LAST UPDATED: 9/5/26 – Are Antimalarial Medications Worth Taking?
It’s a question many international travelers still wrestle with: Is taking antimalarial medication worth it? Do you deal with possible side effects, or skip the pills and accept a higher risk of contracting malaria? On paper, the answer seems obvious — but you might be surprised how many travelers still choose to forgo antimalarial protection.
Malaria Today: The Global Reality
According to the World Health Organization, malaria remains one of the world’s most significant infectious diseases. In 2023, there were an estimated 249 million cases and over 600,000 deaths, with sub‑Saharan Africa accounting for roughly 94% of malaria fatalities. Despite advances in prevention and treatment, malaria continues to pose a serious threat in many regions across Africa, Asia, Oceania, and parts of Latin America.
With numbers like these, the importance of prevention becomes clear — yet travelers still debate whether antimalarial medication is “worth it.”
Why Some People Choose Not to Take an Antimalarial
After reading countless travel forums and speaking with travelers, the most common reasons fall into a few predictable categories:
- Side effects — nausea, vivid dreams, or stomach upset.
- Reliance on mosquito protection — nets, long sleeves, and repellent feel “good enough.”
- Cost or inconvenience — appointments, prescriptions, and medication prices can add up.
- Not 100% effective — some travelers assume they’ll “deal with it later” if they get sick.
- Past experience — people who’ve visited high‑risk areas before without issues may become complacent.
It’s an important topic, and I want you all to be aware of the discussions that are out there, so I have included some links to some recent articles and discussions I have read online.
- Need help with making a decision on “Malaria Pills”
- ‘I regret not taking malaria pills’
- People might not take this potential Malaria drug just because it turns their urine blue
- Malaria: The dangers of not taking anti-malaria tablets
- Should I take anti-malaria medication or not?
- Are Anti-malaria pills necessary if no mosquito bites?
I can certainly understand the reasoning behind some of these reasons for not taking an antimalarial when you travel, but I don’t necessarily agree with any of them.
Side Effects: Real, But Manageable
Yes — some antimalarial medications can cause side effects. But today’s options are far better tolerated than those commonly used 10–15 years ago.
The CDC provides updated guidance on medications such as:
- Atovaquone-proguanil (Malarone) — typically mild side effects, taken daily.
- Doxycycline — inexpensive, but can increase sun sensitivity.
- Tafenoquine — long‑acting, convenient, but requires G6PD testing.
- Mefloquine — effective but less commonly used due to neuropsychiatric side effects.
Talking with a travel‑medicine clinician is the smartest way to match the right medication to your itinerary and health profile.
Mosquito Protection Helps — But It’s Not Enough
Mosquito nets, DEET or picaridin repellent, long sleeves, and avoiding dusk/dawn exposure are all excellent habits. But they are supplements, not substitutes.
All it takes is one bite from an infected mosquito. Using physical protection plus antimalarial medication dramatically reduces your risk.
Cost and Convenience: A Real Barrier, But Not a Dealbreaker
Some antimalarial medications can be pricey, especially for long trips. And yes, scheduling a travel‑clinic appointment can feel like a hassle.
But malaria treatment — especially severe malaria — is far more expensive, dangerous, and disruptive. Many travelers underestimate how quickly malaria can become life‑threatening, even with modern medical care.
If you’re traveling to a high‑risk region, budgeting for antimalarial medication should be considered part of the trip cost, just like visas, insurance, or vaccinations.
“They’re Not 100% Effective” — True, But Misleading
No antimalarial medication guarantees complete protection. But skipping them entirely is like refusing to wear a seatbelt because it’s not guaranteed to save your life.
Antimalarials:
- Reduce your risk of infection.
- Reduce the severity of illness if you do get infected.
- Reduce the likelihood of complications and hospitalization.
Travelers who skip medication because “I’ve been fine before” are relying on luck — not strategy.
The Bottom Line
If you’re traveling to a region with malaria transmission, taking antimalarial medication remains one of the most effective ways to protect yourself. Pair it with strong mosquito‑avoidance habits, and your risk drops dramatically.
Malaria is preventable. It is also deadly. The trade‑off is clear.
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About ten years ago we visited a part of Brazil that was supposedly malaria-free. Anti-malarials were not needed, and we were happy not to have to take them – although we hadn’t had any really bad reactions to any that we had taken previously. We used insect repellent, and after going for a swim, I got a lot of mosquito bites.
About a week after returning home, my husband got sick. We thought it was flu, or perhaps the effects of working alternate evenings in a warm, humid, smelly (ammonia) environment – which was when he seemed to be worst – although after a while he was ok again. After a week of this, I took him to the doctor. He had a malarial episode right there in front of her. It was the worst one he’d had, and was not pleasant to see either. Fortunately it was treatable.
So, I would say please take the pills if they are recommended. I know they’re not 100% guaranteed against contracting the disease, but anything that reduces your risk has to be worthwhile. There is no way of knowing who will get infected – I was the one that got the most bites.
Very well said Annie!! Thank you for sharing your story!