A newly-released United Nations health agency report reveals that the number of people dying from malaria globally has fallen dramatically with more and more countries moving towards its elimination, but the findings also note that gains made were at particular risk in Ebola-affected countries.
“We can win the fight against malaria,” said Dr. Margaret Chan, Director-General of the UN World Health Organization, in a press release on the launch of the World Malaria report 2014. “We have the right tools and our defences are working. But we still need to get those tools to a lot more people if we are to make these gains sustainable.”
According to the report, launched in Geneva and London, analysis across sub-Saharan Africa reveals that despite a 43 per cent population increase, fewer people are infected or carry asymptomatic malaria infections every year: the number of people infected fell from 173 million in 2000 to 128 million in 2013.
The report said between 2000 and 2013, access to insecticide-treated bed nets increased substantially. In 2013, almost half of all people at risk of malaria in sub-Saharan Africa had access to such protection, a marked increase from just 3 per cent in 2004.
“And this trend is set to continue, with a record 214 million bed nets scheduled for delivery to endemic countries in Africa by year-end,” WHO said.
Access to accurate malaria diagnostic testing and effective treatment of the life-threatening disease caused by parasites that are transmitted to people through the bites of infected mosquitoes has also significantly improved worldwide, it said.
But the report also noted the Ebola outbreak in the West African countries most affected by the disease has had a devastating impact on malaria treatment and the roll-out of malaria interventions. “In Guinea, Sierra Leone and Liberia…the majority of inpatient health facilities remain closed, while attendance at outpatient facilities is down to a small fraction of rates seen prior to the outbreak.”
Given the intense malaria transmission in the worst-affected countries, which saw an estimated 6.6 million malaria cases and 20,000 malaria deaths in 2013, WHO said it has issued new guidance on temporary measures to control the disease during the Ebola outbreak including administering anti-malarial drugs even when patients have not been tested for malaria.
But globally, an increasing number of countries are moving towards malaria elimination, the report said.
Many regional groups are setting ambitious elimination targets, the most recent being a declaration at the East Asia Summit to eliminate malaria from the Asia-Pacific region by 2030.
In 2013, two countries reported zero indigenous cases for the first time (Azerbaijan and Sri Lanka), and 11 countries succeeded in maintaining zero cases (Argentina, Armenia, Egypt, Georgia, Iraq, Kyrgyzstan, Morocco, Oman, Paraguay, Uzbekistan and Turkmenistan). Another four countries reported fewer than 10 local cases annually (Algeria, Cabo Verde, Costa Rica and El Salvador).
But the report also noted significant challenges and singled out sub-Saharan Africa where one third of households in areas with malaria transmission did not have a single insecticide treated net.
Even though diagnostic testing and treatment have been strengthened, millions of people continue to lack access to these interventions. Progress has also been slow in scaling up preventive therapies for pregnant women, and in adopting recommended preventive therapies for children under five years of age and infants.
While funding to combat malaria has increased threefold since 2005, it is still only around half of the $5.1 billion that is needed if global targets are to be achieved.
Ray Chambers, who has served as the UN Secretary-General's Special Envoy for Malaria since 2007, highlights the remarkable progress made in recent years.
“While staying focused on the work ahead, we should note that the number of children dying from malaria today is markedly less than 8 years ago. The world can expect even greater reductions in malaria cases and mortality by the end of 2015, but any death from malaria remains simply unacceptable,” he was quoted as saying.
Based on an assessment of trends in reported malaria cases, WHO said 64 countries are on track to meet the Millennium Development Goal target of reversing the incidence of malaria.
Some 3.2 billion people in 97 countries and territories are at risk of being infected with malaria, according to WHO. In 2013, there were an estimated 198 million malaria cases worldwide, 82% of which were in the African region. Malaria was responsible for an estimated 584,000 deaths worldwide in 2013, killing an estimated 453,000 children under five years of age.