Malaria cases hit record high in Indonesia as elimination challenges persist

JAKARTA – Indonesia recorded its highest number of malaria cases in 2025, mainly driven by population mobility and climate change that hamper elimination efforts to reduce patients, especially in high-burden regions such as Papua.

In 2025, the country’s Health Ministry recorded 706,000 malaria cases across the archipelago, an increase from 543,000 in 2024, and 418,000 in 2023.

“In 2025, we recorded the highest number of cases, with fluctuations largely driven by population mobility and weather conditions that contributed to rising cases across regions,” said Health Ministry communicable diseases director Prima Yosephine in a press briefing on April 30.

Despite 412 of 514 regencies across the country being declared malaria-free, the disease remains rampant in the country’s easternmost regions, with more than 95 per cent of all reported cases found in six provinces across Papua.

The highest concentration of cases was detected in Papua province. Elimination efforts in Papua continue to face challenges due to the region’s vast forested area, where many local communities live and work, Dr Prima said.

The topography makes it difficult for the health authorities to reach them, as well as distribute healthcare services and infrastructure.

Malaria is an infectious disease caused by the Plasmodium parasite spread through the bites of a female Anopheles mosquito infected by the pathogen. The mosquitoes require small and seasonal bodies of water for their larvae and pupae to grow, making tropical swamps and rainforests in Papua suitable habitats for the Anopheles.

Funding also remains a major hurdle, as the government’s allocations for the malaria eradication campaign have been reduced following Indonesian President Prabowo Subianto’s austerity measures, leaving the ministry reliant on other support, including from philanthropic organisations.

“The challenging geography makes financing more costly,” Dr Prima said. “With the current austerity policy, it’s necessary to formulate effective malaria control funding to achieve elimination.”

Outside Papua, disease transmission is largely driven by population migration, especially those travelling from malaria-endemic areas who carry the parasite when moving to other regions.

One example was Rokan Hilir regency in Riau, which was declared malaria-free in 2018 but recorded new cases a year later. The outbreak was initially contained, but cases surged to more than 2,000 in 2024, prompting the local administration to declare a malaria state-of-emergency multiple times through early 2026.

Dr Prima also pointed to climate change as a factor that has exacerbated the malaria transmission.

Warming average temperatures and erratic rainfall patterns caused by global heating trigger frequent heavy rainfall that creates more mosquito breeding sites and increasing transmission risks.

Dr Prima urged people to take extra precautions, such as using mosquito repellent, installing window screens and sleeping under bed nets.

To accelerate the national malaria elimination target by 2030, the Health Ministry has been strengthening surveillance to improve case identification.

It also improves treatment by distributing free anti-malarial medication, intensifying mosquito control measures and promoting behavioural change among communities. Targeted interventions have also been rolled out in endemic areas, including distribution of bed nets and preventive treatment for mobile populations, such as miners, forest workers, as well as police and military personnel.

But the surge in cases in 2025 may expose policy gaps, particularly the failure to integrate public health with environmental, energy and human resource strategies to address malaria as a disease shaped by human interaction with the environment, said epidemiologist Dicky Budiman.

“It reflects not only programme shortcomings, but also a lack of system readiness in responding to new pressures from climate change, increased population mobility, and the zoonotic ecology, in which ecological conditions facilitate disease transmission from animals to humans,” he said.

Dr Dicky noted that efforts to tackle malaria in hard-to-reach areas in Papua have been further complicated by natural resource exploitation such as mining and logging, which are often carried out without proper health impact assessment.

The epidemiologist urged the government to implement stronger, sustained and consistent strategies in both malaria prevention and control for the country to meet its 2030 malaria elimination target.

“Failing to achieve the target could pose a threat to national health security due to the risk of local outbreaks and potential regional spread,” Dr Dicky said.

“It would also impose a significant economic burden through reduced productivity when workers fall ill on top of rising healthcare costs.” THE JAKARTA POST/ASIA NEWS NETWORK