Chioma Umeha
Reductions in malaria cases have stalled after
several years of decline globally, according to the new World malaria report
2018.
To get the reduction in malaria deaths and disease
back on track, the World Health Organisation (WHO) and partners are joining a
new country-led response, launched today, to scale up prevention and treatment,
and increased investment, to protect vulnerable people from the deadly disease.
For the second consecutive year, the annual report
produced by WHO reveals a plateauing in numbers of people affected by malaria
in 2017.
There were an estimated 219 million cases of
malaria, compared to 217 million the year before, the report said.
But, in preceding years, the number of people
contracting malaria globally had been steadily falling, from 239 million in
2010 to 214 million in 2015, it added.
“Nobody should die from malaria. But, the world
faces a new reality: as progress stagnates, we are at risk of squandering years
of toil, investment and success in reducing the number of people suffering from
the disease,” says Dr Tedros Adhanom Ghebreyesus, WHO Director-General.
“We recognise we have to do something different ,
now. So today we are launching a country-focused and, led plan to take
comprehensive action against malaria by making our work more effective where it
counts most, at local level.”
Malaria is hitting hardest
In 2017, approximately 70 per cent of all malaria
cases (151 million) and deaths (274 000) were concentrated in 11 countries, 10
in Africa (Burkina Faso, Cameroon, Democratic Republic of the Congo, Ghana,
Mali, Mozambique, Niger, Nigeria, Uganda and United Republic of Tanzania) and
India.
There were 3.5 million more malaria cases reported
in these 10 African countries in 2017 compared to the previous year, while
India, however, showed progress in reducing its disease burden.
Despite marginal increases in recent years in the
distribution and use of insecticide-treated bed nets in sub-Saharan Africa
– the primary tool for preventing
malaria – the report highlights major coverage gaps. In 2017, an estimated half
of at-risk people in Africa did not sleep under a treated net.
Also, fewer homes are being protected by indoor
residual spraying than before, and access to preventive therapies that protect
pregnant women and children from malaria remains too low.
High impact response needed
In line with WHO’s strategic vision to scale up
activities to protect people’s health, the new country-driven “High burden to
high impact” response plan has been launched to support nations with most
malaria cases and deaths.
The response follows a call made by Dr Tedros at
the World Health Assembly in May 2018 for an aggressive new approach to
jump-start progress against malaria. It is based on four pillars; galvanizing
national and global political attention to reduce malaria deaths and driving
impact through the strategic use of information.
Others are, establishing best global guidance,
policies and strategies suitable for all malaria endemic countries and
implementing a coordinated country response.
Catalyzed by WHO and the RBM Partnership to End
Malaria, “High burden to high impact” builds on the principle that no one
should die from a disease that can be easily prevented and diagnosed, and that
is entirely curable with available treatments.
“There is no standing still with malaria. The
latest World malaria report shows that further progress is not inevitable and
that business as usual is no longer an option,” said Dr Kesete Admasu, CEO of
the RBM Partnership. “The new country-led response will jumpstart aggressive
new malaria control efforts in the highest burden countries and will be crucial
to get back on track with fighting one of the most pressing health challenges
we face.”
Targets set by the WHO Global technical strategy
for malaria 2016–2030 to reduce malaria case incidence and death rates by at
least 40 per cent by 2020 are not on track to being met.
Progress
The report highlights some positive progress. The
number of countries nearing elimination continues to grow (46 in 2017 compared
to 37 in 2010). Meanwhile in China and El Salvador, where malaria had long been
endemic, no local transmission of malaria was reported in 2017, proof that
intensive, country-led control efforts can succeed in reducing the risk people
face from the disease.
In 2018, WHO certified Paraguay as malaria free,
the first country in the Americas to receive this status in 45 years. Three
other countries – Algeria, Argentina and Uzbekistan – have requested official
malaria-free certification from WHO.
India – a country that represents four per cent of
the global malaria burden – recorded a 24 per cent reduction in cases in 2017
compared to 2016.
Also in Rwanda, 436 000 fewer cases were recorded
in 2017 compared to 2016. Ethiopia and Pakistan both reported marked decreases
of more than 240 000 in the same period.
“When countries prioritize action on malaria, we
see the results in lives saved and cases reduced,” says Dr Matshidiso Moeti,
WHO Regional Director for Africa. “WHO and global malaria control partners will
continue striving to help governments, especially those with the highest
burden, scale up the response to malaria.”
Domestic financing
As reductions in malaria cases and deaths slow,
funding for the global response has also shown a levelling off, with US$ 3.1
billion made available for control and elimination programmes in 2017 including
US$ 900 million (28 per cent) from governments of malaria endemic
countries. The United States of America
remains the largest single international donor, contributing US$ 1.2 billion (39
per cent) in 2017.
To meet the 2030 targets of the global malaria
strategy, malaria investments should reach at least US$6.6 billion annually by
2020 – more than double the amount available today.
