Africa: It Takes a Village to End Malaria –

The 78th World Health Assembly, the World Health Organization’s decision-making body, took place in Geneva, Switzerland, from 19 to 27 May. Every year, delegates from WHO member states come together to discuss and decide on the priorities and policies of the organisation going forwards.

The event takes place at a crucial time in global health, when shortfalls in funding threaten to undo gains made, with many lives at stake.

Some of the key themes discussed at this year’s meeting included better preparing for health emergencies and increasing the number of people experiencing better health and wellbeing. Much of this discussion overlaps with Malaria Consortium’s mission — in particular the emphasis of applying a human-centred approach for better health, a core tenet of Malaria Consortium’s work.

Earlier this year, I had the opportunity to present the important work we’re doing in this area at BX2025 in Abu Dhabi. The event was hosted by the Behavioural Insights Team (BIT) and the Behavioural Science Group and focused on the intersection of behavioural science and public policy.

Why tools alone don’t work

At Malaria Consortium, we know that distributing life-saving tools is only half the story. Insecticide-treated nets (ITNs), vaccines and antimalarial medications only work when people use them correctly and consistently.

The challenge is behavioural: families may not hang nets properly, communities may distrust new vaccines, or patients may not complete medication courses. These aren’t knowledge gaps — they’re deeply rooted habits, perceptions and practical barriers that prevent effective uptake.

By harnessing behavioural science to address the psychological and social factors that influence decision-making, we can achieve the sustained, high-coverage protection necessary for malaria elimination.

For instance, the Be In A Net research project, which is run in partnership with BIT, addresses the gap between ITN access and use. Barriers that can prevent use, such as perceptions that nets are unattractive or uncomfortable, are addressed through providing communities with their own choice of selected colours and textures for their nets. The project also implements public recognition through distributing stickers and bracelets or holding ceremonies to celebrate the people using their nets and encourage continued use.

Working with communities underpins all of Malaria Consortium’s work and is particularly effective in tackling malaria drug resistance. The Community-led Solutions to Antimicrobial Resistance (COSTAR) project employs participatory storytelling to make the concept of drug resistance more tangible, encouraging community members to contemplate a future in which antimicrobial drugs no longer work. Individuals lead dialogues to foster involvement and ownership of these interventions, so that appropriate health-seeking behaviours can be reinforced and become the norm.

The rollout of the groundbreaking malaria vaccine offers a powerful case study on why introducing a life-saving intervention requires far more than effective planning and logistics — it demands trust-building and persistent community engagement. Malaria Consortium supported the rollout of the malaria vaccine in Mozambique, and while initial uptake surged under the campaign, there was a steep drop-off for the second and third doses. This transition exposed the effect of access barriers, and the fragility of one-off social and behaviour change communications, highlighting the critical need for sustained, context-sensitive mobilisation.

From awareness to action

Fear, misinformation, access barriers and even poor timing can derail well-planned and well-intentioned efforts. Behavioural science can provide a roadmap to anticipate and address these sorts of challenges. In practice, this might mean using trusted messengers and emotional narratives to encourage return visits with reminders. The opportunity is clear: since we collectively want malaria vaccines to succeed, we must embed human behaviour in the design of the vaccine rollout. It’s about delivering trust, relevance and resilience.

The path towards malaria elimination will require strategic shifts to integrate behavioural insights to sustain high and correct use of proven current and new interventions. We should continue to embed human-centred approaches and capabilities in malaria programming. This means investing in behavioural diagnostics at the outset, embedding co-design with communities and iteratively testing what truly shifts behaviour. It also requires rethinking what success looks like — not just increased awareness and knowledge, but measurable behaviour change.

What’s at stake

Emerging threats such as rising antimalarial drug resistance and climatic exacerbation of the spread of vector-borne diseases pose major challenges to reaching malaria elimination. Combined with the new funding shortfalls, they have the potential to undo gains made.

Beyond the positive ramifications for health, addressing these challenges head-on would have other implications. A report from Malaria No More UK estimated that cutting malaria by 90 percent by 2030 could boost the economies of malaria-endemic countries by $142.7 billion. Failing to harness the health and economic benefits of ending the devastating effects of malaria on human and socioeconomic development is simply not an option.

Behaviour will be an important key to achieving a malaria-free future. To reach malaria elimination, behavioural science is one of the capabilities that should be at the core of malaria elimination programmes.