'The only good mosquito is a dead one' - on the frontline of the fight against malaria

"For me, the only good mosquito is a dead mosquito," Dr Sarah Moore declares as we tour the institute where she and hundreds of other scientists have dedicated their careers to fighting malaria. After decades of progress, those on the frontline of this epidemiological battle believe eradication of the killer disease is finally within reach. But funding cuts - as countries including the UK and US slash international aid and increase spending in areas such as defence - threaten to reverse hard-won gains.

The Daily Express joined charity Malaria No More UK on a visit to Tanzania to witness the life-saving work it is urging the Government to continue supporting. Born in Wales and trained in Bristol, Dr Moore has spent the last 20 years working at the Ifakara Health Institute, one of Africa's leading research organisations.

As she shows us around the institute's Bagamoyo site, a two-hour drive from the port city of Dar Es Salaam, she explains that huge strides have been made. "When I first started, a child was dying from malaria every minute," Dr Moore says. "Now it's one every three minutes. So that's a pretty impressive improvement, but we're at a crossroads."

There were 263 million global malaria cases in 2023, up from 252 million in 2022, according to the World Health Organisation's annual report. The disease claimed 597,000 lives in 83 countries. Tanzania accounted for 8.6m cases and 25,000 deaths.

The WHO estimates that 2.2 billion cases and 12.7 million deaths have been averted by efforts to prevent and treat the disease since 2000, but it remains a serious global threat.

In an unassuming shipping container housing a complex system of interlocking doors and climactic chambers, research scientist Prisca Kweyamba is breeding some very important mosquitoes.

By modifying their genes at the egg stage using an approach designed in collaboration with Imperial College London, Ms Kweyamba's team has created mosquitoes that are resistant to the Plasmodium parasite that spreads malaria. It develops more slowly in the modified mosquitoes, which have a shorter lifespan - dying before they can infect another human.

These trojan horses could be used to spread resistance. Ms Kweyamba says: "The idea is to release the mosquitoes so they can mate and pass on that gene, so over time you have a population of mosquitoes that are unable to transmit malaria."

Lab work has shown the altered mosquitoes can block transmission and the team now plans to test them in a semi-field setting - one of the many stages needed to prove they are safe for real-world deployment.

Ms Kweyamba hopes they will be released into the wild within eight years. The technique is "not a silver bullet", she says, but "unlike other technologies, it doesn't require much, it just requires the mosquito to do the job itself".

At the institute's insectary, there is a constant hum from thousands of buzzing mosquitoes in mesh boxes on shelves. It may seem counterintuitive but in order to defeat malaria you have to breed a lot of mosquitoes. A constant supply is needed for the testing of vaccines and other interventions.

And in order to rear mosquitoes, you have to feed them. Blood can be collected from donors or cattle but the critters are fussy and often refuse to feed if it is too old or not at the right temperature (they prefer 37C, like the human body).

Dr Brian Tarimo is developing an artificial blood-free diet. He explains: "It looks like any other normal liquid but this contains some essential amino acids and proteins for egg development.

"The whole rationale for this diet is that certain malaria control interventions will require mass rearing and reproduction - one of those being gene drive mosquitoes."

Other research at the Bagamoyo site focuses on improving the simplest defences, such as bed nets and pesticide. In a small room enclosed by a tarpaulin, Dr Moore invites me to make myself comfortable on a bed under a net riddled with holes.

She then hands me two cups brimming with mosquitoes, steps out of the room, zips it closed - and instructs me to release them. The mosquitoes disperse within seconds but none come through the gaping holes.

Dr Moore explains that the net is coated with insecticide, so remains effective when physically damaged. Ifakara's researchers are working with manufacturers to make nets last as long as possible, while also using AI to better predict when they need to be replaced.

Dr Moore says she has only contracted malaria once, while testing a repellent in her back garden, "because I'm pretty good at my job". She recovered within three days after treatment.

Almost every scientist I meet during our visit agrees on one thing - a whole toolbox of interventions will be needed to defeat malaria. The UK has played a leading role in discovering many of those tools, including two vaccines developed by British pharmaceutical company GSK and Oxford University.

Asked if eradication is now within reach, Dr Moore replies: "Of course it's possible. We used to have rampant malaria in the US, in southern parts of Europe, in South East Asia. Suriname has just been shown to be malaria-free. So we're making great progress.

"We have amazing tools, we have digital technologies that we never had. We're positioned to be able to do it but we need to have the political and financial will."

Dr Moore remembers a lecture given by US economist Professor Jeffrey Sachs in the early 2000s, where he said that the amount spent on just one major war could eradicate malaria.

Cash is needed both to develop new or better interventions, and to ensure they reach the people who need them most.

