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Malaria

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The fight against malaria is one of the biggest public health successes of the 21st century. The number of deaths caused by malaria globally declined 50 percent between 2000 and 2015 – that translates to an estimated 6.8 million deaths averted.

We have the tools and treatments to prevent and cure malaria; but in recent years, global investment has plateaued and progress has stalled. This is a fight we can win, if we build and maintain unwavering commitment.

Malaria, caused by a parasite spread by certain types of mosquitoes, is among the deadliest diseases in human history. In 2016, there were 216 million cases and 445,000 deaths from malaria, with about 90 percent of these occurring in sub-Saharan Africa. Pregnant women and children under age 5 are most at risk, because of their weaker immune systems.

Malaria is present in 91 countries, and these increasingly fall into one of two categories: those progressing toward elimination and those with a high burden of malaria that are experiencing setbacks in their responses.

This progress toward elimination underscores the fact that we have effective tools and strategies to halt malaria. The issue is investment. An estimated US$2.7 billion was invested in malaria control and elimination efforts globally in 2016 – less than half the 2020 funding target.

The Global Fund provides 50 percent of all international financing for malaria, and has invested more than US$9.1 billion in malaria control programs in more than 100 countries from 2002-2016, using a comprehensive approach that combines:

  • Education about symptoms, prevention and treatment
  • Prevention through use of mosquito nets, spraying structures with insecticide and preventive treatment for children and pregnant women
  • Diagnosis, including supplying rapid diagnostic tests to community health volunteers
  • Treatment

Number of insecticide-treated nets distributed through Global Fund-supported programs

Community awareness and action

Global Fund partners work with communities in malaria-endemic areas to provided 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 lessons are added to the school curriculum. In Senegal, community health workers are a critical force in the fight to eliminate malaria, particularly in hard-to-reach rural villages.

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Race to elimination

The malaria map is shrinking. The global malaria strategy and the Sustainable Development Goals call for malaria to be eliminated from at least 35 countries by 2030. An additional milestone has been set for the elimination of malaria in at least 10 countries by 2020 – a target the health community believes is well within reach.

In places on the cusp of elimination, the Global Fund supports approaches that focus control activities in targeted geographic areas or for specific, high-risk populations. Enhanced case finding is resource intensive – requiring identifying and following up with every case, including family or community members who also might have been exposed. But it is essential to interrupting malaria transmission and achieving elimination. The investment to eliminate malaria will pay dividends beyond one disease, by alleviating a significant burden on resource-constrained health systems.

Despite the progress and promise, we face serious challenges.

  • The Greater Mekong region is ground zero for the emergence of drug-resistant malaria.
  • Insecticide resistance is widespread across Africa, where the disease burden is highest.
  • Climate change, migration and political instability impact malaria transmission dynamics and service delivery.
  • Sub-standard and counterfeit drugs can still be found in many markets.
  • Attention and focus can dissipate as the malaria burden drops, or progress stalls.

The last point is significant. The history of malaria elimination efforts shows that the disease will exploit any let up in efforts to control it. Even impressive gains can be wiped out by a lapse during a single transmission season, and failure to maintain effective control can result in resurgence of the disease. A “rebound” can make the situation even worse than before control efforts, because people lose the partial immunity acquired through repeated exposure to malaria.

This is why we must jump-start efforts where progress has stalled and commit to the sustained investment required to achieve the targets of the global malaria strategy.

Why RAI? Investing to Eliminate Malaria in the Mekong

Published 21 December 2017

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