As climate shifts, malaria gains ground in southern Africa

In a remote South African village, Paulina Mhlongo sits in the yard as health workers in green protective gear move briskly through her home, soaking the walls with anti-mosquito insecticide.

Her teenage grandson fell critically ill last year from malaria, the disease that kills more than a quarter of a million people annually and is surging in southern Africa as the climate shifts.

Before this spraying, the family's "only defence" against malaria-carrying mosquitoes was a rattling fan, said Mhlongo, a 63-year-old retiree.

Her village of Calcutta is in Mpumalanga, one of three provinces in South Africa's malaria belt experiencing changing rain patterns and rising temperatures that favour mosquito breeding.

Heavy rains leave pools for eggs, while warmer temperatures speed up mosquito development and shorten the malaria parasite's incubation period.

Malaria cases in Mpumalanga jumped fourfold in January compared with a year earlier, according to the National Institute for Communicable Diseases (NICD).

The upsurge jeopardises South Africa's goal of eliminating the disease by 2029.

Gauteng -- the powerhouse province home to Johannesburg and Pretoria, and where malaria is not endemic -- logged more than 400 cases and 11 deaths in the first three months of 2026, according to the NICD.

While most infections were imported into the province from known hotspots, these figures are "concerning" even if the disease is not being transmitted between people, the public health body said.

Human‑driven climate change has increased the likelihood and intensity of extreme weather, while the naturally occurring La Nina weather phenomenon brought above‑average rains to parts of southern Africa in early 2026, causing flooding that created more mosquito breeding sites, the group said.

Namibia reported 8,760 cases in the first four weeks of 2026, a 68-percent increase from a year earlier.

Flood-hit Mozambique recorded more than 1.35 million cases in the first six weeks of the year, up 55 percent alongside dozens of deaths.

The outlook offers little reassurance as climate volatility deepens.

The increase in malaria cases does not mean the disease is migrating, said Professor Jantjie Taljaard, head of infectious diseases at Stellenbosch University.

Instead, climate change is supercharging existing hotspots and lengthening transmission windows, fuelling far more intense outbreaks.

"Rural environments and areas on the margins of established malaria risk areas are at highest risk," Taljaard said.

The effects are being felt on the frontline at Cunningmoore Clinic, where