Africa-Press – Rwanda. Rwanda has recorded a resurgence of malaria after nearly six years of steady progress in reducing the disease. Between 2017 and 2023, cases had dropped by 90 percent, but infections have been climbing again since January 2024.
In response, the Rwanda Biomedical Centre (RBC) will carry out indoor residual spraying (IRS) in 28 high-burden sectors in September and October.
By July this year, the country had registered 91,169 malaria cases nationwide, according to RBC data. Of these, 79,643 cases—about 87 percent—were concentrated in 15 districts, including Gisagara, Gasabo, Bugesera, Kicukiro, Nyagatare, Nyarugenge, Kirehe, Rulindo, Muhanga, Kayonza, Gicumbi, Karongi, Nyaruguru, Nyamasheke, and Nyamagabe.
What’s driving the resurgence?
“More than half of all cases were reported from 25 sectors, many in cross-border areas with high population movement. The rise in infections is linked to resistance to insecticides and medicines, changing mosquito behavior, and limited funding,” said Dr. Aimable Mbituyumuremyi, Division Manager for Malaria and Neglected Tropical Diseases at RBC.
He explained that mosquitoes are now biting earlier in the evening and more frequently outdoors, putting night-shift workers, security guards, fishermen, farm workers, and sex workers at greater risk.
Therapeutic studies have also confirmed partial resistance to artemisinin-based drugs, the main treatment for malaria. Environmental changes—including rice farming, mining, construction, and rainwater harvesting—are creating new breeding sites, while marshlands and dams remain areas of transmission.
Many people carry the parasite without symptoms, complicating efforts to control its spread. At the same time, intervention coverage has declined. Twelve high-burden districts that once received both IRS and insecticide-treated nets (ITNs) now benefit only from spraying.
This follows updated guidance from the Global Fund and the President’s Malaria Initiative (PMI), which prioritises IRS in high-risk sectors to maximize limited resources and tackle insecticide resistance.
Dr. Mbituyumuremyi added that poor housing conditions allow mosquitoes to enter homes easily, while funding cuts—especially from USAID—are expected to scale down prevention efforts further.
“This is not just about mosquitoes adapting. It is also about protecting vulnerable groups who are left out of traditional interventions,” he noted.
The resurgence was most visible during the peak transmission season from April to June. It was further revealed by new Reactive Case Detection in 25 hotspot sectors across Kigali City, Bugesera, Nyagatare, and Gisagara, which identified infections that might otherwise have gone undetected.
Control measures
RBC says measures are being stepped up. IRS is scheduled for 28 high-burden sectors in Bugesera, Nyagatare, Gisagara, Nyanza, Rwamagana, and Kirehe districts in September and October, with another 55 sectors targeted for February and March 2026.
To address drug resistance, new treatments—including dihydroartemisinin–piperaquine (DHAP) and artesunate–pyronaridine (ASPY)—have been added to the standard Coartem regimen under a multiple first-line therapy approach. Nets treated with dual insecticides are also being procured.
Community outreach continues through seven civil society organizations working with high-risk groups, while national and district task forces conduct daily reporting and risk assessments to guide targeted interventions.
“We are working closely with partners and communities to adapt strategies and sustain progress,” Dr. Mbituyumuremyi said.
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