Rwanda is launching a nationwide malaria control strategy that includes new treatment drugs and a plan to test and treat entire households when one member tests positive, health officials said this week.
The move comes in response to a sharp rise in malaria cases and changes in how the disease is spreading. Officials say both the malaria parasite and the mosquitoes that carry it are adapting, threatening to undermine years of public health progress.
“We are seeing changing patterns in how malaria presents and spreads,” said Epaphrodite Habanabakize, a malaria control Senior Officer at the Rwanda Biomedical Center (RBC). “We need to stay ahead of the parasite.”
Under the new plan, community health workers will test and treat all members of a household when one person is diagnosed with malaria — even if they show no symptoms. The goal is to identify and treat asymptomatic carriers who may unknowingly transmit the parasite to others.
“In a home where one person is sick, it’s likely others have the parasite but are asymptomatic,” Habanabakize said. “Treating them early will reduce the risk of further infections.”
The initiative is being rolled out in the capital, Kigali, where infections have surged in recent months. Out of Rwanda’s 20 most affected sectors, 15 are located in the Kigali. Gasabo District reported the highest number of cases in February at 15,409, followed by Kicukiro with 10,473. Nyarugenge ranked fifth nationwide with 5,161 cases.
Beyond the new community-based approach, RBC is also introducing alternative anti-malaria medications to complement Coartem, the country’s standard treatment. Some patients have stopped responding to Coartem, prompting concerns about drug resistance.
Hospitals in certain districts have already begun receiving the new drugs, which will be rotated with Coartem in different regions and seasons to prevent the parasite from building resistance.
“If we use Coartem in zone A, we’ll use another drug in zone B,” Habanabakize said. “At the end of the year, we’ll switch them. The goal is to keep the parasite from adapting.”
Rwanda recorded 800,000 malaria cases in 2024, up from 600,000 in 2023. While the numbers are far lower than the 5 million cases reported in 2016–17, health officials warn that progress could be reversed without urgent intervention.
Nearly 40% of the cases recorded in the last three months came from Gisagara District in the south, one of the country’s hardest-hit areas, alongside Nyagatare in the east.
Officials are urging the public to remain vigilant by using insecticide-treated mosquito nets, spraying indoors and eliminating standing water where mosquitoes breed.
“The fight against malaria is far from over,” Habanabakize said. “But with early treatment, drug innovation and community involvement, we can stop the cycle of transmission.”
