Malaria cases in Indonesia remain a major challenge, particularly because the disease is not solely related to medical issues but is also influenced by environmental factors, geographical conditions, and interactions between humans, animals, and ecosystems. According to data from the Ministry of Health, Indonesia recorded 706,297 malaria cases in 2025. This figure represents a 30 percent increase compared to 543,965 cases in 2024. The situation requires coordinated handling and support from various stakeholders to achieve the malaria elimination target by 2030.
Professor R. Wisnu Nurcahyo of the Faculty of Veterinary Medicine, Universitas Gadjah Mada (FKH UGM), believes malaria remains difficult to control in Indonesia due to its close connection with environmental conditions. He pointed out that environmental conditions in several regions of Indonesia support the breeding of Anopheles mosquitoes, which act as disease vectors.
“Mosquitoes are highly dependent on environmental factors. This means mosquitoes can live and breed well if the environment supports them. That is what makes malaria in various regions of Indonesia difficult to control,” he said on Thursday (May. 21).
In eastern Indonesia, particularly Papua, geographical conditions such as high rainfall, mountainous topography, and abundant pools of clear water provide ideal breeding grounds for malaria vectors. These conditions contribute to approximately 95 percent of national malaria cases still being concentrated in the region. He added that similar conditions are also found in other areas such as Kalimantan, Sumatra, and the Menoreh Hills region in Kulon Progo, where endemic malaria cases are still reported.
“If geographical conditions are favorable, malaria vectors can easily reproduce,” he said.
Furthermore, Professor Nurcahyo explained that malaria transmission in Indonesia does not entirely originate from human-to-human transmission. From an animal health perspective, there is also the threat of zoonotic malaria originating from wildlife, particularly primates such as long-tailed macaques and orangutans. One type of malaria that requires attention is Plasmodium knowlesi, a parasite that naturally infects primates and can be transmitted to humans through the bites of Anopheles mosquitoes.
“In humans, Plasmodium knowlesi is highly pathogenic. Within one or two days, it can cause high fever, and if not treated immediately, it can lead to death,” he explained.
Regarding treatment, he noted that the government has long provided free antimalarial drugs for communities in endemic areas. However, treatment effectiveness is hampered by several older medications, such as quinine, becoming ineffective due to parasite resistance. This condition has forced health workers to rely on newer-generation drugs, which are more expensive and require more complex distribution systems.
In addition to drug availability, the distribution of medicines and health workers in malaria-endemic regions remains hindered by limited access and security concerns. As a result, communities in remote areas often experience delays in diagnosis and treatment, even though malaria can rapidly develop into a severe condition if left untreated. Therefore, Professor Nurcahyo emphasized that successful malaria control depends not only on health services but also on public awareness in maintaining environmental cleanliness.
“Public education plays a crucial role in malaria prevention, particularly in mosquito control and maintaining environmental hygiene,” he said.
According to Professor Nurcahyo, the 2030 malaria elimination target can still be achieved, provided the One Health approach is implemented consistently. He stressed that malaria control cannot rely solely on the human health sector but must also involve animal health and environmental health as integrated components working together in detection, treatment, vector control, and environmental conservation.
“We must work together, collaborate, and coordinate with one another. Human health, animal health, and environmental health should not operate separately. One Health should not remain merely a slogan,” he concluded.
Author: Ika Agustine
Editor: Gusti Grehenson
Post-editor: Rajendra Arya
Photo: Magnific