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SPAR 2025

Malawi Bolsters Health Security: The 2025 SPAR Journey

PHIM-IHR SECTION
Securing Malawi’s Future: The 2025 State Party Annual Self-Assessment (SPAR)

A comprehensive multisectoral evaluation of the International Health Regulations (2005) core capacities.

By Khwima Esther Mkalira

Public Health Institute of Malawi (PHIM)

February 10, 2026

The Public Health Institute of Malawi (PHIM), under the Ministry of Health and with support from the World Bank, the Malawi Health Emergency Preparedness, Response and Resilience (MHEPRR) Project, and the World Health Organization (WHO), successfully conducted the State Party Annual Self-Assessment Report (SPAR) 2025 Compilation and Submission Workshop from 3rd to 6th February 2026 at Chikho Hotel, Mponela, Dowa.

Foundation of Resilience.

Health security is not an accidental achievement; it is a meticulously planned state of readiness. As the 2025 SPAR workshop commenced in Mponela, the atmosphere was charged with a sense of national duty. The assessment served as a critical pulse-check on 15 core technical areas that define Malawi’s ability to protect its citizens from global health threats. From Legal Instruments to Radiation Emergencies, every indicator was scrutinized through a lens of transparency and multisectoral accountability.

The workshop was designed to move beyond mere compliance. It aimed to institutionalize the culture of self-evaluation. Dr. Matthew Kagoli opened the sessions by reminding the participants that the data produced here would influence the allocation of resources under the MHEPRR project for years to come.

Dr. Matthew Kagoli, PHIM Director, delivering the keynote address where he emphasized that SPAR scores must be backed by verifiable field evidence to ensure global credibility.

Navigating the 15 Technical Areas

The assessment process was rigorous. The IHR Coordination team evaluated the efficiency of communication channels between the National IHR Focal Point and the World Health Organization. Meanwhile, the Financing group looked at the sustainability of emergency funds, ensuring that when the next outbreak hits, the “war chest” is ready.

A core focus remained on Surveillance and National Laboratory Systems. In the wake of recent regional outbreaks, the ability to detect a pathogen in a remote village and confirm its genetic sequence in a central lab within 48 hours is no longer a luxury, it is a survival requirement. The Human Resources for Health and Health Service Provision groups also worked late into the night, mapping out the distribution of specialized clinicians and the readiness of isolation facilities across all 28 districts.

Experts from the IHR Technical Committee seen here during a breakout session, meticulously aligning Malawi’s 2025 performance against the WHO’s Benchmarks for IHR Capacities.

One Health: Beyond the Human Patient

Malawi’s health security strategy recognizes that human health does not exist in a vacuum. The Zoonotic Diseases and Food Safety technical areas highlighted the deep interconnectedness between our livestock, our wildlife, and our people. With 75% of emerging infectious diseases originating in animals, the “One Health” approach was the star of the third day.

Specialists from the Department of Animal Health and Livestock Development joined PHIM researchers to validate data on rabies, anthrax, and brucellosis. This was complemented by a deep dive into Chemical Events and Radiation Emergencies, ensuring that Malawi is prepared for industrial accidents or environmental contamination that could trigger a public health crisis.

The Zoonotic and Surveillance teams collaborating to ensure that animal health indicators are integrated into the national early warning system, moving closer to a true One Health surveillance model.

Multisectoral Disaggregation

50 High-Level Experts

15 Technical Areas

100% Submission Rate

Involved sectors: MoH, Finance, Justice, Agriculture, Environment, WHO, US-CDC, UNICEF, and FAO.

Hard Infrastructure and The Law

Day two of the workshop shifted toward the structural “bones” of health security. Legal Instruments were reviewed to ensure that the Public Health Act and other regulations provide a firm mandate for quarantine, mandatory reporting, and cross-border cooperation. Without a strong legal framework, even the best medical response can be hampered by litigation or jurisdictional confusion.

The Health Emergency Management group focused on the National Emergency Operations Centre (EOC) and its sub-national nodes. The goal is a “seamless” command structure that can pivot from a cholera outbreak to a flood-related health crisis in hours.

