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Published: Wednesday, 20 August 2025

By Dr. Ismail Munyamu (Malaria Youth Champions Uganda)

From time to time, when I talk with families in districts where malaria is common, like Busoga and West Nile, I often hear the same thing: “we hardly need to go to the clinic for malaria these days.” It may sound like a simple remark, but to me it says a lot. It shows that we are making progress in our fight against malaria. 

In my view, a big part of this progress comes from new and better tools to fight the disease. One that stands out is an improved version of the long-lasting insecticidal nets (LLINs) that many people already know. They are now made to stop our night-biting malaria mosquitoes that have become resistant to the pyrethroid insecticides used in conventional nets. These newer nets have two different insecticides, a mix known as dual-active ingredient (dual-AI), from which they get their name – “dual-AI nets.”

What makes dual-AI nets different?

For many years, treated mosquito nets have been at the centre of malaria prevention in Uganda. Over time, however, mosquitoes have adapted and developed resistance to the single insecticide in these nets – the pyrethroids – which has made them less effective. Dual-AI nets help solve this problem by combining a pyrethroid with another type of insecticide, such as chlorfenapyr. This mix works against mosquitoes that can survive pyrethroids, giving people stronger protection. In Uganda, where resistance to pyrethroids has been found in most monitoring sites, these nets are an important way to keep the progress we have made. Trials have already shown that these nets are 45% more impactful at reducing malaria cases than traditional single insecticide nets. 

Strategic targeting for maximum impact

In the most recent national campaign to give every household mosquito nets, districts with the highest number of malaria cases received dual-AI nets. These included hotspots in Busoga, West Nile, and the mid-North. Other areas received PBO nets, which also help to address the threat of resistance. This approach makes the best use of resources by giving the strongest protection to communities that need it most. It is also part of Uganda’s new National Malaria Strategic Plan, which considers the limit in resources and the need to use every tool most effectively.

Early feedback from communities is encouraging. Many people say they are going to the clinic less often for malaria and feel more confident sleeping under these new nets. The anticipation is that dual-AI nets will accelerate the country’s malaria elimination efforts by tackling mosquito insecticide resistance.

The role of youth

Young people, especially through the Malaria Youth Champions network, have played a big role in promoting the use and care of nets. During recent youth-led community dialogues under the Global Fund-supported Gender Equality Fund project, young advocates helped raise awareness and clear up harmful myths about mosquito nets, malaria vaccines, and other prevention methods. These conversations make a difference. When people see a net not just as fabric but as something made to protect their health, they are more likely to use it every night and use it properly.

Improving messaging around nets

Our messages about mosquito nets have often been general, but there is a chance to be more specific. People should know when they are getting a new and improved net, why it is different, and how it gives better protection. A small change in how we talk about nets could make a big difference. For example, we could say, “This is a high-quality net designed to fight even the most stubborn mosquitoes. Using it every night greatly lowers your risk of malaria.” Clear and simple facts like these can encourage more people to use their nets regularly and use them the right way.

Supporting youth to scale impact

Uganda’s youth have the energy and creativity to keep malaria high on the agenda. To build on this, we need steady support, be it small grants for community campaigns, partnerships with media houses for regular airtime, or giving young people a place in national and regional policy discussions. Training in advocacy and malaria knowledge would help young leaders speak with confidence and influence decisions. We have already seen what they can do, with youth-led dialogues helping to correct false information and inspiring real changes in how communities act.

Sustaining gains through domestic and global financing

The Global Fund has been key in making dual-AI nets available to more people in Uganda. But with some partners reducing their support, Uganda needs to increase its own investment to keep these life-saving nets in use. Relying only on outside help is not sustainable, especially given the national goal and the objectives of the Catalytic Framework to End AIDS, TB, and Eliminate Malaria in Africa by 2030.

Young people have welcomed steps taken by the government toward this. These include the President’s launch of the Mass Action Against Malaria Initiative and the continued work of the Uganda Parliamentary Forum on Malaria, which secured 5 billion shillings in the 2024/25 budget for Fansidar (SP) to protect pregnant women. These actions show commitment to the Catalytic Framework to End AIDS, TB, and Eliminate Malaria in Africa by 2030 and the wider call for countries with high malaria burden to strengthen political will and raise more resources within their borders.

Still, malaria continues to take lives, and with less external funding available, it is important to do even more. As the Global Fund replenishment approaches in November, Uganda and its youth should be championing continued investment in malaria elimination, reminding the world that it saves lives and builds stronger, healthier communities everywhere.

Looking ahead

The fight against malaria needs more than tools. It is about people, partnerships, and persistence. Dual-AI nets are a major step forward, but they will only have their full impact if people understand their value, use them the right way, and can keep accessing them.

As a young doctor and malaria advocate, I have seen the change that happens when new ideas are matched with action in the community. My call to our leaders is clear. Invest in young leaders, support the tools that work, and keep malaria elimination high on Uganda’s agenda. The health and strength of future generations depend on it.

About the author

Munyamu Ismail, a medical doctor and public health advocate, has a proven track record in youth-led health programming, policy engagement, and malaria control. He leads the Malaria Youth Champions Uganda, driving national youth-led malaria elimination and advocacy, and serves as Health Thematic Lead on the EU Youth Sounding Board – Uganda, advising on integrating youth health perspectives into EU development programming.