Following 2 years of discussion, important new analyses on the epidemiological and financial dimensions of malaria eradication, a comprehensive examination of the literature, and drawing upon the deep and expansive expertise of the Commissioners and the other authors, the Commission reached four seminal conclusions:

• Malaria, one of the most ancient and deadly diseases of humankind, can and should be eradicated by the year 2050. Malaria will not be eradicated under a business as usual scenario. Specific and essential actions are required at country, regional and global levels to ensure that eradication is achieved. These actions will be reinforced by a global commitment to pursue malaria eradication as a defined, time-bound goal.
• Malaria eradication is a good investment with large social and economic rewards. The benefits of eradication will greatly exceed the costs. Malaria eradication will save many lives in perpetuity; it will promote equity and reduce poverty; it will deliver broad benefits to the human welfare and the economy of Africa and many parts of Asia and the Americas; and it will contribute to UHC, global health security, and the achievement of the SDGs.
• A combination of plausibly available domestic and international resources is sufficient to pay for malaria eradication. Malaria eradication can be afforded. A combined strategy of increasing total spend and emphasizing management and efficiency on the ground will be the recipe for success.
• Alternatives to eradication are untenable. The alternative options—including ongoing investment in control and prevention of re-establishment, the persistence of malaria foci indefinitely in Africa, the risk of a resurgence, and a losing battle against resistance—are extremely unattractive. The issue of equity is central. If the world decides not to push for eradication by 2050 or sooner, it consigns poor communities primarily in Africa to ongoing sickness and death that could be prevented.

Malaria eradication is a goal of epic proportions. It represents the best of human ingenuity and requires an extraordinary level of trust and collaboration among all nations. It is this bigger vision that will propel and sustain us in the long and sometimes difficult road to a malaria-free world.