Malaria

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A mosquito bite can kill. It’s as simple as that. Malaria is caused by parasites transmitted through the bite of an infected female Anopheles mosquito, causing nearly 429,000 deaths a year. Children and pregnant women are particularly vulnerable – in 2015, almost 70 percent of all malaria deaths were children under 5.

Once prevalent across most of the globe – including much of the American South and Northern Italy – elimination efforts of the 20th century have reduced malaria’s footprint to 91 countries. Today, however, half of the world’s population – 3.2 billion people – remains at risk of malaria.

Malaria is both preventable and treatable, and great progress has been made in the last decade alone. New methods of testing, the widespread distribution of insecticide-treated nets and the introduction of artemisinin-based combination therapies (ACTs) have led to a 29 percent drop in malaria mortality rates between 2010 and 2015.

But these gains remain fragile. If efforts are neglected, malaria could resurge within just one infectious season. Global funding for malaria has grown to US$2.9 billion per year, but this is less than half the amount required to maintain the gains against this disease.

There are other challenges in the response to malaria. Growing resistance to artemisinin and its partner drugs, as well as resistance to the insecticide used on nets, is threatening the response in much of Southeast Asia. The use of nets for other than their intended purpose also poses a threat to prevention and control efforts. Weak health management information systems make monitoring outbreaks and the impact of prevention efforts much more difficult.

Reducing the impact of malaria involved a multipronged plan that includes education, prevention, diagnosis, treatment and monitoring.

The Global Fund supports a number of different interventions in the response to malaria. Depending on the country context, these could include such programs as:

  • Awareness programs
  • Indoor residual spraying of homes
  • Distribution of insecticide-treated nets
  • Destruction or removal of breeding sites

Boots on the ground against malaria

A team of spray operators and supervisors set out in the early morning to begin household spraying in Matabele North Province, Zimbabwe, near the northern border with Zambia. Spraying takes place once a year in the remote clusters of homesteads and aims to kill mosquitoes that spread malaria.

Education

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 many countries, malaria prevention modules are added to the school curriculum in both grade schools and higher education. In every community, both children and adults are taught methods for preventing malaria.

Prevention

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. For example, in Sri Lanka, larvivorous (larvae-eating) fish were introduced to bodies of water where mosquitoes normally breed. Through 2016, programs supported by the Global Fund had distributed 795 million nets to protect families. Sleeping under an insecticide-treated net halves malaria cases among children.

Fighting malaria in Myanmar

Myanmar has made great impact against malaria, but the mission is not complete. A committed, on-the-ground partnership is working to lift the burden imposed by the mosquito-borne parasite.

Diagnosis

Diagnosis is also key, because not every fever signals malaria. By giving people the wrong treatment, you could be contributing to drug resistance. Until recently, a diagnosis of malaria required time-consuming laboratory tests, which were not available in many countries. However, in recent years inexpensive rapid diagnostic kits that are accurate and that can be used in any setting have become available.

Treatment

Through 2016, programs supported by the Global Fund had provided 668 million treatments for malaria.

In the last decade, we have seen the introduction of artemisinin-based combination therapies (ACTs), a new generation of antimalarial treatment that 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.

Monitoring

As the incidence of malaria continues to decrease, it becomes even more important for countries to record and track cases so that they can monitor outbreaks.

Insecticide-treated nets distributed

Published 20 July 2017