WHO calls on global health partners to step up the fight against malaria

The World Health Organization (WHO) calls on countries and global health partners to step up the fight against malaria, a preventable and treatable disease that continues to claim hundreds of thousands of lives every year.

Better targeting of interventions, new tools and more funding are needed to change the global trajectory of the disease and achieve internationally agreed goals.

According to the latest WHO news World report on malaria, progress against malaria continues to stabilize, particularly in high-load African countries.

Gaps in access to life-saving tools are undermining global efforts to curb the disease, and the COVID-19 pandemic is expected to further delay the fight.

It is time for leaders across Africa – and around the world – to once again address the challenge of malaria, just as they did when they laid the foundation for the progress made since the beginning of this century. Through joint action and a commitment to leave no one behind, we can achieve our shared vision of a malaria-free world. “

Dr Tedros Adhanom Ghebreyesus, Director General, World Health Organization

In 2000, African leaders signed the historic Abuja Declaration pledging to reduce malaria deaths on the continent by 50% over a 10-year period.

Strong political commitment, coupled with innovations in new tools and a sharp increase in funding, catalyzed a period of unprecedented success in global malaria control. According to the report, 1.5 billion malaria cases and 7.6 million deaths have been averted since 2000.

A plateau in progress

In 2019, the global malaria case count was 229 million, an annual estimate that has remained virtually unchanged for the past 4 years. The disease claimed around 409,000 deaths in 2019 compared to 411,000 in 2018.

As in past years, the African region took over 90% of the overall burden of the disease. Since 2000, the region has reduced the number of victims of malaria by 44%, from 680,000 to 384,000 annually. However, progress has slowed in recent years, particularly in countries with a high disease burden.

A funding gap both internationally and nationally poses a significant threat to future earnings. In 2019, total funding reached US $ 3 billion against a global target of US $ 5.6 billion. Funding shortages have led to critical gaps in access to proven malaria control tools.

COVID-19 an extra challenge

In 2020, COVID-19 emerged as an additional challenge to delivering essential health services around the world. According to the report, most malaria prevention campaigns have been able to move forward this year without major delays.

Ensuring access to malaria prevention – such as insecticide-treated nets and preventative medications for children – has supported the COVID-19 response strategy by reducing the number of malaria infections and, in turn, easing the burden on health systems.

WHO has worked rapidly to provide countries with guidance to tailor their responses and ensure the safe provision of malaria services during the pandemic.

However, WHO fears that even moderate interruptions in access to treatment can lead to considerable loss of life.

The report notes, for example, that a 10% disruption in access to effective malarial care in sub-Saharan Africa could lead to an additional 19,000 deaths. The 25% and 50% outages in the region could result in an additional 46,000 and 100,000 deaths, respectively.

“While Africa has shown the world what can be achieved if we unite to end malaria as a public health threat, progress has stalled,” said Dr. Matshidiso Moeti, WHO Regional Director for Africa.

“COVID-19 threatens to further derail our efforts to defeat malaria, particularly by treating people with the disease. Despite the devastating impact COVID-19 has had on African economies, international partners and countries need to do more to ensure that the resources are there to expand the malaria programs that are making such a difference in people’s lives. “

WHO response

A key strategy to reignite progress is the “High burden to high impact” (HBHI) response, catalyzed in 2018 by the WHO and the RBM Partnership to End Malaria.

The response is led by 11 countries, including 10 in sub-Saharan Africa, which account for around 70% of the world’s malaria burden.

Over the past 2 years, HBHI countries have moved away from a one-size-fits-all approach to malaria control, opting instead for tailored responses based on local data and intelligence.

A recent analysis of Nigeria, for example, found that through an optimized mix of interventions, the country could avoid tens of millions of additional cases and thousands of additional deaths by 2023, compared to a business-as-usual approach.

Although it is too early to measure the impact of the HBHI approach, the report finds that deaths in the 11 countries were reduced from 263,000 to 226,000 between 2018 and 2019. India continued to make significant gains, with reductions in cases and deaths of 18% and 20%, respectively, in the last 2 years.

There has, however, been a slight increase in the total number of cases among HBHI countries, from an estimated 155 million in 2018 to 156 million in 2019.

Achieve global malaria goals

This year’s report highlights the milestones and events that have helped shape the global response to the disease over the past few decades.

Since the 1990s, leaders of malaria-affected countries, scientists and other partners have laid the groundwork for a renewed malaria response that has contributed to one of the largest returns on investment in global health.

According to the report, 21 countries have eliminated malaria in the past 2 decades; of these, 10 countries have been officially certified as malaria-free by the WHO.

Faced with the continuing threat of antimalarial drug resistance, the 6 countries of the Greater Mekong sub-region continue to make important progress towards their goal of eliminating malaria by 2030.

But many countries with a high malaria burden are losing ground. According to WHO global projections, the 2020 target for reducing the incidence of malaria cases will be missed by 37% and the target for reducing mortality will be missed by 22%.