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Between 2000 and 2021, Malawi achieved significant health improvements, including an 18-year increase in life expectancy. Much of this progress was supported by international donors, who funded over half of health expenditures in 2018/2019. However, projected declines in donor funding, coupled with government health spending that is not expected to increase quickly enough to compensate, pose a threat to these recent gains. This is especially concerning given the country's high burden of major infectious and non-communicable diseases. In this issue, Margherita Molaro and colleagues use the Malawi-specific mathematical model, Thanzi La Onse, to estimate the health burden under different annual growth rates in health expenditure. In an accompanying Perspective, Editorial Board member Peter MacPherson and colleagues discuss how countries across Africa are facing health crises driven by aid cuts, shifting demographics, and infectious and environmental threats. While renewed public health strategies, smarter investments, and stronger surveillance can help, reversing funding cuts is vital.
Image Credit: Keith Wako, Pexels
Citation: (2025) PLoS Medicine Issue Image | Vol. 22(8) September 2025. PLoS Med 22(8): ev22.i08. https://doi.org/10.1371/image.pmed.v22.i08
Published: September 9, 2025
Copyright: © 2025 . This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Between 2000 and 2021, Malawi achieved significant health improvements, including an 18-year increase in life expectancy. Much of this progress was supported by international donors, who funded over half of health expenditures in 2018/2019. However, projected declines in donor funding, coupled with government health spending that is not expected to increase quickly enough to compensate, pose a threat to these recent gains. This is especially concerning given the country's high burden of major infectious and non-communicable diseases. In this issue, Margherita Molaro and colleagues use the Malawi-specific mathematical model, Thanzi La Onse, to estimate the health burden under different annual growth rates in health expenditure. In an accompanying Perspective, Editorial Board member Peter MacPherson and colleagues discuss how countries across Africa are facing health crises driven by aid cuts, shifting demographics, and infectious and environmental threats. While renewed public health strategies, smarter investments, and stronger surveillance can help, reversing funding cuts is vital.
Image Credit: Keith Wako, Pexels