Ronald Phiri and Dori Chiume analyzing the alignment of Malawi’s updated Public Health Bill with the IHR (2005) requirements for legal authority during emergencies.

Communities and Borders: The Human Shield

The final technical sessions focused on the interfaces where the health system meets the public. Points of Entry (PoE) and Border Health are Malawi’s first line of defense. Staffing and infrastructure at major borders like Mchinji, Dedza, and Songwe were evaluated to ensure that traveler screening is effective yet efficient.

Simultaneously, the Risk Communication and Community Engagement (RCCE) team discussed the “infodemic” challenge. In the digital age, fighting misinformation is as important as fighting a virus. The Infection Prevention and Control (IPC) team further analyzed hospital standards, ensuring that our medical facilities are places of healing rather than sources of further infection.

Gloria Jeremia leading a vigorous debate on the scoring of food-borne disease surveillance protocols in local markets.

The Points of Entry (PoE) and Border Health team during a break, having finalized their assessment of screening capacities at international airports.

The Road to 2026: Consolidation and Research

As the 2025 SPAR report reached its final draft, the focus turned to Research Integration. PHIM’s research department is now tasked with using the gaps identified during this workshop to drive new studies. Whether it is a study on antimicrobial resistance or the effectiveness of community-based surveillance, the 2025 SPAR has provided the roadmap.

The workshop concluded with a commitment to “Documentation Rigor.” Every score submitted to the WHO must be defensible. This requires a national culture of archiving, from meeting minutes to training logs ensuring that Malawi’s progress is not just claimed, but proven.

PHIM officers and researchers seen here uploading the final validated scores and evidence documents to the WHO Strategic Partnership for Health Security and IHR (SPH) portal.

Conclusion: A Resilient Tomorrow

The 2025 SPAR compilation workshop was more than an administrative exercise; it was a reaffirmation of Malawi’s sovereignty through safety. By looking honestly at our strengths and vulnerabilities across all 15 technical areas, we have ensured that the MHEPRR project is grounded in reality. Malawi is better prepared, more integrated, and more resilient than ever before.

“Health security is a journey, not a destination. The SPAR 2025 assessment proves that when sectors collaborate, from agriculture to finance. Malawi becomes an impenetrable fortress against public health threats.”

February 2026

This workshop was made possible through the technical and financial support of the World Bank and the World Health Organization, as part of the ongoing Malawi Health Emergency Preparedness, Response and Resilience (MHEPRR) Project.

Co-Authored & Published By

Moses Nyambalo Phiri

Public Health Institute of Malawi

Ministry of Health, Republic of Malawi

February 7, 2026
IDSR Epidemiological Bulletin – Week 2.

IDSR Bulletin Dashboard – Week 2, 2026

Weekly IDSR Bulletin

Epidemiological Week 2 (5-11 January, 2026)

Status: Official Release Published: Jan 24, 2026

Editorial Team

Dr. Matthews Kagoli

Mrs. Mtisunge Yelewa

Mr. Austin Zgambo

Mr. Sikhona Chipeta

Mr. James Jere

Mr. Noel Khunga

Public Health Institute of Malawi

COMPLETENESS
95.0%

TIMELINESS
87.3%

MALARIA
52,213

EBS SIGNALS
19

TYPHOID
69

MATERNAL DEATHS
2

I. Performance & Surveillance

District Reporting Completeness

Bulletin Analysis The national reporting completeness for Week 2 reached a commendable 95.0%, demonstrating strong engagement from most districts. This metric reflects the percentage of expected reports that were successfully entered into the One Health Surveillance Platform (OHSP). However, several key districts like Mangochi and Mzimba South are identified as needing urgent improvement to reach the 100% target. Consistent reporting is the backbone of our early warning system and ensures no local outbreaks are missed. District health management teams are urged to support their data clerks in maintaining these high standards. Without complete data, the PHIM cannot accurately allocate resources or assess the true public health burden across the country. We congratulate the districts that achieved 100% and set a benchmark for the rest of the nation.

