Malaria Incidence in Rwanda Rises from 45 to 76 per 1,000 in 2023/24–2024/25

Malaria incidence in Rwanda rose sharply to 76 cases per 1,000 people in the 2024–2025 fiscal year, up from 45 per 1,000 in 2023–2024, highlighting a renewed surge in transmission despite ongoing control efforts.

The latest data from the Rwanda Biomedical Centre (RBC) also shows that total malaria cases rose from 610,832 in 2023–2024 to 1,131,314 in 2024–2025, before dropping to 928,616 in 2025–Q1 2026 (First Quarter 2026). However, the current figures remain significantly higher than the 619,559 cases recorded in 2022–2023.

Health officials say the increase in incidence, a key indicator of how widely the disease is spreading, points to a broader resurgence that requires more targeted and adaptive responses.

Speaking during a press briefing on April 20, Dr. Aimable Mbituyumuremyi, Division Manager for Malaria and Other Parasites at RBC, said the country is now grappling with a resurgence driven not only by environmental factors, but also by declining effectiveness of traditional control measures.

He said, “The country is seeing a malaria resurgence, both in cases and incidence.”

He noted that while the recent decline in cases offers some relief, transmission levels remain elevated compared to earlier years.

“The figures are still above what we recorded before the surge, which means we cannot relax interventions,” he added.

Data covering July 2025 to March 2026 further reveals uneven distribution across the country, with Gisagara District recording 216,350 cases—the highest nationwide. Other high-burden districts include Gasabo with 98,077 cases, Bugesera with 74,073, and Kicukiro with 65,297.

In contrast, Nyabihu recorded the lowest number of cases at 2,521, followed by Burera with 3,680 and Rubavu with 5,169.

According to Dr. Mbituyumuremyi, the variation in case numbers underscores the need for geographically tailored interventions rather than uniform national responses.

“Malaria is not evenly distributed across the country, and our response must reflect the level of risk in each area,” he said.

In high-burden districts, authorities are scaling up indoor residual spraying, expanding access to mosquito nets, and strengthening testing and treatment services. Community outreach is also being intensified to encourage early care-seeking.

At the same time, health experts warn that biological and environmental changes are complicating control efforts. Rising insecticide resistance is weakening the effectiveness of mosquito nets and spraying, while mosquitoes are increasingly biting outdoors and earlier in the evening.

“Some of our key interventions are becoming less effective, which is a serious concern,” Dr. Mbituyumuremyi said.

He added that human activities such as rice farming, mining, construction, and water harvesting are creating more breeding sites, while longer rainy seasons are accelerating mosquito reproduction.

Other contributing factors include reduced immunity in communities after years of lower transmission, delays in seeking treatment, and cross-border population movement.

Of particular concern is early evidence suggesting that malaria parasites may be responding less effectively to artemisinin, the main drug used in treatment.

To address this risk, Rwanda introduced Multiple First-Line Therapies in 2024, allowing the use of different artemisinin-based combination treatments simultaneously to slow the development of drug resistance.

“Using multiple therapies helps us protect the effectiveness of current treatments for a longer period,” he explained.

With incidence rising and resistance threats emerging, health authorities say sustained vigilance and data-driven strategies will be critical to reversing the current trend.