FOR the first time in decades, defeating malaria in our lifetime is possible, according to WHO. Yet in Pakistan, where 1.8m cases were reported in 2025 despite a 10pc drop from the year before, that promise remains fragile. The disease still thrives where poverty, weak health systems and climate shocks intersect, a reminder that progress can be reversed as quickly as it is made. This warning from WHO deserves to be taken seriously. Pakistan has yet to recover from the malaria surge triggered by the 2022 floods, which exposed how climate-driven disasters can rapidly undo years of disease control. As temperatures rise, rainfall patterns shift and flooding recurs, the conditions that favour mosquito breeding are becoming harder to contain. Climate adaptation and disease control can no longer be treated as separate agendas. There have been gains worth protecting. Nearly 16.9m suspected cases were screened in 2025, most confirmed patients received treatment, and around 12m insecticide-treated nets have been distributed over three years. Community-based case management offers hope for reaching remote populations often left beyond the health system’s reach. New vaccines and other innovations could further strengthen the fight.

But tools alone do not defeat disease. Delivery does. Persistent transmission in Balochistan, rural Sindh and parts of KP underlines the inequities that sustain malaria. Basic Health Units and Rural Health Centres must have reliable supplies of rapid diagnostic tests, effective medicines and, where appropriate, vaccines. Surveillance must be strengthened, not weakened by shrinking aid. The larger lesson is that malaria control cannot depend on donor cycles or emergency responses after outbreaks erupt. It requires steady domestic investment, especially as global health financing comes under strain. Pakistan’s public health priorities must reflect this reality. The opportunity to push malaria back may be real. But opportunity alone saves no one. Unless prevention, funding and front-line delivery are intensified now, a disease that should be receding may yet resurge.

Published in Dawn, April 28th, 2026