Climate change and malaria in west Africa: a review of strategies to handle one of the world's most prominent anthroponoses.

Abstract

Climate change is intensifying the threat of malaria in Africa by altering the geographical range, seasonality, and transmission intensity of the disease. Rising temperatures promote mosquito breeding and parasite development, whereas extreme weather events, particularly flooding, disrupt control efforts and create breeding sites, enabling their spread into previously unaffected highland areas. These factors pose an evolving public health challenge. Malaria-control strategies, often designed for stable climatic conditions, risk being outpaced by rapid environmental changes. However, little is known regarding how national policies integrate climate adaptation into strategic planning. We qualitatively analysed national malaria strategic plans and related policy documents from 11 west and central African countries, published between 2015 and 2025. We assessed incorporation of climate and weather information into malaria surveillance, early-warning systems, and vector-control planning. Although most countries recognise the influence of climate and seasonality on malaria transmission, explicit integration of climate data into planning and surveillance remains scarce. Ghana and Nigeria use advanced data-driven approaches, including predictive agent-based modelling and subnational stratification, to guide interventions, whereas Togo, Benin, Senegal, and The Gambia show emerging progress. However, most national malaria strategic plans remain reactive rather than predictive because of data, technical, and coordination gaps. This Review highlights policy and implementation gaps in integrating climate adaptation within malaria-control programmes. We recommend climate-resilient malaria strategies centred on enhanced surveillance, integrated meteorological forecasting, and strengthened institutional capacity to support adaptive, evidence-based interventions.