World Malaria Day (25 April) 2020: “Zero malaria starts with me”

World Malaria Day is celebrated on 25 April each year. This year, the theme is “Zero malaria starts with me”.

Background Information:

Since 2000, global efforts to curb malaria have resulted in millions of cases and deaths averted – proof that progress is possible. Many countries with a low burden of the disease have moved quickly towards the goal of zero malaria.

In 2018, 27 countries reported fewer than 100 cases of malaria, up from 17 countries in 2010. Four countries –

  1. Algeria,
  2. Argentina,
  3. Paraguay and
  4. Uzbekistan –

were certified malaria-free by WHO over the last 2 years and, globally, 38 countries and territories have achieved this milestone.

Six countries of the Greater Mekong subregion –

  1. Cambodia,
  2. China (Yunnan Province),
  3. Lao People’s Democratic Republic,
  4. Myanmar,
  5. Thailand and
  6. Viet Nam –

reduced their malaria caseload by 76% in the period 2010 to 2018. Notably, there was a steep decline in cases of P. falciparum malaria, a primary target in view of the ongoing threat of antimalarial drug resistance.

Progress off track

Pregnant women and children continue to be hardest hit. An estimated 11 million pregnant women living in 38 African countries were infected with malaria in 2018; as a result, nearly 900 000 babies were born with a low birth weight – a major risk factor for infant mortality. Globally, children under the age of 5 accounted for about two-thirds of all malaria deaths in 2018.

wmd2020-child-2-1500pix

Key Messages:

Malaria by numbers: global and regional malaria burden

In 2018, there were an estimated 228 million cases of malaria in 89 countries. No significant gains were made in reducing malaria cases in the period 2014 to 2018. The estimated number of malaria deaths in 2018 stood at 405 000, a similar number to the previous year.

The WHO African Region accounted for 93% of malaria cases and 94% of deaths worldwide in 2018.

More than half of all cases were in 6 countries:

  • Nigeria (25% of cases);
  • Democratic Republic of the Congo (12%);
  • Uganda (5%); as well as
  • Côte d’Ivoire (4%),
  • Mozambique (4%) and
  • Niger (4%).

Global targets and funding

In view of recent data and trends, two critical targets of the WHO Global technical strategy for malaria 2016–2030 – reducing malaria

  • case incidence and
  • death rates

by at least 40% by 2020 – will be missed. As such, progress towards the malaria-specific target of the Sustainable Development Goals, which calls for ending malaria worldwide by 2030, is also off track.

In 2018, total funding for malaria control and elimination reached an estimated US$ 2.7 billion, falling far short of the US$ 5 billion funding target of the global strategy. Nearly 70% of malaria funding was provided by international sources. Governments of malaria-endemic countries contributed about 30% of total funding.

Gaps in access to core interventions

  • In 2018, only half (50%) of the population at risk of malaria in Africa slept under an insecticide-treated net, a similar figure to the previous year and a marginal improvement since 2015.
    wmd2020-nets-2-1500pix
  • About third (31%) of eligible pregnant women in Africa received the recommended 3 or more doses of preventive malaria therapy in 2018.
    wmd2020-pregnany-1500pix.tmb-479v
  • Over the period 2015 to 2018, a high proportion (36%) of children in sub-Saharan Africa showing signs of a fever did not receive any medical attention.
    wmd2020-treatment-1500pix

“High burden to high impact”

As a response to recent data and trends, WHO and the RBM Partnership to End Malaria have catalyzed “High burden to high impact”,  a new approach to intensify support for countries that carry a high burden of malaria, particularly in Africa. The approach is founded on 4 pillars:

  1. Political will to reduce malaria deaths
  2. Strategic information to drive impact
  3. Better guidance, policies and strategies
  4. A coordinated national malaria response

Pillar 1 calls on leaders of malaria-affected countries to translate their stated political commitments into resources and tangible actions that will save more lives. To this end, campaigns that engage communities and country leaders – like “Zero malaria starts with me” – can foster an environment of accountability and action.

“Zero malaria starts with me”

The “Zero malaria starts with me” campaign – first launched in Senegal in 2014 – was officially endorsed at the African Union Summit by all African Heads of State in July 2018.

Signs of hope

While progress in the global response to malaria has levelled off, a subset of countries with a low burden of malaria is moving quickly towards elimination.  In 2018:

  • 49 countries reported fewer than 10 000 indigenous malaria cases, up from 40 countries in 2010
  • 27 countries reported fewer than 100 malaria cases, up from 17 countries in 2010.

Countries that achieve at least 3 consecutive years of zero indigenous cases can apply for an official WHO certification of malaria elimination. In 2019, 2 countries were certified malaria-free: Algeria and Argentina. Globally, a total of 38 countries and territories have achieved this milestone.

Some countries with a high burden of malaria are also making strong strides in reducing their burden of the disease.

  • India, a country that carries 3% of the global malaria burden, registered 2.6 million fewer cases in 2018 over the previous year.
  • Uganda, which carries 5% of the burden, reported 1.5 million fewer cases in 2018 compared to 2017.

Prospects for new interventions

Boosting investments in the development and deployment of a new generation of malaria tools is key to achieving the 2030 global malaria targets. Future progress in the fight against malaria will likely be shaped by technological advances and innovations in new tools, such as new diagnostics and more effective antimalarial medicines.

Vector control

A number of new tools and technologies for malaria vector control have been submitted to WHO for evaluation. Tools currently under evaluation include, for example,

  • new types of insecticide-treated nets,
  • spatial mosquito repellents,
  • vector traps,
  • gene-drive approaches and
  • sugar baits designed to attract and kill Anopheles mosquitoes.

wmd2020-irs-1500pix

Malaria vaccine

In 2019, 3 countries – Ghana, Kenya and Malawi – introduced the RTS,S malaria vaccine in selected areas through a WHO-coordinated pilot programme. The vaccine has been shown through rigorous clinical trials to reduce four in 10 malaria cases in young children. Evidence and experience from the programme will inform future policy decisions on the vaccine’s potential wider deployment.

Useful Links:

Link to World Malaria Day 2020 web site:

https://www.who.int/news-room/campaigns/world-malaria-day/world-malaria-day-2020

Link to WHO guidance on treating endemic malaria and pandemic COVID-19:

https://www.who.int/malaria/areas/epidemics_emergencies/covid-19/en/

Link to WHO fact sheet on malaria (updated 14 January 2020):

https://www.who.int/en/news-room/fact-sheets/detail/malaria

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