Innovation meets impact: Fighting malaria in a warming world

In the Brazilian Amazon, where rivers serve as roads and homes are scattered across vast stretches of rainforest, malaria is more than an illness — it’s a force that quietly erodes the foundations of family and community. As one frontline health worker explained, “Malaria, in our experience, destroys the family first. Because if the provider is sick, the family cannot get fish, nor income, nor flour. And thus begins the downfall of the family.”

This is the reality for thousands across the Amazon, where 99% of Brazil’s malaria cases occur. When a parent falls ill, children miss school, work is delayed, and livelihoods are threatened. Malaria may not claim as many lives in South America as it does in Africa, but its social and economic toll remains deep and persistent.

Now, climate change is intensifying these pressures. In the Amazon, rising temperatures, unpredictable rainfall, and record floods are reshaping malaria transmission. By 2050, Brazil’s average temperature could increase by 2.2 degrees Celsius, potentially extending the malaria season by over a month. Severe flooding events — increasingly common in the states of Amazonas, Acre, and Pará — are followed by prolonged droughts, which isolate riverine and Indigenous communities from care. These converging crises threaten to undo years of progress toward Brazil’s goal of eliminating malaria by 2035.

As the world turns its attention to Belém, Pará, for climate conference COP30, the intersection of climate and health has never been more urgent — nor has the leadership opportunity. Brazil is stepping forward with the Belém Health Action Plan, a flagship initiative that positions health adaptation at the center of global climate discussions. Building on momentum from the recent Global Conference on Climate and Health in Brasília, the plan reflects Brazil’s commitment to innovation, setting a vision for climate-resilient health systems and equitable access to new tools. And it calls on the world to follow its lead.

Central to this vision is the development of simple, long-lasting, and heat-stable health tools that can withstand the challenges of both geography and climate. In regions where people may live many hours from the nearest clinic, where floods wash away roads or droughts cut off river transport, and where health services are often overwhelmed due to health challenges resulting from climate change, innovative solutions must meet people where they are.

For decades, treatment for Plasmodium vivax malaria, the most common species in the Americas, required seven or 14 days of pills. Many patients stopped treatment once the fever subsided, unaware that the parasite could linger in the liver and relapse weeks later. The result: recurring illness, lost income, and community fatigue.

That changed with tafenoquine, a liver-stage treatment developed by GSK and Medicines for Malaria Venture, or MMV, that prevents relapse in a single dose. In a region where patients are often on the move or far from health posts, tafenoquine has proven transformative.

“By bringing tafenoquine to the municipalities where most malaria cases occur, we’re not just reducing numbers — we’re rebuilding confidence that elimination is possible,” said Alexander Vargas, head of the National Malaria Program in Brazil.

In 2025 alone, preliminary data from the Brazilian National Malaria Program show that over 13,000 Brazilians received the new treatment across 83 municipalities and 13 Indigenous Sanitary Districts, contributing to a 22% drop in malaria cases compared to 2024. The Ministry of Health has already expanded its rollout to all high-transmission areas of Pará state, including Belém — a powerful signal of how science and political will can converge for climate-resilient health.

But as climate change reshapes malaria transmission worldwide, innovation must continue to power elimination in the Amazon and beyond. The next frontier — long-acting injectable medicines that provide up to six months of malaria protection in a single dose across malaria strains — could transform prevention, offering durable, heat-stable protection in even the most remote corners of the world.

This is the kind of innovation envisioned in the Belém Health Action Plan — resilient, simple, and designed for a warming world. From the Amazon to Africa, what unites these efforts is a simple truth: The tools that are long-lasting and single-dose are the ones that have the potential for the widest reach.

As COP30 unfolds in Belém, the world’s attention will turn to the Amazon, a living laboratory for resilience. Brazil’s fight against malaria offers a lesson that reaches far beyond its borders: When innovation meets simplicity, and when science meets the realities of those on the frontlines, disease elimination becomes possible.

With sustained political will and investment in innovation, we can build a future where malaria — and the inequities it fuels — are finally left behind.

Please visit the Vivax Information Hub for more information about P. vivax malaria. https://www.vivaxmalaria.org/