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WHO report: Progress on malaria slows, 2020 targets in danger
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Global progress against malaria has slowed in recent years, leaving officials unsure of whether countries will achieve goals for significant reductions in cases, according a WHO report.
After a near-steady decline, the estimated number of malaria cases across 91 countries increased from 211 million in 2015 to 216 million the following year, according to the WHO’s annual World Malaria Report.
“In recent years, we have made major gains in the fight against malaria,” WHO Director-General Tedros Adhanom Ghebreyesus, PhD, MSc, said in a news release. “We are now at a turning point. Without urgent action, we risk going backward and missing the global malaria targets for 2020 and beyond.”
Those targets include a reduction in malaria cases and mortality by 40% by the year 2020. The report indicates the world is not on track to achieve that goal.
Factors that may have contributed to the stalled progress range from inadequate funding to armed conflict, experts suggested at a Nov. 21 press conference outlining the report. There, two officials with WHO’s Global Malaria Programme — director Pedro Alonso, MD, PhD, and the team leader for surveillance, Abdisalan Noor — discussed the report’s findings.
The data show that the WHO African region accounted for about 81% of the world’s malaria cases and about 91% of deaths from the disease in 2016.
Of the 15 countries accounting for 82% of worldwide malaria fatalities that year, India is the only non-African country. Nigeria alone had 30% of malaria fatalities, followed by the Democratic Republic of the Congo, with 14%.
Two WHO regions had more countries with a sizable increase in malaria cases than those with a large decrease. In Africa, four countries had a decrease of more than 20% between 2015 and 2016, while eight countries had an increase of more than 20%. In the Americas, three countries saw a decrease of more than 20% in that period, and nine countries had an increase of more than 20%.
Alonso suggested that a lack of funding is contributing to the problem, among other reasons.
“It’s always difficult, in the fight against malaria, to point to any one reason for this,” he said. “We clearly identify the fact that funding has plateaued ... In many ways, it was somehow written on the wall that, in the face of plateaued levels of funding, and with the currently available tools, we would soon reach the limit of what we can achieve with those tools and that funding.”
Worldwide, about $2.7 billion was invested in malaria control in 2016, but WHO says that $6.5 billion is needed by 2020 to meet malaria strategy targets for 2030. Endemic countries contributed $800 million that year, or 31% of the total.
The United States contributed the most funding last year, with $1 billion, or 38% of total funding. However, Congress this year has suggested a huge slash in funding for the President’s Malaria Initiative (PMI), which has provided aid to African countries for more than a decade. In May, the legislature proposed a 44% budget reduction for the PMI for 2018.
According to a study published in PLoS Medicine, that would result in 67 million additional malaria cases and more than 290,000 deaths by 2020. If PMI funding is maintained, the researchers said, 162 million cases would be avoided and more than 692,00 lives saved in that period.
Noor noted that WHO in its report also focused on armed conflict and other calamities that can disrupt malaria control measures. They include the recent fighting between Nigerian authorities and Boko Haram in the north of that country, as well as the ongoing fighting in Yemen and South Sudan, and the social and economic upheaval in Venezuela.
“These conflict situations have led to severe interruptions in health services and have therefore resulted in increases in malaria,” Noor said. “Any conflict, however short, can lead to significant interruptions in health services and reverse gains fairly quickly.” – by Joe Green
References:
Winskill P, et al. PLoS Med. 2017;doi:10.1371/journal.pmed.1002448.
World Malaria Report. 2017. http://www.who.int/malaria/publications/world_malaria_report/en/. Accessed November 28, 2017.
Disclosures: Alonso and Noor report no relevant financial disclosures.