Just before dawn, students stream through the bright pink gates of St. Anne's Ahero Comprehensive School in Kisumu County in western Kenya.
It's the start of a school day - and the mosquitoes are hungry. Clouds of them descend from the dense canopy of trees growing high above the school yard. In the pre-dawn darkness, even more mosquitoes crowd around classroom doors, waiting for a chance to bite.
Malaria is a deadly and persistent threat in Kenya. An estimated 4 million people suffer from the disease each year. Kisumu County, along the shores of Lake Victoria, has one of the highest malaria burdens in the entire country.
St. Anne's sits between a rice plantation and the flood-prone Nyando River, providing ideal conditions for malaria-carrying mosquitoes to thrive - with life-threatening consequences, especially for children.
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"I've been sick with malaria a couple of times," says Angela Rose, 14. "It's very painful. You don't have the energy to learn. The headache, the chills, the vomiting, the diarrhea... it's not a good feeling at all."
Angela is the student body president and wants to be a pilot when she grows up.
She is also part of St. Anne's Health Club - a group of students who meet weekly to discuss the health issues that affect them, including malaria. With support from the Global Fund, 20 such clubs have been established across schools in the area. Equipped with the knowledge to raise awareness among their peers, Health Club members serve as trusted sources of information in their schools and communities.
"Students can understand how the challenges they are facing can be solved," Angela explains.
Children lead a malaria awareness performance event at St. Anne's Ahero Comprehensive School. Brian Otieno/The Global Fund Through skits, spoken word poems and songs, Health Club members create malaria prevention messages that resonate with the other students. They have also painted educational murals on classroom walls to encourage behavioral change - a cornerstone of malaria prevention. This focus is especially urgent given that children under 5 account for over 75% of all malaria deaths in the wider region.
"Some of our community members lack awareness of this disease," says Elvis Brian, 14, the deputy student body president and deputy chair of the Health Club. "When they experience symptoms, they may take other drugs that are not meant for this disease. We want to help them understand what they should do when malaria attacks them."
"If we work hand-in-hand together as a family, as a community, we will end these diseases - diseases that are not necessary," says Granton Akwaba, 14, secretary of the Health Club, and an aspiring neurosurgeon.
As part of Health Club activities, a trained community health promoter routinely visits the school to provide health education, test students with malaria symptoms, and treat uncomplicated cases. More severe cases are referred to the nearby Ahero County Hospital.
To further reduce the risk of malaria, Health Club members organize after-school activities to drain the stagnant water around the school and cut the long grass. The County Government of Kisumu also conducts regular larviciding and indoor residual spraying.
Type an optional group caption Kenya's story is part of a larger global pattern in the fight against malaria: After years of rapid declines in malaria cases and deaths, progress has stalled. The pressures that Kenya and many other countries are facing today - extreme weather, evolving mosquito behavior and funding gaps - risk a worldwide resurgence of this deadly disease. Maintaining momentum in the fight against malaria has never been more urgent.
More frequent rains and intense flooding across the country are causing widespread destruction and displacement. The rainy season that once began in April is now starting as early as February. The water left behind as floodwaters recede creates ideal breeding conditions for malaria-carrying mosquitoes.
Displacement also increases the risk that families do not have insecticide-treated mosquito nets to sleep under, as mass net distribution campaigns are disrupted. At the same time, the chaos places additional strain on already-stretched health systems and makes it harder for people to seek care and receive prompt, lifesaving treatment.
"It is raining a lot," says Elvis. "My worry is that the rains will increase the spread of malaria because of the stagnant water and the long grass."
In March alone, at least 21 counties across Kenya were affected by severe flooding, with 88 deaths reported and more than 34,000 people displaced. Low-lying areas around St. Anne's were particularly vulnerable, with the Nyando River flooding roads, villages and farmland.
The presence of the Anopheles stephensi mosquito - normally limited to Asia and the Middle East - was recorded across seven counties in northern Kenya in 2024. This malaria-carrying mosquito poses a particular threat because it can evade many of the most effective prevention measures. While other species tend to bite indoors, making indoor residual spraying and insecticide-treated nets effective, Anopheles stephensi has been observed biting outside, reducing the impact of these interventions.
It can also breed without relying on seasonal rains and can tolerate high temperatures, which means that malaria transmission could become a year-round risk, even in dry regions. More concerning still, the mosquito has shown resistance to multiple classes of insecticides and can easily breed in urban environments, putting populations in historically low-risk cities in danger.
While Anopheles stephensi has not yet been officially recorded in western Kenya, experts from the Kenya Division of National Malaria Program and the Kenya Medical Research Institute (KEMRI) warn that it could increase malaria transmission in the north and spread to malaria-endemic counties such as Kisumu, further complicating malaria control efforts.
Fully understanding the extent of its spread - and mounting an effective response - will require tailored surveillance and sustained investment. In an already resource-constrained environment, meeting this challenge will be difficult.
International funding cuts to Kenya's malaria response are deeply concerning and risk unraveling hard-won gains against the disease.
Kenya has always faced shortages during mass mosquito net distribution campaigns, but the scale of the current gap is unprecedented. Under existing commitments, the Global Fund will be the sole supporter of the upcoming campaign, financing 9.6 million insecticide-treated nets against an estimated need of 15 million. This leaves millions of people unprotected in high-burden areas.
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The consequences are far-reaching. More malaria limits economic growth and perpetuates a cycle of poverty. Funding shortfalls are already forcing cuts to essential social and behavior change interventions - including school Health Club activities led by students like Angela, Granton and Elvis - that are critical to ensuring nets are used correctly and consistently. Without urgent action to close this gap, Kenya risks an increase in avoidable illness and deaths, and the erosion of years of progress.
In 2024, a 12-year-old student at St. Anne's died from cerebral malaria - a severe form of the disease that causes delirium, seizures and coma.
"It really hurts to lose someone because of malaria," says Granton. "I also lost my grandmother to the disease. That's what inspired me to work with the Health Club to help end malaria, typhoid and other diseases."
Despite the challenges they face, the children remain determined that a malaria-free future is within reach.
"Malaria is a disease that can be stopped," says Granton. "It shouldn't be a threat to our lives.We are strong - and if we stand together, we can end it."
FootNotes
Written by Margo Mombrinie. Photography and video by Brian Otieno, Natalia Jidovanu and Kelvin Juma of Narretrieve. Sincere thanks to the National Malaria Control Program (NMCP), the County Government of Kisumu, AMREF Health Africa, and the students, teachers and administrators of St. Anne's Ahero Comprehensive School.
