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
Perspectives
Cardiovascular-kidney-metabolic syndrome: A new frontier or simple rebranding?
PLOS Medicine: published August 21, 2025 | https://doi.org/10.1371/journal.pmed.1004723
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The case for stronger regulation of deceptive nutrition-related claims on unhealthy food
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PLOS Medicine: published August 1, 2025 | https://doi.org/10.1371/journal.pmed.1004670
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PLOS Medicine: published August 1, 2025 | https://doi.org/10.1371/journal.pmed.1004680
Association between surgeon training grade and the risk of revision following total knee replacement: An analysis of National Joint Registry data
PLOS Medicine: published August 12, 2025 | https://doi.org/10.1371/journal.pmed.1004685
The transmission blocking activity of artemisinin-combination, non-artemisinin, and 8-aminoquinoline antimalarial therapies: A pooled analysis of individual participant data
PLOS Medicine: published August 14, 2025 | https://doi.org/10.1371/journal.pmed.1004683
Current global practice and implications for future research on disseminating health research results to study participants: A systematic review
PLOS Medicine: published August 14, 2025 | https://doi.org/10.1371/journal.pmed.1004569
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The potential impact of declining development assistance for health on population health in Malawi: A modelling study
PLOS Medicine: published August 21, 2025 | https://doi.org/10.1371/journal.pmed.1004488
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Predicting knee osteoarthritis progression using neural network with longitudinal MRI radiomics, and biochemical biomarkers: A modeling study
PLOS Medicine: published August 21, 2025 | https://doi.org/10.1371/journal.pmed.1004665
Shared decision-making and deprescribing to support anti-thrombotic therapy (dis)continuance for persons living with cancer in their last phase of life: A realist synthesis
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Evaluating the impact of differentiated service delivery (DSD) on retention in care and HIV viral suppression in South Africa: A target trial emulation using routine healthcare data
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Efficacy of biomarkers in the endochondral phase of fracture repair and healing in long bones: A clinical observational studys
PLOS Medicine: published August 29, 2025 | https://doi.org/10.1371/journal.pmed.1004640