Ghana’s decades-long progress in malaria control is now under serious threat as health experts warn of the growing resistance of malaria parasites to artemisinin, the cornerstone of global malaria treatment. Speaking at a high-level dialogue on malaria elimination during the ICASA 2025 conference, Dr. Felicia Antwi, WHO Country Representative for Malaria and Neglected Tropical Diseases, cautioned that “emerging mutations of the malaria parasite are gradually weakening the potency of artemisinin-based combination therapies (ACTs), which have been the world’s most effective malaria medicines for the past years.”
Countries such as Rwanda, Eritrea, Ethiopia, Tanzania, and Uganda have already reported increasing trends of partial resistance, and experts fear that with high regional mobility and increased air travel, the entire continent is now at risk. The challenge is compounded by weak surveillance systems. Although tools and guidelines for detecting resistance exist, many African countries lack the funding to implement them effectively. Dr. Antwi urged governments to take ownership of malaria research, education, and monitoring activities, stressing that
“ The medicines we rely on are becoming gradually ineffective because the parasites are learning to overcome them. If we lose these ACTs, we lose our strongest line of defence. We will see more severe cases, more deaths, overcrowded health facilities, and higher outofpocket payments for households ”
poor treatment adherence, self-medication, and the circulation of fake or substandard drugs are worsening the threat. Dr. Hilarius Abiwu, Programme Manager of the National Malaria Elimination Programme (NMEP), described malaria as the single disease consuming the largest share of Ghana’s health budget. He revealed that “the malaria programme spends an average of US$100 million annually on interventions, with 60 percent of it funded by the Global Fund, while the government contributes the remaining 40 percent.”
He warned that drug resistance could sharply increase treatment costs, noting that medicines once priced under US$1 have already been replaced by far more expensive ACTs due to earlier resistance. “If we fail to protect the medicines we have now, Ghana will pay multiple times more just to treat malaria. This is why we need investments not only from government and global partners, but also from the private sector,” he added.
Abiwu cited AngloGold Ashanti as an example of how private sector involvement can make a difference, pointing out that the mining company significantly reduced malaria-related sick days after investing in vector control. He called for a multi-sectoral approach, highlighting how agriculture, sanitation, transport, and tourism all contribute to mosquito breeding risks. “Agricultural activities are contributing to the problem we are having with malaria, because they do irrigation, which is a breeding ground for mosquitoes. We are talking about open drains that are filled with a lot of water and become breeding places. We have lorry tyres in the transport sector which is one of the biggest breeding places for mosquitoes. In tourism, people coming into this country are bringing in some of these parasites, which can be transmitted to us very easily. So, the only way we can get ahead of the game is to make sure that we make the appropriate investments,” he explained.
Civil society leaders also emphasized the importance of inclusive collaboration. Mrs. Cecilia Senoo, Executive Director of Hope for Future Generations, argued that malaria control efforts remain overly centralized. “Malaria elimination cannot succeed when key partners are sidelined. Civil society, manufacturers, mothers, community leaders, and the media all have critical roles. We need innovative strategies for prevention and sustained education,” she said. Senoo urged the government to invest in malaria research and scale up the malaria vaccination programme, stressing that Ghana must not rely solely on donor funding.
The growing resistance to artemisinin is not just a medical issue but a socio-economic one. Malaria already consumes a significant portion of Ghana’s health budget, and rising treatment costs could strain households and the national economy. The risk of overcrowded health facilities, increased mortality, and reduced productivity threatens to reverse years of progress. Without urgent investment in surveillance, research, and community education, Ghana could face a resurgence of malaria cases at levels not seen in decades.
The message from experts is clear: Ghana must act decisively to protect its strongest line of defence against malaria. This means investing in surveillance systems, strengthening regulation against fake drugs, improving treatment adherence, and expanding vaccination programmes. It also requires mobilizing the private sector, civil society, and communities to play active roles in prevention and education. As Dr. Antwi warned, losing ACTs would mean losing decades of progress. The time to act is now, before resistance spreads further and the cost of inaction becomes unbearable.
