Rwanda has achieved progress in reducing malaria cases and deaths over recent years. Between the 2016/2017 and 2023/2024 fiscal years, malaria cases dropped by 90%, from 4.8 million to 620,000. Malaria-related deaths also saw a decline, dropping from around 650 to 67 over the same period. This progress is evident in the number of districts nearing malaria pre-elimination status, which has grown from three, in 2017, to 27 currently. Despite the improvement, the number of malaria cases in 2024 raised concerns. From January to October, malaria cases surged to 630,000, up from 432,000 during the same period in 2023. October alone accounted for 112,000 cases, with 89% (100,000 cases) concentrated in 15 districts. ALSO READ: What’s driving malaria resurgence in Rwanda? According to the national malaria programme, 52% of these October cases, about 58,000, were reported in 25 sectors across Gisagara, Bugesera, Gasabo, Kicukiro, Nyanza, Nyamasheke, and Nyagatare districts. The government has embarked on measures to address the challenge. Here are the seven ways Rwanda is tackling the problem: 1. Deploying new WHO-approved drugs To tackle drug resistance, Rwanda is introducing Dihydroartemisinin-Piperaquine (DHAP) and Artesunate-Pyronaridine (ASPY) as alternatives to Coartem. Dr. Aimable Mbituyumuremyi, the Division Manager for Malaria and Other Parasitic Diseases at Rwanda Biomedical Center (RBC), noted that these medications, endorsed by the World Health Organization, are designed to improve treatment outcomes. Healthcare workers across the country are undergoing training to ensure the smooth adoption of these drugs. ALSO READ: What you should know about new antimalarial drugs amid case surge 2. Distributing advanced insecticide-treated nets Since 2020, Rwanda has distributed pyrethroid-PBO and G2 insecticide-treated bed nets to combat mosquito resistance. These nets specifically target resistant mosquito populations. According to Dr. Mbituyumuremyi, preparations are underway for the next phase of distribution to further bolster their effectiveness. 3. Expanding indoor residual spraying Indoor residual spraying was scaled up in high-burden districts like Nyagatare, Kirehe, Gisagara, and Bugesera. This intervention targets mosquito breeding grounds, reducing transmission risks. 4. Focus on malaria hot spots The Ministry of Health intensified investigations in districts where the majority of cases are concentrated, which accounted for 89% of October’s cases. These findings inform targeted interventions, such as enhanced community mobilization and vector control measures. 5. Combating self-medication and misuse Self-medication and improper drug use are the practices mainly fuelling drug resistance. Many people purchase antimalarial drugs without prescriptions, often taking incorrect doses. Dr. Mbituyumuremyi stressed the need for patients to consult healthcare professionals to ensure proper treatment and prevent further resistance. Message from Minister @nsanzimanasabin on the rise in malaria cases in some districts. ----- Ubutumwa bwa Minisitiri @nsanzimanasabin ku bwiyongere bwa Malariya mu turere tumwe na tumwe. pic.twitter.com/5TjrvX1G4X — Ministry of Health | Rwanda (@RwandaHealth) January 4, 2025 6. Engaging communities and local leaders Community involvement is central to malaria prevention. Local leaders and stakeholders are being mobilized to educate residents on measures such as clearing stagnant water and consistent bed net use. The Minister of Health, Dr. Sabin Nsanzimana, urged citizens to take proactive steps. He said: “Even a small cap of stagnant water can breed thousands of mosquitoes. Clearing bushes, removing stagnant water, and seeking prompt treatment are essential.” 7. Adapting to changing mosquito behaviour Mosquitoes are increasingly biting outdoors and earlier in the evening, diminishing the effectiveness of traditional methods like bed nets. Dr. Nsanzimana stressed the need for integrated approaches, including outdoor vector control, indoor spraying, and heightened public awareness.
