‘World Malaria Day’ is marked annually on 25 April to focus global attention on malaria and its devastating impact on families, communities and societal development, especially in the Sub-Saharan Africa region.
This year, the day was marked with the theme: “Harness innovation to reduce the malaria disease burden and save lives.”
WHO Regional Director for Africa, Dr. Matshidiso Moeti stated in her massages during the day that this theme aligns with her call to urgently scale up innovation and the deployment of new tools in the fight against malaria, while advocating for equitable access to malaria prevention and treatment, within the context of building health system resilience.
The past year has seen significant breakthroughs in malaria prevention and control, in spite of the COVID-19 pandemic. Landmark recommendations on the use of the first vaccine against malaria – RTS,S – were released by the World Health Organization late last year.
This vaccine will be used to prevent malaria among children aged six months to five years, who live in moderate- to high-transmission settings. While this is a groundbreaking advance in the development of new tools to fight this disease, with the potential to save millions of lives, supplies are currently limited.
As such, it is important to ensure that the doses that are available are utilized for maximum impact, while ensuring continued availability of other preventive measures to those most at risk. Malaria remains a significant public health and development challenge.
In the last year, about 95 percent of the estimated 228 million cases occurred in the WHO/AFRO Region1, along with 602 020 reported deaths. Out of six of our countries the 2 are the worst impacted by malaria in the Region, are reported to have accounted for up to 55 percent of cases globally, and for 50 per cent of these deaths.
Despite some slowing of progress to reduce malaria cases and deaths, and the disruptions to health services caused by COVID-19, we are still much further ahead than we were in 2000. We need to reignite that momentum, and build on the recent advances.
For example, seasonal malaria chemoprevention (SMC) campaigns were implemented as planned in 2021, ensuring protection for an additional 11.8 million children. Indoor residual spraying was also carried out, and long-lasting insecticidal nets distributed, largely as planned.
Other notable achievements include the scaled implementation of RTS,S vaccine pilots in Ghana, Kenya and Malawi, which reached up to 900 000 children. The ultimate goal is to reduce the number of people catching and dying from malaria.
This requires a focus on research and on leveraging available evidence to ensure that our targeted interventions are an efficient use of resources, which produce measurable results. We also need to work on drug and insecticide resistance, as well as focus on new strains of malaria arising in the Region, which are more difficult to detect, and treat.
Malaria is, however, about much than medical and technological interventions. Malaria affects households and communities, and these communities need to be empowered to play an active role in the fight against this disease.
As WHO in Africa, we recognize that a whole-of-society approach requires us to listen to, and learn from, those who are worst impacted. World Malaria Day today is an occasion to renew political commitment and encourage continued investment in malaria prevention and control.
“I call on countries and communities affected by malaria to work closely with development partners to advance our countries along the road to elimination, while contributing to the achievement of other Sustainable Development Goals. I personally, and the WHO Regional Office in Africa, remain fully committed to the fight against malaria. I believe we can overcome the challenge if we collaborate closely with governments, partners and communities.”
Together, we can accelerate our efforts to achieve a malaria-free Africa, the regional director’s office sated in its press release sent to The Ethiopian Herald with regard to the malaria day.
According to the latest World malaria report, there were 241 million cases of malaria in 2020 compared to 227 million cases in 2019. The estimated number of malaria deaths stood at 627 000 in 2020 – an increase of 69 000 deaths over the previous year. While about two thirds of these deaths (47 000) were due to disruptions during the COVID-19 pandemic, the remaining one third of deaths (22 000) reflect a recent change in WHO’s methodology for calculating malaria mortality (irrespective of COVID-19 disruptions).
The new cause-of-death methodology was applied to 32 countries in sub-Saharan Africa that shoulder about 93 per cent of all malaria deaths globally. Applying the methodology revealed that malaria has taken a considerably higher toll on African children every year since 2000 than previously thought.
The WHO African Region continues to carry a disproportionately high share of the global malaria burden. In 2020 the Region was home to 95 per cent of all malaria cases and 96 per cent of deaths. Children under 5 years of age accounted for about 80 per cent of all malaria deaths in the Region.
Four African countries accounted for just over half of all malaria deaths worldwide: Nigeria (31.9 per cent), the Democratic Republic of the Congo (13.2 percent), United Republic of Tanzania (4.1 per cent) and Mozambique (3.8 per cent).
Over the last 2 decades, expanded access to WHO-recommended malaria prevention tools and strategies – including effective vector control and the use of preventive antimalarial drugs – has had a major impact in reducing the global burden of this disease.
Early diagnosis and treatment of malaria reduces disease, prevents deaths and contributes to reducing transmission. WHO recommends that all suspected cases of malaria be confirmed using parasite-based diagnostic testing (through either microscopy or a rapid diagnostic test). Diagnostic testing enables health providers to swiftly distinguish between malarial and non-malarial fevers, facilitating appropriate treatment.
The best available treatment, particularly for P. falciparum malaria, is artemisinin-based combination therapy (ACT). The primary objective of treatment is to ensure the rapid and full elimination of Plasmodium parasites to prevent an uncomplicated case of malaria from progressing to severe disease or death.
Over the last decade, antimalarial drug resistance has emerged as a threat to global malaria control efforts in the Greater Mekong sub region. WHO is also concerned about more recent reports of drug-resistant malaria in Africa. Regular monitoring of drug efficacy is needed to inform treatment policies in malaria-endemic countries, and to ensure early detection of, and response to, drug resistance.
For more on WHO’s work on antimalarial drug resistance in the Greater Mekong sub region, visit the Mekong Malaria Elimination Programmed webpage. WHO is also developing a strategy to address drug resistance in Africa.
Malaria elimination is defined as the interruption of local transmission of a specified malaria parasite species in a defined geographical area as a result of deliberate activities. Continued measures to prevent re-establishment of transmission are required.
In 2020, 26 countries reported fewer than 100 indigenous cases of the disease, up from 6 countries in 2000. Countries that have achieved at least 3 consecutive years of zero indigenous cases of malaria are eligible to apply for the WHO certification of malaria elimination.
Since 2015, 9 countries have been certified by the WHO Director-General as malaria-free, including Maldives (2015), Sri Lanka (2016), Kyrgyzstan (2016), Paraguay (2018), Uzbekistan (2018), Argentina (2019), Algeria (2019), China (2021) and El Salvador (2021).
BY HAFTU GEBREZGABIHER
THE ETHIOPIAN HERALD FRIDAY 6 MAY 2022