Timeliness Performance

Bulletin Analysis Timeliness of reporting for Week 2 stands at 87.3%, which is below the desired national performance threshold of 100%. Timeliness is measured by the submission of reports by the designated deadline each Monday, allowing for rapid national analysis. The bulletin highlights that central facilities, including Kamuzu Central Hospital and QECH, must streamline their internal data flows to improve their reporting speed. Delays in reporting directly hinder the National IDSR Secretariat’s ability to trigger immediate responses to emerging threats. Each hour of delay potentially increases the risk of unchecked disease transmission within the community. We are monitoring the barriers to timely submission, including technical issues on the OHSP platform and staff availability. All facility focal persons are reminded that “Time is Health” in the context of surveillance.

EBS Signal Distribution

Bulletin Analysis A total of 19 Event-Based Surveillance (EBS) signals were captured during this reporting period, representing a vital layer of our surveillance architecture. EBS focuses on capturing unstructured information about public health events that may not be captured by routine indicator-based reporting. All 19 signals were verified, indicating that the community and health workers are highly vigilant in spotting unusual occurrences. The District Rapid Response Teams (DRRTs) are now tasked with conducting formal risk assessments for every verified event. These signals range from clusters of unknown illnesses to environmental hazards that pose a risk to human health. Strengthening EBS detection at the community level remains a priority for the upcoming quarter. We encourage all districts to continue utilizing the toll-free lines and community structures to report these signals.

II. Disease Morbidity

Malaria Cases (Week 2)

Bulletin Analysis Malaria continues to dominate the morbidity profile of Malawi, with 52,213 cases reported in Week 2 alone. Alarmingly, this high case volume was accompanied by 6 confirmed deaths, emphasizing the need for early diagnosis and treatment. Most districts are currently seeing high transmission rates, typical of the current seasonal trends. The PHIM recommends that all health facilities ensure a steady supply of Rapid Diagnostic Tests (RDTs) and Artemisinin-based Combination Therapy (ACTs). Public health messaging should focus on the consistent use of insecticide-treated nets (ITNs) and seeking medical care within 24 hours of fever onset. Surveillance data shows that children under five and pregnant women remain the most vulnerable populations. Continued monitoring of case fatality rates is essential to evaluate the quality of inpatient care.

Bloody Diarrhoea

Bulletin Analysis During Week 2, 1,186 cases of bloody diarrhoea were reported, along with 4 related deaths. This condition is a sensitive indicator for serious enteric pathogens, including those that cause dysentery and cholera. Given the ongoing cholera outbreaks in some regions, every case of bloody diarrhoea must be treated with high clinical suspicion. Health workers are instructed to collect stool samples for laboratory confirmation to identify the specific causative agents. Infection Prevention and Control (IPC) measures must be strictly enforced at the facility level to prevent nosocomial transmission. Safe water, sanitation, and hygiene (WASH) interventions at the community level are the primary defense against these waterborne diseases. The Ministry of Health is working with partners to distribute chlorine and hygiene kits in the most affected districts.

Typhoid Fever Trends

Bulletin Analysis Typhoid fever remains a significant concern with 69 cases reported this week, showing a slight upward trend compared to previous weeks. This disease is closely linked to poor sanitation and contaminated food or water sources. Clinical teams are advised to maintain high suspicion for patients presenting with prolonged fever and gastrointestinal symptoms. Accurate laboratory diagnosis via blood culture is encouraged wherever possible to guide appropriate antibiotic therapy. We are also monitoring for signs of antimicrobial resistance, which has been observed in Typhoid strains in the region. Public health teams should investigate clusters of cases to identify common sources of contamination. Improvements in urban and peri-urban water systems are long-term requirements to reduce this burden.

III. Critical Alerts & Mortality

Maternal Deaths (N=2)

Bulletin Analysis Two maternal deaths were reported during Epidemiological Week 2, serving as a somber reminder of the challenges in maternal health. Every maternal death is considered a public health emergency under the IDSR framework and must be reported within 24 hours. A comprehensive Maternal Death Surveillance and Response (MDSR) audit is mandatory for these cases to identify the root causes. These audits look at “three delays”: delay in seeking care, delay in reaching a facility, and delay in receiving appropriate care. The findings from these audits are crucial for implementing systemic changes to prevent future tragedies. We must continue to promote institutional deliveries and ensure that basic emergency obstetric care is available 24/7. Strengthening the referral chain between primary health centers and district hospitals remains a top priority.

