气候变化正在改变非洲疟疾的地理分布。随着气温上升，东非和南部非洲的高海拔地区正变得越来越适宜疟疾传播，而西非部分地区则因过度炎热反而不利于疟疾蚊虫活动[1]。疟疾蚊虫传播的最优温度范围约为25摄氏度，温度低于16摄氏度或高于34摄氏度时传播会大幅下降[1]。
非洲疟疾负担依然沉重。世卫组织非洲地区占全球疟疾病例和死亡人数的约95%[1]。其中，尼日利亚、刚果民主共和国和尼日尔三国承载该地区约49.7%的疟疾死亡人数[1]，而该地区约76%的疟疾死亡者是5岁以下儿童[1]。
尽管西非可能从气候变化中获得短期益处，但作为历史上疟疾负担较低的地区，东部和南部非洲正面临新的威胁[1]。非洲卫生系统应对气候变化的速度滞后于气候变化的步伐[1]。世卫组织在2025年4月警告，资金削减危及疟疾控制工作，超过一半受调查的疟疾流行国报告疟疾服务中断严重[1]。在疫苗方面，一项《柳叶刀》发表的研究发现，RTS,S/AS01疟疾疫苗在加纳、肯尼亚和马拉维的试点项目中使符合条件儿童的全因死亡率降低了13.2%[1]。
Climate change is fundamentally altering the geographic distribution of malaria transmission across Africa, with rising temperatures creating new breeding grounds for disease-carrying mosquitoes in previously cooler regions while rendering some historically endemic areas less suitable for transmission.[1] The World Health Organization's African region accounts for approximately 95% of global malaria cases and deaths, with Nigeria, the Democratic Republic of the Congo, and Niger together responsible for 49.7% of all malaria deaths in the region.[1] About 76% of malaria deaths in Africa occur among children under five years old.[1]
The shift in transmission patterns stems from temperature dynamics that directly affect mosquito reproduction and parasite development. Malaria transmission occurs optimally around 25 degrees Celsius (77 degrees Fahrenheit), with transmission substantially declining below 16 degrees Celsius or above 34 degrees Celsius.[1] This temperature sensitivity means that highland areas in East and Southern Africa, historically burdened with lower malaria rates, are becoming increasingly conducive to disease spread as temperatures rise, while parts of West Africa may experience reduced transmission as heat intensifies.[1] However, health systems in East and Southern Africa have not adapted quickly enough to keep pace with these climate-driven changes, leaving populations in these regions vulnerable to emerging threats.[1]
Public health interventions offer some promise in combating the evolving threat. A study published in The Lancet found that the RTS,S/AS01 malaria vaccine reduced all-cause mortality by 13.2% among eligible children in pilot programs across Ghana, Kenya, and Malawi.[1] Nonetheless, efforts to control malaria are being undermined by funding shortages—in April 2025, the WHO warned that budget cuts are jeopardizing malaria control initiatives, with more than half of surveyed malaria-endemic countries reporting severe disruptions to malaria services.[1]