This article walks through the eight findings and the recommendations based on the report ‘Malaria: Turning the Tide’. These findings have specific relevance for community health workers, managers and planners, and global partners.

• The report is available in English and in French.
• Read the report launch announcement and watch the launch event in English and in French.
• Enroll now in the peer learning certification ‘Turning the tide’ course in English and in French for any practitioner, planner or partner who wants to use these insights to strengthen their malaria work.

The full report carries more contributors, more countries, and more operational detail than any single article can. Read it.

Practical knowledge you can use

The report provides knowledge you can use. How can you know that it actually helped? We recommend four indicators sized for a working planner, a district team or a partner organisation.

• One decision changed, and you can name which one.
• Something moved in the right direction in private providers, in data, or in a new tool.
• A frontline contributor can see their experience in the decision that followed.
• The reader has a colleague they did not have before, and they can call on them when they have a problem.

What the report recommends

The recommendations are organised under three priority areas: private providers, data quality and use, and new tools.

For community-level staff

• Map the drug shop, the pharmacy and the faith-based clinic the neighbours visit before they come to the public facility, and ask the owners to refer suspected malaria cases.
• Keep a simple notebook for one month for the fevers heard about in homes that never reach the register, and bring it to the supervisor.
• When a new net, a new test or a new vaccine arrives, meet with one religious leader and one youth group before the first dose or the first distribution.

For managers and planners

• Build a national plan that includes private pharmacies, drug shops and faith-based facilities, with referral, quality assurance and supervision, not only information.
• Add one routine channel that captures what frontline workers see outside the register, for example a quarterly structured call with district-level contributors.
• Budget community engagement at the same time as cold chain and supply, and plan for misinformation as a predictable cost rather than a surprise.

For global research and product partners

• Fund implementation research on test-before-treat and referral models that connect pharmacies, drug shops and faith-based facilities with the public system.
• Treat convergent frontline reports on seasonality shifts, biting patterns, net non-use and counterfeit drugs as a qualitative early-warning signal and study them as such.
• Co-design acceptance studies for R21, next-generation nets and new diagnostics with frontline contributors before the trial protocol is locked.

How to read evidence grounded in health worker experiences

One contributor account does not prove what works everywhere.

It shows what is possible and what to test.

Where experience and routine data disagree, the report asks the reader not to choose, but to ask why they differ.

The eight findings

1. Even health workers cannot protect their own families

“Three of my children, aged 1, 3 and 5, have suffered from malaria, even though they sleep under mosquito nets. The youngest was hospitalised.”

Bisimwa Muzusa Emmanuel, physician, Bukavu, Democratic Republic of the Congo.

• Community health staff and volunteers: you are not alone, colleagues across the continent are losing sleep, income and children to malaria despite doing everything right.
• Managers and planners: the household cost of malaria is doubled by lost work and missed school, which budget models built on direct treatment costs miss.
• Global partners: when health workers who follow every rule still see repeat infections at home, current tools correctly used are not enough where vectorial capacity is high.

2. The climate is moving faster than the playbook

“Prolonged rains and higher temperatures have expanded mosquito breeding grounds, making malaria transmission harder to control.”

Melanie Abongo, public health specialist, Nairobi, Kenya.

• Community health staff and volunteers: if the mosquitoes are biting earlier, in new places, in new seasons, you are seeing what dozens of other countries are seeing.
• Managers and planners: fixed campaign calendars tied to traditional rainy seasons are losing their grip. Build flexibility into timing and geography.
• Global partners: convergent qualitative reports from dozens of sites describing the same shifts in seasonality, biting patterns and range expansion form an early-warning signal that precedes routine surveillance.

Some malaria care happens where guidelines do not reach

“People are afraid of the cost of hospital care. They turn to street medicines. This makes both treatment and data very hard.”

Koldimadji Moguena, nurse, Ennedi West, Chad.

• Community health staff and volunteers: when a patient arrives late and severe, they almost always tried something cheaper first. That path is information you can act on.
• Managers and planners: any treatment strategy that does not engage private pharmacies and drug shops will underdeliver. Several contributors report more than 60 percent of fever care happening outside public facilities.
• Global partners: the report cites a working case from Gabon where pharmacies were equipped to test before treating, with operational data on overtreatment and resistance pressure that routine systems do not capture.

A net that works in a trial may not work in a home

“Many people prefer to use nets for other things, for fishing, for hedges, for fencing chicken coops.”