SARI Mortality (CFR 3.4%)

Bulletin Analysis Severe Acute Respiratory Infection (SARI) surveillance identified 59 cases this week, resulting in 2 deaths. This results in a Case Fatality Rate (CFR) of 3.4%, which requires close monitoring to ensure it does not escalate. SARI surveillance is critical for monitoring the circulation of influenza-like illnesses and potential new respiratory pathogens. All SARI cases should have oropharyngeal or nasopharyngeal swabs collected for virological testing at the national laboratory. Early detection of respiratory outbreaks is essential for preventing wide-scale transmission, especially in crowded environments. Clinical management should focus on early supportive care and oxygen therapy for severe cases. The PHIM is keeping a close watch on these trends as we move through different seasonal patterns.

AEFI Surveillance

Bulletin Analysis The 91 cases of Adverse Events Following Immunization (AEFI) reported this week demonstrate a highly active and transparent safety monitoring system. Most of these events were reported as minor reactions, which are expected occurrences in any large-scale vaccination program. High AEFI reporting rates indicate that health workers are properly trained to observe and record any unusual health events post-vaccination. This data is vital for maintaining public trust in the national immunization program. Each serious AEFI is thoroughly investigated by a dedicated committee to determine causality. We commend the districts for their diligence in maintaining these safety standards. Continuous communication with parents and caregivers about what to expect after vaccination helps in managing these events effectively.

IV. Vaccine Preventable & Special Events

Mpox Alerts (Week 2)

Bulletin Analysis While there were zero new confirmed Mpox cases in Week 2, the system successfully generated four distinct Mpox alerts. This signifies that the surveillance system is sensitive enough to catch potential cases for further investigation. Mpox remains a disease of international concern, and Malawi must maintain high levels of vigilance at points of entry and within communities. Health workers are reminded to look for symptoms such as unexplained acute rash, fever, and lymphadenopathy. Prompt isolation of suspected cases and collection of lesion swabs for PCR testing are standard operating procedures. Public awareness campaigns should continue to emphasize the importance of reporting any unusual skin conditions. We are working closely with regional partners to share data and coordinate prevention efforts.

AFP (Polio) & Meningitis

Bulletin Analysis Two cases of Acute Flaccid Paralysis (AFP) were reported this week, which are critical for our ongoing Polio-free certification efforts. Every case of AFP in a child under 15 years must be investigated with two stool samples collected 24 hours apart. Furthermore, five cases of Meningococcal meningitis were reported, highlighting the need for rapid diagnostic response. Meningitis can spread quickly in close-contact settings, and immediate laboratory confirmation is required to initiate the correct antibiotic treatment. CSF samples should be transported in Trans-Isolate (TI) medium to ensure the viability of the bacteria. Districts should ensure they have adequate supplies of the necessary collection kits and transport media. Early detection and response to these cases are key to preventing large-scale outbreaks.

Immunization Outreach

Bulletin Analysis The Expanded Programme on Immunisation (EPI) data suggests that while routine coverage is stable, outreach strategies need strengthening. Some clusters of vaccine-preventable diseases, such as measles, have been linked to “zero-dose” children who have never been reached by the system. It is vital to map out hard-to-reach areas and schedule regular mobile clinics to bridge the coverage gap. Immunization is the most cost-effective public health intervention available and is the primary tool for reducing child mortality. Cold chain maintenance at the facility level must be monitored daily to ensure vaccine potency. Community leaders and traditional authorities are key partners in encouraging families to complete the full vaccination schedule. We aim for at least 95% coverage for all primary vaccines to maintain herd immunity.

V. Summary of Recommendations

1. Reporting Quality

Kamuzu Central, Mangochi, Mzimba South, and QECH must address timeliness issues immediately.

2. Cholera Containment

All partners and government ministries must collaborate to contain ongoing cholera outbreaks through WASH and case management.

