Shortages of mosquito nets on the Rwandan market and the continued use of old, worn-out ones are increasing the risk of malaria infection. ALSO READ: Malaria response focuses on high-burden districts According to Vestine Kaneza, a community health worker at Kabuye Health Centre in Jabana Sector of Gasabo District, many insecticide-treated mosquito nets in households are now more than three years old and may no longer provide adequate protection against mosquitoes. She noted the need for replacement nets to maintain effective prevention. ALSO READ: Where the malaria fight begins: Inside the community health frontlines Kaneza said that community health workers sometimes face limited availability of antimalarial medicines such as Coartem, which are used for immediate first-line treatment before patients are referred to health facilities. Dr Aimable Mbituyumuremyi, Division Manager for Malaria and Neglected Tropical Diseases at the Rwanda Biomedical Centre (RBC), said the shortage of insecticide-treated nets increases malaria transmission among people who lack other preventive measures, such as indoor residual spraying. He added that insufficient diagnostic tools and antimalarial drugs can delay treatment, raising the risk of severe illness and death from malaria. “Some of these issues occur because community health workers do not sometimes receive additional stock from health centres, while in other cases there are challenges related to the equitable distribution of supplies,” Mbituyumuremyi said. “We need to engage with individual community health workers to understand the challenges they face. Isolated cases may go unnoticed if they are not reported.” He noted that several measures are already being implemented, including the procurement and distribution of insecticide-treated mosquito nets in targeted sectors. Distribution has been completed in some areas and is planned for the remaining zones before the end of June. Rapid diagnostic tests and antimalarial drugs are also being distributed regularly. Mbituyumuremyi identified low funding, drug resistance, mosquito resistance, the increasing number of uncontrolled mosquito breeding sites, and human and mosquito behaviour as some of the main challenges affecting malaria control efforts. Increased rainfall often creates favourable conditions for mosquito breeding, leading to a rise in malaria cases. Rwanda Meteorology Agency forecasts 20 and 120 millimetres of rainfall in June, slightly above the long-term average of 10 to 100 millimetres. Mbituyumuremyi said the country expects flooding and the formation of stagnant water bodies during the rainy season, both of which contribute to increased malaria transmission. He urges the public to use all available malaria prevention measures. Data from the Rwanda Biomedical Centre shows that malaria cases have fluctuated in recent years. Cases increased from about 611,000 in 2023/24 to 1.13million in 2024/25 before declining to juts over 928,000 in 2025/26. Malaria control interventions Rwanda has adopted a targeted malaria control approach that allocates resources based on district-level risk. Using a classification system that groups districts into four categories by annual parasite incidence, interventions are tailored to local transmission levels. While prevention and treatment are implemented nationwide, priority is given to high-burden districts where impact is expected to be greatest. The 2026-2030 malaria control strategy will continue focusing on the most affected areas, particularly districts in the Eastern Province, which consistently record the highest transmission rates. Mbituyumuremyi said that areas classified as having high malaria transmission, with at least 100 cases per 1,000 people annually, are concentrated mainly in parts of Nyagatare, Gatsibo, Kayonza, Rwamagana, Ngoma and Kirehe districts. These areas will receive focal indoor residual spraying, routine distribution of insecticide-treated mosquito nets, standard case management, and standard social and behaviour change interventions. Districts classified as having moderate transmission, with 50 to 99 cases per 1,000 people, will receive routine mosquito net distribution, standard case management, social and behaviour change interventions, as well as mass distribution of nets aimed at maintaining high coverage in at-risk communities. Areas with low transmission, where annual parasite incidence ranges from 30 to 49 cases per 1,000 people, will receive routine mosquito net distribution, case management, social and behaviour change interventions, and reactive case detection. The same package of interventions will be implemented in very low transmission areas, where annual parasite incidence is below 30 cases per 1,000 people. Mbituyumuremyi said malaria transmission is no longer evenly distributed across the country. While much of Northern and Western provinces now record low or very low transmission rates, several Eastern districts continue to carry a heavier burden due to environmental conditions favourable for mosquito breeding. “Rice fields are a concern because they create ideal conditions for mosquitoes to breed and sustain malaria transmission. People living near wetlands, irrigated farmland, and large water bodies are at higher risk of infection.”
