As malaria cases persist, community health workers remain at the forefront of the response, delivering early diagnosis and treatment that reduce severe illness and deaths. In the 2024–2025 fiscal year alone, they managed about half of all reported cases, according to Rwanda Biomedical Centre (RBC). ALSO READ: Malaria response focuses on high-burden districts Experts say community health workers educate communities on malaria prevention and encourage early and timely care-seeking. They also support the government’s indoor residual spraying programme, which involves applying insecticide inside homes in high-risk sectors. ALSO READ: Rwanda rolls out new malaria strategy after recording 87,000 cases in March Malaria has been resurging in the country and data from RBC shows that cases fluctuated in recent years, rising from 610,832 in 2023–2024 to 1,131,314 in 2024–2025, before declining to 928,616 in 2025–2026. This remains higher than the 619,559 cases recorded in 2022–2023. The national incidence rate also increased from 45 cases per 1,000 people in 2023–2024 to 76 per 1,000 in 2024–2025. As World Malaria Day is marked on April 25, this year’s theme, “Driven to End Malaria: Now We Can. Now We Must,” highlights that with new vaccines, treatments, and technologies, ending malaria is achievable, while also urging urgent action and increased funding. I n Rwanda, the fight against malaria continues, with community health workers supporting the response at the community level. Dr. Eric Niyongira, a public health practitioner, said malaria remains a major public health concern in the country. He explained that community health workers are the foundation of malaria care, particularly at the primary healthcare level, where nearly half of cases are managed within communities. Introduced in 1995, community health workers have strengthened malaria control through health education, prevention, early diagnosis, and prompt treatment. “Their close connection with communities enables them to deliver holistic, patient-centred care, extending beyond testing and treatment to include follow-up, adherence support, and early identification of complications. This complements facility-based services, where high patient volumes often limit such continuity of care,” Dr. Niyongira said. Vestine Kaneza, a community health worker at Kabuye Health Centre, in Tetero Village, Kabuye Cell, Jabana Sector, said she has always urged area residents to consistently sleep under insecticide-treated mosquito nets, eliminate stagnant water where mosquitoes breed, close windows by 6 p.m., and comply with indoor residual spraying and other government malaria prevention programmes. “We call upon people to visit the nearest health centers for a check-up if they experience symptoms such as fever and headaches,” she said. Kaneza noted that community health workers continue to face several challenges including limited access to rapid diagnostic test kits (RDTs) used to confirm malaria cases, as well as shortages of antimalarial medicines such as Coartem, which are needed for immediate first-line treatment before referring patients to hospitals. She also pointed out that many insecticide-treated mosquito nets in households are now more than three years old and may no longer provide adequate protection, underscoring the need for replacements. Additionally, she emphasized the need for financial support for community health workers to ensure the smooth execution of their duties. Nonetheless, the trust community health workers enjoy within communities enhances their effectiveness in driving behaviour change through local platforms, supporting sustainable malaria prevention efforts, Dr. Niyongira said. “Their impact demonstrates the importance of investing in strong primary healthcare systems to accelerate malaria control and elimination,” he said. Community health workers assist in the distribution and proper use of mosquito nets, mobilise communities during prevention campaigns, and collect and report malaria cases to the health system, helping Rwanda track outbreaks and respond effectively. The country is shifting its malaria response approach, moving away from a uniform strategy to targeted interventions based on risk levels. The government’s 2025–2030 plan recognises that malaria transmission is uneven across the country, requiring tailored responses. In high-burden districts, indoor spraying will continue alongside expanded distribution of mosquito nets and increased testing and treatment. Community health workers will intensify outreach efforts to encourage early care-seeking. In moderately affected areas, routine net distribution, treatment services, and awareness campaigns will continue, with mass campaigns introduced when necessary. In low-transmission areas, the focus will be on early detection and testing people living near confirmed cases. In areas where transmission is already low, health workers will prioritise rapid detection and follow-up to prevent resurgence. Rwanda has begun discussions on introducing a malaria vaccine into its national immunisation programme, as health officials assess scientific, regulatory, and system readiness amid rising cases. In a recent interview with The New Times, Hassan Sibomana, the Director of the Vaccine Programmes Unit at RBC, said the process is still at an early stage and no decision has been made on the specific vaccine to be used. Any vaccine introduction follows a defined technical process, including World Health Organization (WHO) prequalification, national regulatory approval, and a recommendation from the National Immunisation Technical Advisory Group (NITAG). “We assess the malaria burden, the affordability of the vaccine, and whether the health system has the capacity to introduce another vaccine,” Sibomana said. “Most of the challenges associated with vaccine rollout relate to preparation and system readiness, including logistics, financing, and service delivery. These are addressed during the preparation phase before the final readiness assessment,” he added. Once introduced, the vaccine will be integrated into the routine immunisation programme to ensure wide access. Malaria cases continue to rise in some districts. Data covering July 2025 to March 2026 shows that Gisagara District recorded 216,350 cases, followed by Gasabo with 98,077, Bugesera with 74,073, Kicukiro with 65,297, Ngoma with 62,537, and Nyagatare with 50,628. ALSO READ: What’s driving malaria resurgence? Experts say the resurgence is driven by multiple factors, including growing insecticide resistance, which is reducing the effectiveness of indoor residual spraying and mosquito nets. Mosquitoes are also increasingly biting people outdoors and earlier in the evening. Activities such as mining, rice farming, construction, and rainwater collection increased breeding sites. Longer rainy seasons, reduced community immunity after years of lower transmission, delays in seeking treatment, and cross-border movement are also contributing to the challenge.
