A year after the World Health Assembly resolved to eliminate malaria from at least 35 countries by 2030, a new World Health Organization (WHO) report released today – on World Malaria Day – shows that the goal, although ambitious, is achievable.
In a press release, WHO said that in 2015, all countries in the WHO European region reported, for the first time, zero indigenous cases of malaria, down from 90,000 cases in 1995.
“Our report shines a spotlight on countries that are well on their way to eliminating malaria,” said Pedro Alonso, Director of the WHO Global Malaria Programme. “WHO commends these countries while also highlighting the urgent need for greater investment in settings with high rates of malaria transmission, particularly in Africa. Saving lives must be our first priority.”
Outside the WHO European region, eight countries reported zero cases of the disease in 2014: Argentina, Costa Rica, Iraq, Morocco, Oman, Paraguay, Sri Lanka and United Arab Emirates.
Another eight countries each tallied fewer than 100 indigenous malaria cases in 2014, and a further 12 countries reported between 100 and 1,000 indigenous malaria cases in 2014, according to the agency.
The Global Technical Strategy for Malaria 2016-2030, approved by the World Health Assembly in May 2015, calls for the elimination of local transmission of malaria in at least 10 countries by 2020.
WHO estimates that 21 countries are in a position to achieve this goal, including 6 countries in the African region, where the burden of the disease is heaviest.
Countries moving towards elimination of malaria
Since the year 2000, malaria mortality rates have declined by 60 per cent globally. In the WHO African region, malaria mortality rates fell by 66 per cent among all age groups and by 71 per cent among children under 5 years old.
The advances came through the use of core malaria control tools that have been widely deployed over the past decade, including insecticide-treated bed nets, indoor residual spraying, rapid diagnostic testing and artemisinin-based combination therapies.
But reaching the next level – elimination – will not be easy, WHO noted. Nearly half of the world’s population, 3.2 billion people, remain at risk of malaria. In 2015 alone, 214 million new cases of the disease were reported in 95 countries and more than 400,000 people died of malaria.
WHO emphasized that the efficacy of the tools that secured the gains against malaria in the early years of this century is now threatened. Mosquito resistance to insecticides used in nets and indoor residual spraying is growing, as is parasite resistance to a component of one of the most powerful antimalarial medicines.
Further progress against malaria will likely require new tools that do not exist today, and the further refining of new technologies, the agency said.
WHO noted that in 2015, for the first time, the European Medicines Agency issued a positive scientific opinion on a malaria vaccine. In January 2016, WHO recommended large-scale pilot projects of the vaccine in several African countries, which could pave the way for wider deployment in the years ahead.
Need for strong political commitment and funding
“New technologies must go hand in hand with strong political and financial commitment,” said Mr. Alonso.
WHO stressed that governments must strengthen surveillance of cases to identify gaps in coverage and be prepared to take action based on the information received. As countries approach elimination, the ability to detect every infection becomes increasingly important.
Reaching the goals of the “Global Technical Strategy” will require a steep increase in global and domestic funding – from $2.5 billion today to an estimated $8.7 billion annually by 2030, the agency said.
WHO added that through “robust financing and political will,” affected countries can speed progress towards malaria elimination and contribute to the broader development agenda as laid out in the 2030 Agenda for Sustainable Development.
In his message on the Day, UN Secretary-General Ban Ki-moon said malaria is a formidable opponent, so there is no guarantee that progress will continue. “If we lower our guard, experience shows that the disease may come back. Mosquitoes develop resistance to insecticides and malaria parasites can become resistant to medicines.”
He commended the World Health Assembly for setting ambitious goals for 2030: reducing malaria cases and mortality by at least 90 per cent; and eliminating malaria in at least 35 countries.
“Reaching these goals will require significantly greater investment in fighting malaria. But it will take more than money. It will take political will and leadership,” said Mr. Ban, stressing that as the world celebrated progress against this “ancient killer,” everyone involved must redouble their efforts to reach the 2030 malaria goals.