South Sudan’s warm, humid climate and vast wetlands provide ideal breeding grounds for malaria-transmitting mosquitoes. These conditions are further worsened by seasonal flooding, which intensified in 2024, displacing communities and disrupting already fragile healthcare systems — exacerbating malaria transmission across the country.
In a major step to tackle the disease, South Sudan introduced the R21 malaria vaccine into its national immunization program in July 2024. Over 645,000 vaccine doses were distributed across 28 high-burden counties. So far, 79,196 children aged 5 to 23 months have received the vaccine. However, the programme has faced significant challenges, including a 57% dropout rate between the first and second doses and an alarming 82% dropout by the third dose.
To improve malaria diagnosis and treatment, the WHO also provided 1.4 million rapid diagnostic tests (RDTs) and antimalarial medications for over 760,000 people. Injectable artesunate, the standard treatment for severe malaria, was made available to support case management throughout the health system.
Efforts to prevent malaria have also seen measurable gains. The 2023 Malaria Indicator Survey revealed a sharp rise in access to insecticide-treated nets (ITNs) — from 55% in 2017 to 94.7% in 2023. Usage rates improved from 32% to 67% over the same period. However, despite these gains, malaria prevalence among children under five increased dramatically from 32% to 52.6%, suggesting that ITNs alone are not sufficient.
To enhance impact, the Ministry of Health and partners have implemented a subnational tailoring strategy, adjusting interventions based on local epidemiological data and contexts. These targeted approaches aim to maximize the effectiveness of malaria prevention and treatment in high-burden areas.
Despite all these efforts, malaria remains a critical public health emergency in South Sudan. Health authorities continue to call for sustained international support, improved vaccine adherence, and a multi-layered strategy to turn the tide against one of the country’s deadliest diseases.
