In Uganda, a country that shoulders the third-highest burden of malaria cases globally, time has become both the enemy and the solution. Every hour a patient goes untreated, the risk of complications and death grows exponentially. Recognizing this, the Ministry of Health, with technical support from World Health Organization (WHO), launched the “24.2 hours initiative” on 25 April 2025. This is a transformative malaria strategy designed to save lives by racing against the clock.
The initiative’s name speaks volumes: 24 hours to treat uncomplicated malaria; 2 hours to initiate care for severe malaria. If fully implemented, the approach could halve malaria deaths in Uganda and reduce severe cases by 80%, saving around 1,400 lives and preventing 500,000 hospitalizations annually.
In 2023, Uganda had nearly 12 million malaria cases and 2,793 deaths. Malaria causes 30–40% of outpatient visits, 20% of hospital admissions, and up to 10% of inpatient deaths. More alarmingly, while globally only 1–3% of uncomplicated malaria cases become severe, Uganda’s hospitalization rate was around 6% in 2023 four times higher than the global average. Delays in diagnosis and treatment remain the leading culprits.
“The country, as a signatory to the Yaoundé Declaration calling for zero malaria deaths, has prioritized the elimination of malaria mortality. We are emphasizing timely diagnosis and prompt treatment 24 hours for uncomplicated malaria, and just two hours for severe cases,” said Dr Jane Ruth Aceng Ocero, Uganda’s Minister of Health.
“The 24.2 Initiative is a strategic shift to eliminate delays in treatment and reduce both mortality and drug resistance. In its core lies the principle that severe malaria should be treated as a medical emergency, deserving the same urgency as childbirth complications or trauma cases,” explained Dr Jimmy Opigo, Programme Manager of Uganda National Malaria Elimination Programme.
The initiative embeds crucial pillars of care: early diagnosis, prereferral treatment with rectal artesunate, improved triage, quality inpatient management, and post-discharge chemoprevention. The goal? Every patient, no matter how remote, receives the right care at the right time.
The program relies on free of charge community-based malaria case management for all age groups in rural and underserved areas. This approach is crucial since 60% of Ugandans depend on often costly private healthcare. By decentralizing services and ensuring access even on weekends and holidays, the 24.2 Initiative advances health equity, universal health coverage, and poverty reduction.
Launched on World Malaria Day 2025, the initiative sits within the broader framework of the Uganda Malaria Mortality Reduction Strategy (UMMRS) that was developed by nationwide dialogue led by Ministry of Health. Key contributors to UMMRS include WHO, Makerere University, President’s Malaria Initiative, Clinton Health Access Initiative, Malaria Consortium, Mbale and Jinja hospitals, andNational Drug Authority among others. Financial contribution came from Roll Back Malaria and technical support was offered by WHO. WHO also provided logistical coordination and advocacy as well.
“This initiative and malaria mortality reduction strategy showcase strong political leadership, effective partnerships, and locally tailored solutions. They align with the 2025 World Malaria Day theme: ‘Malaria Ends with Us: Reinvest, Reimagine, Reignite’, which calls for renewed investment, innovative strategies, and united action to fight malaria.,” said Dr Kasonde Mwinga, WHO Representative in Uganda.
Reducing malaria mortality is not only a health imperative, but also a social justice issue. The 24.2 Hours Initiative positions Uganda as a pioneer in delivering prompt, lifesaving, equitable care.
In a race where every second counts, Uganda is choosing to act fast.
