• Malaria

    Half of the world’s population is at risk for malaria. Once widespread across five continents, malaria’s “footprint” has been reduced to 99 countries. And since 2000, malaria-endemic countries have significantly stepped up their efforts to respond to malaria, which has led to a 47 percent drop in malaria death between 2000 and 2014. But these gains are fragile – there are a number of countries where, if prevention efforts are not maintained, malaria could resurge within just one infectious season.

    Malaria is caused by parasites transmitted to humans through the bite of infected female Anopheles mosquitoes. Children under five and pregnant women are particularly vulnerable.

    An effective response to malaria is a multipronged effort, involving education, prevention, diagnosis and treatment. Education means ensuring that those populations living in malaria-endemic areas are provided with information about what malaria is, how it is transmitted, what treatments are available, and, most importantly, what actions to take if malaria is suspected. In Ghana, for example, village elders teach their community “not to let the sun set twice” on a child with fever. In every community, both children and adults are taught methods for preventing malaria.

    Prevention involves the distribution of insecticide-treated nets, the use of indoor residual spraying of households and, if appropriate, interventions targeting the larval stages of the mosquito. Through the end of 2014, programs supported by the Global Fund had distributed 450 million nets to protect families. Sleeping under an insecticide-treated net halves malaria cases among children.

    Diagnosis is also key, because not every fever signals malaria. In recent years, rapid diagnostic kits that are inexpensive, accurate and can be used in any setting have been introduced, greatly facilitating the response.

    In the last decade, we have seen the introduction of artemisinin-based combination therapies (ACTs), a new generation of antimalarial treatment which are highly effective. Unfortunately, however, we are already seeing resistance to the key ingredient, artemisinin, as well as the partner drugs, develop in certain parts of the world. This is one of the great challenges facing us in the fight against malaria.

    Great strides have been made in all these areas in the last decade, but it is important to maintain and even expand these efforts. Experts estimate that, in order to sustain these gains, US$5.1 billion is needed each year. Currently, less than half that amount is being made available. Increased investment in the response to malaria is urgently needed.