Countries Make Little to No Progress in Malaria Reduction, WHO

A new report released by the World Health Organization (WHO) has revealed there has been little to no progress in the plans geared towards the reduction of malaria cases.

The GTS 2020 milestones for morbidity and mortality which aimed at reducing malaria cases by 40 percent in 2020, 75 percent by 2025, and 90 percent by 2030 were not achieved globally.

There were an estimated 241 million malaria cases and 627 000 malaria deaths worldwide in 2020. This represents about 14 million more cases in 2020 compared to 2019, and 69 000 more deaths.

Approximately two-thirds of these additional deaths (47 000) were linked to disruptions in the provision of malaria prevention, diagnosis, and treatment during the pandemic.

However, things could have been far worse if not for the efforts of malaria-endemic countries to maintain services, the report said.

Even before the pandemic, global progress against malaria had leveled off, and countries with a high burden of the disease were losing ground.

Since 2015, the baseline of WHO’s global malaria strategy, 24 nations have registered increases in malaria mortality.

ALSO READ: Africa Needs Crucial Economic Reforms if they are to Recover Post-Covid

Now, critical 2020 milestones of WHO’s global malaria strategy have been missed, and without immediate and dramatic action, the 2030 targets will not be met.

Of the 93 countries that were malaria-endemic globally in 2015, 30 (32 percent) met the GTS morbidity milestone for 2020, having achieved a reduction of 40 percent or more in case incidence or having reported zero malaria cases.

Twenty-four countries (26 percent) had made progress in reducing malaria case incidence but did not achieve the GTS milestone.

Meanwhile, thirty-two countries (34 percent) had increased case incidence and 17 countries (18 percent) had an increase of 40 percent or more in malaria case incidence in 2020 compared with 2015.

In seven countries (7.5 percent), malaria case incidence in 2020 was similar to that of 2015. Forty countries (43 percent) that were malaria endemic in 2015 achieved the GTS mortality milestone for 2020, with 32 of them reporting zero malaria cases.

Fifteen countries (16 percent) achieved reductions in malaria mortality rates but of less than the 40 percent target.

Malaria mortality rates remained at the same level in 2020 as they were in 2015 in 14 countries (15 percent), whereas mortality rates increased in another 24 countries (26 percent), 12 of which had increases of 40 percent or more.

Across all transmission settings in east Africa, severe malaria was concentrated in children aged under 5 years, with the number of severe disease cases increasing with transmission intensity.

Severe anemia was the most common manifestation of severe malaria according to the report.

The WHO African Region continues to carry a disproportionately high share of the global malaria burden. In 2020 the Region was home to 95 percent of all malaria cases and 96 percent of deaths.

Children under 5 years of age accounted for about 80 percent of all malaria deaths in the Region.

Four African countries accounted for just over half of all malaria deaths worldwide: Nigeria (31.9 percent), the Democratic Republic of the Congo (13.2 percent), the United Republic of Tanzania (4.1 percent), and Mozambique (3.8 percent).

Malaria is responsible for an average annual reduction of 1.3 percent in Africa’s economic growth. Malaria-related absenteeism and productivity losses cost Nigeria, for example, an estimated US$ 1.1 billion every year.

In 2003, malaria cost Uganda an estimated gross domestic product equivalent to US$ 11 million. In Kenya, approximately 170 million working days and 11 percent of primary school days are lost to malaria each year.

In Kenya, this disease presents challenges to the health system at both the national and regional levels. Highly infectious, it is the leading cause of mortality in the country, resulting in thousands of deaths every year.

There are approximately 3.5 million new clinical cases and 10,700 deaths each year. The mosquito-borne disease acutely affects western Kenya, where malaria is the principal cause of sickness and death mainly due to climatic factors.

In response to the ongoing malaria crisis, the Kenyan government has been heavily relying on the use of the RTSS vaccine which has already been used in counties with a high prevalence of malaria to vaccinate at least 190,000 children under two years as of June 2021. This supplemented the process of issuing mass mosquito nets.

The focus of global funding and attention has been diverted, making preventable child deaths more likely. The WHO said Countries are paying very little attention to a disease that is still killing over 400,000 people every year, mainly children.

The situation now is especially precarious. Without accelerated action, the world is in danger of seeing an immediate resurgence of the disease, particularly in Africa.

ALSO READ: NSE Stocks Hit 7-Month Low Due to Omicron Strain

This is due to a convergence of threats – ranging from COVID-19 and Ebola outbreaks to flooding and other humanitarian emergencies – which have led to disruptions in malaria services in several high-burden African countries.

The emergence of antimalarial drug resistance in East Africa is also a considerable concern

The WHO Global technical strategy for malaria 2016–2030, updated in 2021, provides a technical framework for all malaria-endemic countries.

It is intended to guide and support regional and country programs as they work towards malaria control and elimination.

Guided by several strategies, the Global Malaria Program recommends the following to coordinate WHOs global efforts to control and eliminate malaria.

1. The setting, communicating, and promoting the adoption of evidence-based norms, standards, policies, technical strategies, and guidelines
2. Keeping independent score of global progress
3. Developing approaches for capacity building, systems strengthening, and surveillance
4. Identifying threats to malaria control and elimination as well as new areas for action.