Global efforts to control and eliminate malaria have saved an estimated 3.3 million lives since 2000, reducing malaria mortality rates by 45 percent globally and by 49 percent in Africa, World Health Organization (WHO) indicated on Thursday.
An expansion of prevention and control measures has been mirrored by a consistent decline in malaria deaths and illness, despite an increase in the global population at risk of malaria between 2000 and 2012, WHO said in its World Malaria Report 2013, adding that increased political commitment and expanded funding have helped to reduce incidence of malaria by 29 percent globally, and by 31 percent in Africa.
The large majority of the 3.3 million lives saved between 2000 and 2012 were in the ten countries with the highest malaria burden, and among children aged less than five years, who are most affected by the disease. Over the same period, malaria mortality rates in children in Africa were reduced by an estimated 54 percent, noted the report.
"This remarkable progress is no cause for complacency: absolute numbers of malaria cases and deaths are not going down as fast as they could," Dr. Margaret Chan, WHO Director-General, said in the report, adding, "The fact that so many people are infected and dying from mosquito bites is one of the greatest tragedies of the 21st century." International funding for malaria control increased from less than USD 100 million in 2000 to almost USD 2 billion in 2012. Domestic funding stood at around USD 0.5 billion in the same year, bringing the total international and domestic funding committed to malaria control to USD 2.5 billion in 2012, less than half the USD 5.1 billion needed each year to achieve universal access to interventions, noted WHO.
Without adequate and predictable funding, the progress against malaria is also threatened by emerging parasite resistance to Artemisinin, the core component of ACTs, and mosquito resistance to insecticides. Artemisinin resistance has been detected in four countries in south-east Asia, and insecticide resistance has been found in at least 64 countries, it pointed out.
"The remarkable gains against malaria are still fragile," said Dr. Robert Newman, Director of the WHO Global Malaria Program, pointing out at the same time that "in the next 10-15 years; the world will need innovative tools and technologies, as well as new strategic approaches to sustain and accelerate progress." WHO mentioned that it is currently developing a global technical strategy for malaria control and elimination for the period 2016-2025, as well as a global plan to control and eliminate Plasmodium vivax Malaria.
Prevalent primarily in Asia and South America, P. vivax Malaria is less likely than P. falciparum to result in severe malaria or death, but it generally responds more slowly to control efforts, the report said, noting that about 9 percent of the estimated global malaria cases are due to P. vivax, although the proportion outside the African continent is 50 percent.
Also, the report showed that there were an estimated 207 million cases of malaria in 2012, which caused approximately 627,000 cases. An estimated 3.4 billion people continue to be at risk of malaria, mostly in Africa and south-east Asia. Around 80 percent of malaria cases occur in Africa, it added.
In addition, WHO pointed out that malaria prevention suffered a setback after its strong build-up between 2005 and 2010, noting a slowdown in the expansion of interventions to control mosquitoes for the second successive year, particularly in providing access to insecticide-treated bed nets. This has been primarily due to lack of funds to procure bed nets in countries that have ongoing malaria transmission.
In sub-Saharan Africa, the proportion of the population with access to an insecticide-treated bed net remained well under 50 per cent in 2013. Only 70 million new bed nets were delivered to malaria-endemic countries in 2012, below the 150 million minimum needed every year to ensure everyone at risk is protected.
However, in 2013, about 136 million nets were delivered, and the pipeline for 2014 looks even stronger, suggesting that there is real chance for a turnaround. There was no such setback for malaria diagnostic testing, which has continued to expand in recent years. Between 2010 and 2012, the proportion of people with suspected malaria who received a diagnostic test in the public sector increased from 44 percent to 64 percent globally, the report mentioned.
Access to WHO-recommended artemisinin-based combination therapies (ACTs) has also increased, with the number of treatment courses delivered to countries rising from 76 million in 2006 to 331 million in 2012.
Despite this progress, millions of people continue to lack access to diagnosis and quality-assured treatment, particularly in countries with weak health systems, WHO indicated, pointing out at the same time that the roll-out of preventive therapies, recommended for infants, children under five, and pregnant women, has also been slow in recent years.