Shortly after midday, the World Health Organisation launched their annual ‘World Malaria Report’. With 210 pages of facts, stats and colourful graphics, it’s a scientist’s dream. And as parasitologists across the globe update their manuscripts, let’s look at what this year’s report says.

If you’d like to read the report in full, you can download a PDF copy here.

Theme

The theme for this year’s ‘World Malaria Report’ is about getting the malaria response back on track. In the document’s Foreword, WHO Director-General Dr Tedros says that the global response to malaria ‘has stalled’ and that we are ‘off course’ to meet critical milestones set out in the WHO Global Technical Strategy for Malaria.

By Numbers

The number of malaria cases increased in 2017 by 3.5 million, with the total number of estimated cases standing at 219 million. This compares to an estimated 217 million cases in 2016 and 239 million in 2010.  92% of all malaria deaths in 2017 occurred in Africa. It is still true that every two minutes a child dies from the disease.

Investment

An estimated $3.1 billion was invested in malaria control and elimination efforts globally. Nearly three-quarters of this ($2.2 billion) was spent in Africa. Governments of endemic regions contributed 28% of the total funding in 2017, a figure unchanged from the year before. In terms of international sources of finance, the USA was the largest contributor, providing $1.2 billion. The United Kingdom, in contrast, contributed $300 million and the Bill & Melinda Gates Foundation provided $100 million.

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Despite funding levels remaining stable since 2010, the report says that this is not satisfactory. To reach the Global Technical Strategy targets by 2030, funding must increase to $6.6 billion per year by 2020.

Malaria Commodities

Insecticide-Treated Mosquito Nets (ITNs): The number of ITNs distributed between 2015 and 2017 stands at 624 million. This is significantly greater than the 465 million ITNs distributed between 2012-2014.

Rapid Diagnostic Tests (RTDs): The report estimates that 276 million RDTs were sold globally in 2017. In sub-Saharan Africa, RTDs are becoming the most used method of diagnosis.

Artemisinin-based Combination Therapy (ACT): 2.74 billion treatment courses of ACT were procured between 2010-2017. An estimated 30% of patients who received ACTs were not tested for malaria.

Prevention

The report suggests that half of the people at risk of malaria in Africa were sleeping under an ITN in 2017, this compares to 29% in 2010. However, coverage has been at a standstill since 2016.

Fewer people at risk of malaria are being protected by indoor residual spraying with protection declining from a peak of 5% in 2010 to 3% in 2017.

Surveillance

In 2017, 36 out of 46 countries in the WHO Africa Region indicated that at least 80% of public health facilities were reporting data on malaria.

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Elimination

In 2017, 46 countries reported fewer than 10,000 indigenous cases of malaria. 26 countries reported less than 100 cases. Paraguay was certified malaria-free in 2018, while Algeria, Argentina and Uzbekistan have made requests for certification.

Resistance

Drug: ACTs are remaining effective with overall efficacy rates greater than 95%.

Insecticide: Resistance to pyrethroids – the only insecticide class used in ITNs – is widespread. Resistance to organochlorines, carbamates and organophosphates remains significant. The report suggests greater resistance monitoring and management plans.

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