Abstract Malaria is widely framed as a public health crisis in Africa, measured in mortality and morbidity, yet this narrow perspective obscures its deeper role as a structural constraint on economic development. Beyond the human toll, malaria suppresses productivity, erodes education and human capital, weakens institutions and slows national growth, locking countries into self-perpetuating cycles of poverty that health arguments alone cannot break. It is estimated that malaria reduces GDP growth in endemic countries by between 0.7% and 3% annually, with cumulative losses over decades dwarfing the direct costs of control and treatment. Historically, recognising malaria as both a cause and a consequence of underdevelopment helped mobilise economists, finance ministries and development agencies, enabling major global investments and substantial progress. As this developmental narrative has faded, political momentum has weakened, even as progress stalls and biological threats intensify. Climate change now adds a further destabilising force, threatening to amplify transmission precisely in settings least equipped to absorb the shock. This article argues that malaria must once again be understood as both a health and a developmental emergency. At a moment when new tools and transformative interventions offer realistic pathways to elimination, reframing malaria in economic and developmental terms is essential to re-engage finance and policy actors and align scientific opportunity with the long-term investments required to achieve elimination.