The fight against malaria is one of humanity's biggest public health successes. The world has seen 1.5 billion cases averted and 7.6 million lives saved over the last two decades. Global malaria mortality fell by 60% over this period. But progress has plateaued with COVID-19 threatening to derail hard-won gains. We must #UniteToFight both diseases.
Malaria, caused by a parasite spread by certain types of mosquitoes, is among the world's deadliest diseases. Pregnant women and children under age five are most at risk because of their weaker immune systems. In 2019, children under five accounted for 67% of all malaria deaths worldwide.
Malaria is present in more than 80 countries, and these increasingly fall into one of two categories: those progressing toward elimination and those with a high burden and experiencing setbacks. The Global Fund is urgently working to accelerate the needed investments in malaria control, prevention and treatment while safeguarding the world's progress during the pandemic.
The pandemic has led to postponed malaria control programs and deadly delays in treatment. History shows that the disease will relentlessly exploit these lapses. Impressive gains can be wiped out during a single transmission season, and failure to maintain effective control can result in resurgence. A “rebound” can make the situation even worse than before control efforts because people lose the partial immunity acquired through repeated exposure to malaria. We must #UniteToFight the two diseases.
The Global Fund provides 56% of all international financing for malaria, and has invested more than US$13.5 billion in malaria control programs as of August 2020. Our comprehensive approach combines:
We are relentless in the fight against malaria because we know Global Fund investments save lives. Malaria deaths were reduced by 46% since 2002 in countries where the Global Fund invests.
Through leveraging economies of scale, working with partners and negotiating directly with manufacturers, the cost of an insecticide-treated mosquito net is now down to less than US$2 and the cost of antimalarial treatment dropped to US$0.58 in 2019. All together these savings enabled us to purchase more than 14 million extra nets and treat more than 24 million additional people for malaria.
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 2018 – a reduction from the US$3.2 billion invested in 2017, and well short of the US$5 billion estimated to be required globally to stay on track toward agreed
The malaria map is shrinking. Twenty-one countries have eliminated malaria over the last two decades and, of these, 10 countries were officially certified by WHO as malaria free. Countries of the Greater Mekong continue to make major gains, with a staggering 97% reduction in cases of P. falciparum malaria since 2000 – a great achievement given the ongoing threat from antimalarial drug resistance. The global goal to eliminate malaria from at least 35 countries by 2030 is within our reach. But as the malaria parasite evolves and drug resistance increases, we must develop more innovative tools and approaches.
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.
Global Fund partners work with communities in malaria-endemic areas to provide 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.
Published 14 December 2020