The urgent need to be prepared for the syndemic challenge of COVID-19 and malaria On World Malaria Day, we analyse the risks malaria endemic countries face with the twin challenge of both COVID-19 and malaria Malaria is a life-threatening disease caused by parasites, with an estimated 228 million cases and 405,000 deaths occurring globally. Countries in sub-Saharan Africa and India carry almost 85 percent of the global malaria burden. COVID-19 was declared a global pandemic in March 2020 and has affected more than 140 million people and caused more than three million deaths around the world. Malaria and COVID-19 mask each other’s symptoms leading to misdiagnosis of both, especially with co-infection tending to lead to worse outcomes. The figure below indicates causes for global death tally for 2020 with COVID-19 deaths far exceeding breast cancer or malaria.