccine is undergoing pilot trials in select countries and it is hoped to provide protection from the parasite in the future.14

Malaria and economic prosperity

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There are high economic costs of malaria

Okorosobo et al. (2013)15 estimate that the malaria “penalty” to GDP ranges from 0.41% of GDP in Ghana to 8.9% of GDP in Chad, all of which could be regained following elimination of malaria. Complete eradication of the disease would increase GDP in Uganda by 50 million USD.

Azemar and Desbordes (2009)16 find that in the median sub-Saharan African country, foreign direct investment could increase by as much as one-third as a result of malaria and HIV eradication, slightly more than one-half of this is attributed to malaria.

Data Quality & Definitions

The United Nations give the following definitions:17

The malaria incidence rate (Ii) is the number of new cases of malaria (Cases) divided by the total population (Pop) and multiplied by 100,000.

Ii = (Cases / Pop) * 100,000

The malaria death rate (Id) is the number of deaths due to malaria (Deaths) divided by the total population (Pop) and multiplied by 100,000.

Id = (Deaths / Pop) * 100,000

WHO estimates of the number of malaria deaths, 2010 – WHO (2012)18

RegionEstimateLowerUpper% <5
African596 000429 000772 00091%
Region of the Americas1 1007001 80029%
Eastern Mediterranean15 3007 20023 50070%
European000
South-East Asia43 00031 10060 30032%
Western Pacific4 0002 4006 10041%
World660 000490 000836 00086%

WHO estimates of the number of malaria cases (in thousands), 2010 – WHO (2012)19

RegionEstimateLowerUpper% falciparum
African174 000110 000242 00098%
Region of the Americas1 1009001 30035%
Eastern Mediterranean10 4006 40016 60083%
European0.20.20.2
South-East Asia32 00025 90041 90053%
Western Pacific1 7001 3002 10079%
World219 000154 000289 00090%

Comparison of WHO and IHME malaria deaths

In our section on Deaths Due to Malaria, we present regional estimates from the World Health Organization (WHO) and the Institute of Health Metrics and Evaluation (IHME), Global Burden of Disease (GBD). These estimates in some cases differ notably.

In the chart below we have plotted annual deaths from malaria by country, from IHME estimates (y-axis) versus estimates from WHO (x-axis). Note that the latest WHO estimates by country are only available for the year 2013. Also shown is the line of parity: countries that lie along this line have the same estimated number of deaths from the IHME and WHO; countries which lie above this line have higher estimates from IHME; and those below have higher estimates from WHO.

For many countries — although not all — IHME estimates tend to be higher than WHO figures. This difference for some countries is highly significant; for example, in 2013, IHME estimates for Nigeria, Democratic Republic of Congo and India were approximately double that of WHO figures. The discrepancy between these estimates results from differences in methodology, data coverage and sourcing. Figures shown in this entry from both IHME and WHO will continue to be updated as new data is released — hopefully this data will begin to converge with time.

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Data Sources

World Health Organization (WHO)
  • Data: Data on cases, deaths (reported and estimates) and prevention and treatment

  • Geographical coverage: Global – by country and WHO region

  • Time span: Since 2000 (for reported deaths); shorter for other measures.

  • Available at: Online here.
  • WHO data on malaria deaths and cases (1990-2006) is also available through Gapminder where it can be plotted against a second indicator.

Institute of Health Metrics and Evaluation (IHME), Global Burden of Disease (GBD)
  • Data: Death rates & absolute number of deaths from malaria
  • Geographical coverage:Global, across all regions and countries
  • Time span:Available from 1990 onwards
  • Available at: Online here

World Development Indicators (WDI) – published by the World Bank
  • Data: Children with fever receiving antimalarial drugs (% of children under age 5 with fever), use of insecticide-treated bed nets (% of under-5 population)
  • Geographical coverage: Global – by country & world region
  • Time span: Annual data – since 2000.
  • Available at: Online here.

United Nations – Millennium Development Goals Database
  • Data: Notified cases of malaria (per 100,000 people) and malaria death rate (all ages & ages 0-4)

  • Geographical coverage: Global – by country and region.

  • Time span: Only very recent data.

  • Available: Notified cases of malaria (per 100,000 people) here.

    Malaria death rate (all ages) here.

    Malaria death rate (ages 0-4) here.


DHS Malaria Indicator Survey (MIS)
  • Data: Detailed survey data from African countries
  • Geographical coverage: Some African countries.

  • Time span: late 2000s

  • Available at: Online here.


The MARA/ARMA (Mapping Malaria Risk in Africa/Atlas du Risque de la Malaria en Afrique) project
  • Data: MARA LITe malaria prevalence data, distribution of the Anopheles gambiae, entomological inoculation rates, related climate data and malaria distribution maps and estimated populations at risk.
  • Geographical coverage:  Entire Africa – low level
  • Time span: Mostly recent data
  • Available at: Online at http://www.mara-database.org//login.html.
  • Often it is possible to download the data and to view the data visualized on maps.


Conley, McCord and Sachs (2007) Malaria Dataset
  • Data: % of population at risk of malaria.
  • Geographical coverage: Global – by country.
  • Time span: 1960 - 2000 (observations every 5 years – including interpolations)
  • Available at: Online here.

WHO data on incidence of malaria cases
  • Data: Incidence of malaria cases
  • Geographical coverage: Global – by country.
  • Time span: 1962-1997 – annual data.
  • Available at: Online available at the website of Marta Reynal-Querol.

Other sources: Up-to-date information on the current state of malaria is published by the Roll Back Malaria Partnership – a partnership between WHO, UNICEF, UNDP and the World Bank.