Mutayongwa Mihigo Christian, physician, Kabare, Democratic Republic of the Congo.

• Community health staff and volunteers: the pattern is widespread. Ask families why before assigning blame. Heat, poor housing, family size and skin reactions are the recurring drivers.
• Managers and planners: coverage reports do not tell you whether nets are used. Post-distribution surveys do. Fund and read them.
• Global partners: contributors describe more round and flexible nets being accepted more readily than rectangular ones, a design variable that sits between efficacy trials and coverage statistics and is worth a closer look.

The cheapest tool is the one communities already own

“Young people clean the gutters and drains to stop mosquitoes from breeding. They do it to protect their families.”

Expert Kikobo Yves International, Kimbanseke district, Kinshasa, Democratic Republic of the Congo.

A nurse in Man, Côte d’Ivoire, Diby N’guessan Narcisse, contributes an account of breeding-site treatment paired with motorised spraying and a documented drop in local incidence.

Contributors also describe youth-led drain maintenance in Kinshasa and ducks eating mosquito larvae in Madagascar.

• Community health staff and volunteers: clearing water, cutting bush and fixing drainage works. It also brings in youth groups and faith leaders who would not attend a malaria meeting.
• Managers and planners: vector control is chronically underfunded relative to its reach. It is also the only intervention that reaches communities with no facility access.
• Global partners: these local innovations are natural experiments in integrated vector management, worth studying alongside the formal evaluation literature.

New vaccines succeed or fail on trust, before a single dose is given

“When RTS,S was being prepared in Ghana, false videos and audios spread fast. We worked with researchers and health services to speak on radio, in community centres, and through mobile vans. The new challenge will be hesitancy.”

Kingsley Kofi Nignere, community health worker, Kintampo Municipal, Ghana.

• Community health staff and volunteers: your voice, alongside religious and community leaders, is what families listen to before they accept a new vaccine.
• Managers and planners: misinformation arrives before the vaccine does. Budget community engagement at the same time as cold chain and supply, not after.
• Global partners: a decade of comparable patterns, from RTS,S preparation in 2017 through the current R21 rollout, shows acceptance is a predictable variable. Treating it as noise has efficacy costs at population level.

Malaria falls when many hands move together

“Malaria in my area has drastically reduced because of a multi-layered approach: treated bed nets, prophylaxis in pregnancy, seasonal malaria chemoprevention in children, the malaria vaccine, prompt case management, and environmental management.”

Daniel Kwesi Ekwam, pharmacist, Wa Municipality, Ghana.

• Community health staff and volunteers: the tools exist. What is missing is the link between them, the chief, the imam, the drug shop owner and the district office.
• Managers and planners: every success story in the report is multi-tool and multi-actor. No single intervention carries a decline on its own.
• Global partners: contributors describe sustained reductions across multiple settings driven by specific combinations of interventions, which is operational intelligence on what integration looks like at district level.

Frontline workers are asking for the basics, and for quality

“I would ask our leaders to keep fake and low-quality malaria drugs out of circulation. Then we can trust that every drug bought will work.”

Bamidele Olayinka, physician, Osun State, Nigeria.

• Community health staff and volunteers: what you ask for every day, free drugs, real nets, drugs that work, is what your peers in many other countries are asking for too.
• Managers and planners: the top ask is not a new tool. It is the reliable availability of the ones that exist, free of counterfeit, at primary health care level.
• Global partners: counterfeit and substandard antimalarials are repeatedly named as a driver of both apparent treatment failure and drug resistance, with direct relevance to published pharmacovigilance work.

References

• The Geneva Learning Foundation. (2026, April). Malaria: Turning the Tide. Teach to Reach 11 Listening and Learning Report 19 (English edition). https://doi.org/10.5281/zenodo.15126588
• The Geneva Learning Foundation. (2026, April). Le paludisme en Afrique: inverser la tendance. Teach to Reach 11 Rapport d’écoute et d’apprentissage 19 (édition française). https://doi.org/10.5281/zenodo.18067469
• Sadki, R. (2026, 17 April). Turning the tide: a new insights report demonstrates why health worker knowledge is critical to ending malaria. redasadki.me. https://redasadki.me/2026/04/17/turning-the-tide-a-new-insights-report-demonstrates-why-health-worker-knowledge-is-critical-to-ending-malaria/
• The Geneva Learning Foundation. (2026, May 17 launch). Malaria: from the shadows to the light, peer learning to action course (TGLF c-31995). https://go.learning.foundation/tglf/c/31995