18 December 2012

Malaria Fight Losing Momentum, Warns WHO

The leveling of funding for malaria prevention and treatment since 2010 has led to a slowing of promising progress against the deadly impact of the disease finds a new WHO report. The World Malaria Report 2012 finds that 1.1 million lives were saved over the past decade thanks to broad efforts to stem the impact of malaria. More than half of the averted deaths, 58% to be precise, took place in the 10 countries with the greatest malaria burden. However, slowing funding, warns the report, could threaten much of the decade's building momentum.

The WHO estimated that $ 5.1 billion is needed every year until 2020 in order to achieve universal access to malaria interventions. Present funding comes in at only $ 2.3 billion per year, less than half of the estimated need. "There is an urgent need to identify new funding sources in order to further scale up and sustain malaria control efforts, and to protect the investments made in the last decade," says WHO Director-General Helen Chan in her introduction of the report. "We also need to examine new ways to make existing funds stretch further by increasing the value for money of malaria commodities and the efficiency of service delivery."

In 2010, 219 million people were infected by malaria. Of that number, 660,000 died. The greatest burden of malaria deaths falls on children in Africa. However, the good news is that deaths caused by malaria are preventable. Long-lasting insecticidal nets (LLINs) provide protection when people are sleeping and malaria-carrying mosquitoes are active and indoor residual spraying helps to keep more mosquitoes out of households. The development of artemisinin-based combination therapy (ACT) has helped to bring about effective treatment for people who contract malaria, but there are growing concerns regarding the emergence of ACT resistance in southeast Asia.

Further, the report finds that the distribution of LLINs and indoor residual spraying are declining since 2010. 66 million LLINs were distributed this year, less than half of the 145 million that were distributed in 2010. Fourteen countries account for 80% of all malaria deaths including the DR Congo, Nigeria and India. The report recommends pouring greater resources into the higher burden countries in order to maxamize results.

“Global targets for reducing the malaria burden will not be reached unless progress is accelerated in the highest burden countries,” says Dr Robert Newman, Director of the WHO Global Malaria Programme in Geneva in the press release. “These countries are in a precarious situation and most of them need urgent financial assistance to procure and distribute life-saving commodities.”

Another challenge is the ability to accurately track and report on cases of malaria. The report says that inaccurate data in 41 countries means that it is impossible to make accurate estimates regarding progress in preventing and treating malaria. "A principal reason for low rates of case detection in countries with the highest numbers of cases is the use of private health facilities by a large proportion of patients, these facilities are usually not covered by a ministry of health surveillance system," explain the authors. "This pattern of care-seeking presents challenges not only for establishing surveillance systems but also for ensuring universal access to diagnostic testing and appropriate treatment."

The report recommends supporting better surveillance in order to better track the national changes and ensure that the funding towards malaria efforts in the countries with the highest case and mortality burden are successful. Overall, the report seeks to prevent the progress made leading up to 2010 is not lost. “During the past eight years, scaled-up malaria control helped us avert over a million deaths. We must maintain this momentum and do our utmost to prevent resurgences,” says Ellen Johnson Sirleaf, President of Liberia and Chair of the African Leaders Malaria Alliance, who held an official launch event for the report in Monrovia, Liberia.

Read the full report here.

I originally wrote this for the PSI Impact Blog.