Turning the tide, The Geneva Learning Foundation’s first peer learning course about malaria, opened on 29 June 2026 with nearly 2,000 participants. Four days later, on 2 July, course participants joined Teach to Reach 15, the Foundation’s convening of health workers from over 60 countries, to share early learning alongside the launch of its climate and health report. This is the fifth article in a series of six from that convening, and the first to narrow from climate in general to one disease. It carries what malaria practitioners said about seasons that no longer behave, and about the programme decisions that follow. The next Teach to Reach, number 16, takes place on 6 August 2026.
The season is not what the season used to be.
Alidor Kayembe, an assistant nurse in the Kasaï central province of the Democratic Republic of Congo, described the working assumption of a whole malaria programme in one paragraph.
“Here in Kasaï central, we have two seasons, the rainy season and the dry season. Right now we are in the dry season. In the health facilities we see malaria cases fall. During the rainy season, cases rise.”
For a control programme, this is the operational rhythm.
Bed nets before the rains.
Rapid tests during.
Case management surges.
Anyone in a malaria-endemic country has organised a career around some version of that curve.
In the same room, Noelly Zola, a physician in the Gombe health zone in Kinshasa, described what happens when the curve stops holding.
“It is true that we are now in the dry season. But even in the dry season, the anopheles are with us. They have not disappeared. And the malaria rate has not fallen. It keeps rising.”
Two DRC voices, a thousand kilometres apart, describing the same phenomenon.
In one, the season still gates the burden.
In the other, the season no longer does.
Whether the difference is the climate crisis cannot be settled by the recording of a plenary.
It is what a research surveillance system would take years to detect at scale, and it is what these two workers detected in one afternoon of their own routine practice.
A health worker’s account of a shifting disease pattern is not an anecdote.
It is an early-warning signal about a familiar disease in a new pattern, from someone who has read the pattern every week for years and now says it has moved.
What the network already sees
The rest of the room filled in the shape, and as it did, something shifted in the register of the accounts.
These were not workers reporting damage to an authority.
They were workers who had realised their own reading of the disease counted as evidence, and had started acting on it.
That is the difference between a worker who has knowledge and a worker who knows her knowledge counts.
The first keeps her head down.
The second builds something and tells the next person how.
Innocent Badikebe wrote in from the DRC.
“We observed the surges in malaria cases in the Bena Tshiadi health zone, Kasaï central province, on the border of the Sankuru river.”
Yves Ifefa, a public health analyst at the Kinshasa provincial health division, reported what the city decided to do.
“In Kinshasa, aware of the level of unsanitary conditions taking over the city, the President of the Republic created a task force, led by an army commander, to make the city clean and reduce mosquito breeding sites blamed for malaria.”
Ariss Idrssa Issaka, in Niamey, reported the work he had already done.
“I ran a study on the effects of climate change on malaria incidence over a 5-year period.”
Alexis Mbumb, in Lubumbashi, described his organisation’s flood studies “with many malaria and cholera patients. We need technical and financial partners.”
Marilia Raquel Mucavele, in Mozambique, added the One Health frame.
“Malaria is not only a human health issue.”
Geno Katembo, a veterinarian in Butembo, expanded it into observed evidence
“We also observed the consequences of climate change on animal health. In areas where ticks were not seen, we are now seeing tick-borne diseases, as in the high-altitude areas of Lubero territory.”
The pattern is the same story told from ten places at once.
Rainfall rewrites the anopheles map.
Longer dry seasons force households into surface water that carries other diseases.
Torrential rains break the drainage a city depended on since it was built, and the drainage clogs with waste the health workers now have to name in public.
Malaria control now sits inside a climate problem that programme staff did not sign up for.
Phenina Andrew, a Nigerian health worker, put the analytical version in words.
“Changes in temperature, rainfall, and humidity can create better breeding conditions for mosquitoes and may increase malaria transmission in new areas.”
Bed nets and beds
The most useful moment in the malaria segment was not about statistics.
It was about beds.
Séverin Yangama, at the intermediate level of the health system in Katanga province, named the assumption embedded in the standard vector-control kit.
“The bed net is designed to be used on a bed. We have a large part of the population that does not use a bed. They sleep without a bed net because there is no bed. The conditions for using a bed net are tied to having a bed.”
A vector-control programme that measures success by bed net distribution has embedded a household environment that not all households have.
A worker in Katanga can see this, and did.
Could anyone else, anywhere else?
What the course is going to have to do
Marlène Kapinga Mulumba, from the Direction Formation Continue at the Ministry of Health in the DRC and a TGLF Ambassador, said what most of the room seemed to feel.
“With The Geneva Learning Foundation, this is not theory. It is practitioners bringing experiences that help us in the field.”
The malaria evidence in the room, taken together, gave the course three tasks the standard technical brief will not carry.
- Read what climate change is doing to malaria seasonality and act on it as the practical parameter for the next planning cycle, not as a hypothesis.
- Treat the vector-control kit as a kit that assumes a household environment, and confront the fact that the environment is not universal.
- Take community perception of standard interventions seriously as evidence of the trust the response is or is not carrying.
Jellisters Debitha, a community health worker with the Kenya Malaria Youth Corps, wrote the version the course will have to work with.
“Vector control and climate emergency logistics cannot exist in isolated policy silos. To build a resilient health system, we must merge climate adaptation with malaria elimination by leveraging youth networks on the ground to handle both emergency response and community-led prevention.”
Jellisters’ sentence carries a whole design brief.
The malaria programme, the climate-response programme, the youth-network programme, and the emergency-logistics programme are not four programmes.
They are one programme seen from four angles, and they will only work when the same worker can move across all four in a working week.
The current funding architecture is not built for that.
The workforce is.
That is the shape of a network the Foundation has been building since 2023, scaled to more than 80,000 health workers in 137 countries.
Turning the tide is a stage in that network, not the network itself.
The tide it wants to turn is the tide Alidor described in one paragraph, and the reason the course exists is that no research institution in a high-income country can read that tide the way a nurse in Kasaï central can.
The cost that decides whether any of this lasts
There is a trap in a room this capable.
Watch enough self-reliance and it becomes easy to conclude that nothing more is required.
Ariss and Alexis and the veterinarian in Butembo are already running the studies.
The presidential task force is already clearing the breeding sites.
Alidor is already reading the season better than the dashboard.
Left there, the story flatters everyone and pays no one.
Self-reliance that no one matches becomes a cost the poorest absorb alone.
Alexis said it in the plainest terms available, that he needs technical and financial partners for work he is already doing.
On the same day, the Foundation announced that a consortium called NEXA, led by Grand Challenges Canada and the Science for Africa Foundation, opened a call for proposals built on the responses to the climate and health survey this network had led.
The question the course and the call now share is whether the money will travel the same road the listening did.
Tina Iroghama Agbonyinma keeps asking the version of this that matters most.
Are the local solutions effective, and how do we measure the impact?
On malaria, on 2 July, the learners named the parts of that accountability question a report on malaria alone would not have surfaced.
Séverin’s design critique.
Sarah’s trust question.
Alidor’s shifting season.
Each names an accountability the current system does not carry, and together they describe the shape of one it will need.
The tide the course wants to turn will not turn without Séverin’s environmental argument, without Sarah’s trust question, or without the research-and-practice link that Ariss and Alexis already run and want partners for.
For the reader who has already registered, the invitation is to bring what your own week looks like into the shared conversation.
For the reader who has not, the same invitation, one link away.