3. EPI Strengthening

Focus on routine immunization to prevent measles clusters, particularly in areas with lower historical coverage.

Official Bulletin

Access the full PDF bulletin for Epidemiological Week 2, 2026, including detailed district-level performance tables.

DOWNLOAD OFFICIAL BULLETIN (PDF)

Authored & Published By

Moses Nyambalo Phiri

Public Health Institute of Malawi

Ministry of Health, Republic of Malawi

January 25, 2026
IDSR Epidemiological Bulletin – Week 50.

Malawi IDSR Infographic (Week 50, 2025)

Editorial Team

Dr. Matthews Kagoli Mrs. Mtisunge Yelewa Mr. Austin Zgambo Mr. Sikhona Chipeta Mr. James Jere Mr. Noel Khunga

Weekly IDSR Bulletin

Epidemiological Week 50 (8-14 December, 2025)

Published By

Moses Nyambalo Phiri

Public Health Institute of Malawi

National Surveillance Performance

Completeness

97.9%

↑ Above 80% Target

Timeliness

94.2%

↑ Above 80% Target

Performance Analysis The national reporting performance for Week 50 has remained exceptionally strong, exceeding the Ministry of Health’s minimum target of 80% for both key indicators. Completeness of reporting reached 97.9%, while timeliness was slightly lower at 94.2%, reflecting a high level of engagement from health facilities across the country. Despite these high averages, specific districts such as Balaka, Nkhotakota, and Nsanje were noted as areas requiring targeted support to improve their reporting speed. Maintaining these rates is essential for the early detection of localized outbreaks and for ensuring that the national One Health Surveillance Platform remains an accurate reflection of the country’s health status.

Weekly Disease Alerts (Excl. Malaria)

Alert Insights Outside of the massive Malaria burden, Diarrhoea with blood emerged as a major concern with 1,122 cases reported in a single week. Severe Acute Respiratory Infections (SARI) also remain a critical surveillance priority, recording 107 cases and 6 deaths, indicating a significant clinical severity for respiratory pathogens. Other notable alerts included 70 cases of Adverse Events Following Immunization (AEFI) and 23 cases of Typhoid fever, both of which require continuous monitoring for safety and water quality. The consistent reporting of these varied conditions demonstrates the breadth of the IDSR system’s reach and the vigilance of health workers in identifying non-malarial threats.

Malaria Burden Spotlight

Total Weekly Cases

31,502

Total Weekly Deaths

9

Morbidity Analysis Malaria remains the single most significant cause of morbidity in the Malawian health system, accounting for tens of thousands of cases every week. During Epi-week 50, the 31,502 reported cases highlight the persistent strain that this vector-borne disease places on outpatient departments and community health workers. The reporting of 9 deaths within the week emphasizes that despite widespread treatment availability, Malaria continues to be a fatal threat if not diagnosed and managed early. Public health officials must continue prioritizing the distribution of insecticide-treated nets and ensuring that rapid diagnostic tests are available in even the most remote facilities.

Mpox Status

Epidemiological Status Malawi recorded 1 new confirmed Mpox case in Week 50, bringing the cumulative total since the start of the outbreak to 15 cases. There were also 19 alerts generated during this period, showing that the surveillance system is actively screening for suspicious symptoms. Fortunately, the majority of cases have been managed through outpatient care, and recovery rates remain high across the affected districts. The persistence of sporadic cases indicates that community transmission is still a risk, necessitating continued public health education on hygiene and early reporting.

EBS Signal Management

Signal Verification In Week 50, a total of 63 Event-Based Surveillance (EBS) signals were detected through the One Health Surveillance Platform, showcasing a high level of community vigilance. These signals are critical for identifying unusual health events that may not yet fit standard clinical definitions, such as clusters of animal deaths or sudden human illnesses. It is mandatory for District Rapid Response Teams to conduct immediate risk assessments for all signals that are verified as genuine events. Effective management of these signals serves as the nation’s early warning system, allowing for rapid intervention before localized events escalate into full-scale outbreaks.

December 17, 2025