Putting stalled malaria control efforts back on track

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 to scale up prevention and treatment, and increased investment, to protect vulnerable people from the deadly disease.

The report 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. But in the years prior, the number of people contracting malaria globally had been steadily falling, from 239 million in 2010 to 214 million in 2015.

Where malaria is hitting hardest

In 2017, approximately 70% of all malaria cases (151 million) and deaths (274,000) were concentrated in India and other 10 African countries. 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.

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 is based on four pillars:

•             Galvanising national and global political attention to reduce malaria deaths;

•             Driving impact through the strategic use of information;

•             Establishing best global guidance, policies and strategies suitable for all malaria endemic countries; and

•             Implementing a coordinated country response.

Catalysed 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.

Pockets of progress

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 4% of the global malaria burden — recorded a 24% 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.

Domestic financing is key

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%) from governments of malaria endemic countries.  The United States of America remains the largest single international donor, contributing US$ 1.2 billion (39%) 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.