The UK government has invested £527m in malaria research and development since 2007, according to Malaria No More UK. The charity wants to see continued support for bodies such as Gavi and The Global Fund which help supply malaria defences and treatments to countries that need them.

The Global Fund - a worldwide partnership against HIV, TB and malaria - is entering its eighth replenishment cycle for 2026-28, with an announcement on the UK's contribution expected towards the end of this year. The UK pledged £1bn in the previous round, which raised $18bn overall.

With Sir Keir Starmer under pressure to increase spending on areas such as defence and the NHS, Dr Moore warns that diverting cash away from global health is "low-hanging fruit".

The UK is a wealthy economy with some of the world's top universities and public health institutions and we have some responsibility to share that wealth and educational insights, the scientist says.

But beyond the moral argument, she points to more direct benefits of helping to eradicate malaria. "Africa is the next great economy," she explains.

"In the next 50 years, there are going to be two billion Africans - that's a lot of people requiring infrastructure and resources that you can trade with. A happy, healthy, prosperous Africa is good for the global economy."

Insights gained from malaria research also bolster our defences against pandemics and infections that could soon reach our shores.

"Diseases travel on aeroplanes these days," Dr Moore adds. "Dengue fever is spread by a mosquito and because it's getting warmer, because of climate change, those mosquitoes are now living throughout the winter in southern parts of Europe."

As the Government faces tough funding decisions, Dr Moore is urging the Prime Minister to stand strong on commitments to malaria research. She adds: "This will be one of the best investments you could make. This will send you to your grave having done something great."

Asked about the upcoming pledge, Foreign Office minister Stephen Doughty recently told the House of Commons the UK was proud to be co-hosting the eighth replenishment event with South Africa.

He said allocations would be decided in the coming months, adding: "The Global Fund is the primary channel for UK support to fight HIV, TB, and Malaria. It currently invests approximately $5 billion a year to defeat the three diseases and strengthen health systems.

"In 2023, the Global Fund accounted for 28% of all international financing for HIV, 76% for TB and 62% for malaria."

'My granddaughter's condition just kept getting worse'

Hadija Salum's granddaughter Rainei was fighting for her life in hospital when we visited her home near Dar Es Salaam. A day later, we heard the devastating news that the 18-month-old infant had died of malaria.

Hadija, 49, told us Rainei's illness began with a fever, followed later by uncontrollable shaking. Tests at hospital confirmed a severe case of the disease.

She added: "We were shocked and very worried. Her symptoms were scary. We took her back to the hospital but her condition kept getting worse."

The mother-of-four was herself recovering from a bout of malaria which left hear arms and legs weak and caused painful headaches.

Despite using bed nets and sprays to reduce their risk of infection, her children aged 29 to 11 have also all had it - some multiple times.

"Malaria has been a massive challenge for me and my family," Hadija said. "My son was hospitalised to the point of having IV drips administered, and now my granddaughter is in hospital."

Hadija's son Saidi, 15, had spent a night in hospital the previous month. He said: "I had cold chills and a very severe headache."

Saidi now hopes to become a doctor. Hadija, who sells breakfast items such as chapatis and mandazis from her home for a living, added: "I wish them a good life so they can go to school, study well, get good jobs and take care of themselves - and me when I'm older."

Did you know that the first Brit to win a Nobel Prize did so for their work on malaria? Did you know that the science behind one of the Covid vaccines started with a malaria jab?

And did you also know that last year malaria claimed nearly 600,000 lives - mostly children under five.

Malaria is devastating. It decimates families, societies and economies. And whilst the burden is overwhelming in Africa, we've also started seeing an increased threat in parts of Europe as temperatures rise.

But, despite all this, it is preventable. In no small part because of UK scientists. It was Sir Ronald Ross who won the aforementioned accolade in 1902 for discovering that mosquitoes transmitted malaria - starting a British tradition of excellence in malaria science now well over a century old.

British researchers were at the forefront of the creation of the recent groundbreaking malaria vaccines. The homegrown company, GSK, has even begun development on a second "next-generation" jab. And as mosquitoes adapt and evade interventions, many British companies have pioneered new drugs and insecticides too.

But for these tools to count they need to leave the labs and reach the children who need them.

The Global Fund to Fight AIDS, TB and Malaria is an international organisation which does just that. And later this year it needs governments, including the UK's, to step up with the necessary funding.

If we do, we save lives and make everyone safer. If we don't, we risk unleashing a resurgence of malaria the consequences of which will be felt across the globe.

We hope the UK continues its proud tradition of leadership in malaria science and stewardship towards a more prosperous and secure world for all.

- Dr Astrid Bonfield is CEO of Malaria No More UK