Malaria cases in Mpumalanga increased fourfold in January compared with the same period a year earlier, according to the National Institute for Communicable Diseases (NICD). This intensifies concern over South Africa’s goal of eliminating the disease by 2029. This dramatic malaria cases surge highlights the urgency for effective intervention.
The sharp rise comes as several southern African countries report major increases in malaria cases. This is because heavy rainfall, flooding, and warmer conditions have created ideal breeding grounds for mosquitoes.
Although malaria is mainly endemic in South Africa’s lowveld regions, the latest figures show that the risk is not limited to traditional hotspot areas. Johannesburg and Pretoria, where malaria is not normally transmitted, recorded more than 400 cases and 11 deaths in the first three months of the year. The NICD said this is a concerning trend.
Most infections in Gauteng were imported from known malaria areas rather than locally acquired, according to the health body. However, the NICD described the numbers as concerning. This is particularly important because malaria is often diagnosed late in non-endemic areas, increasing the risk of severe illness and death.
Climate change intensifies Surge in Malaria
Experts say the latest increase does not necessarily mean malaria is permanently moving into new parts of South Africa. Instead, climate change is intensifying outbreaks in existing malaria zones and extending the periods during which transmission can occur.
Human-driven climate change has increased the likelihood and severity of extreme weather events. At the same time, the naturally occurring La Niña phenomenon brought above-average rainfall to parts of southern Africa in early 2026.
Flooding and stagnant water created more mosquito breeding sites, increasing the risk of malaria transmission in vulnerable areas.
Professor Jantjie Taljaard, head of infectious diseases at Stellenbosch University, said climate change is “supercharging” existing malaria zones rather than simply shifting the disease into new regions.
This could force health authorities to rethink malaria prevention strategies. Traditionally, these have focused on summer months and known transmission areas.
Southern Africa Faces Surge in Malaria Infections
South Africa is not the only country dealing with a malaria resurgence.
Namibia reported 8,760 malaria cases in the first four weeks of the year, representing a 68% increase from the same period a year earlier. Mozambique, which has been affected by flooding, recorded a 55% increase in cases. Dozens of deaths were also reported.
The regional surge is putting pressure on malaria control programmes, particularly in border areas. This is where cross-border movement can increase the number of imported infections.
Winter malaria transmission challenges old assumptions
Changing weather patterns are also complicating long-standing assumptions about when malaria prevention is most needed.
Sharon Lindiwe Nyoni, malaria programme manager at the Mpumalanga department of health, said climate change has made malaria planning more complex.
She warned that the idea of malaria being limited to summer no longer holds. Moreover, transmission is now being recorded even in winter.
This has serious implications for public health messaging, mosquito control, diagnosis and treatment. It also places additional pressure on local health systems already managing seasonal outbreaks.
Travellers urged to take malaria precautions
Health experts warn that many people living outside malaria areas become complacent when visiting endemic regions, especially the lowveld. Some travellers do not take malaria prophylaxis, while others may be unsure about preventive medication.
This can be dangerous. People returning from malaria-risk areas may mistake early malaria symptoms for flu, delaying urgent treatment.
Authorities continue to urge travellers to use mosquito repellent, sleep under treated nets where necessary, and wear protective clothing. They also recommend seeking medical advice on prophylaxis before visiting malaria-endemic areas.
With climate volatility deepening across southern Africa, experts say prevention, early diagnosis, and stronger cross-border surveillance will be essential. This will be critical if South Africa is to remain on track to eliminate malaria by 2029.
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