“Money, Population, and Insecticide Resistance: Why malaria cases haven’t declined since 2015” by Paul SHC

Note: I am not a malaria expert. This is my best-faith attempt at answering a question that was bothering me, but this field is a large and complex field, and I’ve almost certainly misunderstood something somewhere along the way.

Summary

While the world made incredible progress in reducing malaria cases from 2000 to 2015, the past 10 years have seen malaria cases stop declining and start rising. I investigated potential reasons behind this increase through reading the existing literature and looking at publicly available data, and I identified three key factors explaining the rise:

1. Population Growth: Africa's population has increased by approximately 75% since 2000. This alone explains most of the increase in absolute case numbers, while cases per capita have remained relatively flat since 2015.
2. Stagnant Funding: After rapid growth starting in 2000, funding for malaria prevention plateaued around 2010.
3. Insecticide Resistance: Mosquitoes have become increasingly resistant [...]

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Outline:

(00:25) Summary

(02:06) Introduction

(04:31) Ok, give me the 1 minute rundown on what malaria is and how we fight it?

(05:22) Preventing malaria has historically meant distributing bednets

(07:58) There's a lot of good evidence showing that bednets have been effective at preventing malaria

(09:07) The percent of people with access to bednets and the percent of people sleeping under bednets have both stayed constant or increased since 2015

(10:47) So what did cause the increase in malaria cases since 2015?

(11:54) Factor 1: Population increase

(17:35) Factor 2: Stagnant funding

(23:21) Factor 3: Insecticide resistance

(34:23) What are the relative contribution of these three components?

(38:10) Factors that don't seem to be major contributors

(38:27) The decline until 2015 and stagnation after do not represent trends in separate countries or regions

(39:37) Removing PFAS from bednets doesn't appear to have affected experimental hut results

(44:23) Anopheles stephensi isn't present in the areas with the highest rates of malaria yet

(45:26) Nobody knows if climate change is making malaria worse

(47:20) Conclusions

The original text contained 6 footnotes which were omitted from this narration.

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First published:
March 16th, 2025

Source:
https://forum.effectivealtruism.org/posts/rxTPv3MdrsHiqK7kM/money-population-and-insecticide-resistance-why-malaria

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Narrated by TYPE III AUDIO.

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