In 2018 the World Health Organization proposed a “10+1” initiative for malaria control and elimination that targets 10 African countries plus India, which together host 70 percent of global cases. Although this approach is promising, it is missing an important component: genomic surveillance. Drug resistance threatens all of the progress made so far against malaria, but genomic surveillance can detect resistance years before the first warning signs appear in clinics. It can answer critical questions about how resistance emerges and spreads and can help control the balance of interventions, preserve the useful life of already existing drugs and ensure effective treatment.