25 September 2015
In 2000, the Millennium Development Goals pledged to halt and to begin to reverse the incidence of malaria by 2015. By September 2015, according to new research by the United Nations Children’s Fund (Unicef) and the World Health Organization (WHO), the rate of new infections had declined by some 37% and deaths by 60%, saving 6.2 million lives in Asia and Africa. But there is still much work to be done before the disease is eradicated.
This new report and its encouraging statistics hold particular resonance for South African health care, with health being one of the pillars of the National Development Plan Vision 2030.
Malaria cases in South Africa, according to the National Institute for Communicable Diseases in December 2014, have dropped from 11071 in 2010/11 to just 9245 in 2013/14.
Africa, however, remains one of the most prevalent regions for malaria infection, yet much work is being done by not only the UN and the WHO, but also through solid investments by African governments and NGOs.
And the good news is that all the hard work is paying off. Malaria deaths worldwide have fallen by 60% since 2000, the UN reported last week, with improved diagnostic tests and the massive distribution of mosquito nets aiding dramatic progress against the disease.
Just 15 years ago, an estimated 262 million malaria infections killed nearly 840 000 people. Today, a significant dent has been made in that number.
— UNICEF (@UNICEF) September 17, 2015
Projections for 2015 indicate that some 214&nsp;million cases are likely to cause 438 000 deaths, according to the joint report from WHO and Unicef. “Global malaria control is one of the great public health success stories of this century,” said WHO director-general Margaret Chan in presenting the report at the UK’s Houses of Parliament in London on 17 September.
Had malaria infection and death rates remained unchanged since 2000, another 6.2 million people would have died, according to the report.
Chan raised hopes that the disease could one day be eradicated with more investment in vaccines and medicines, saying that “malaria has been tamed, but by no means defeated. You either surge ahead or you sink.” She noted that children under five still made up the overwhelming majority of malaria victims.
Most of the gains were recorded in Asia and South America; in Africa the picture was less encouraging. Sub-Saharan nations accounted for nearly 80% of global malaria deaths this year and efforts to curb infection rates in the region lagged substantially behind other parts of the world.
Chan warned that because of uneven progress, more attention and resources had to be paid to the hardest-hit nations. “Eliminating malaria on a global scale is possible – but only if we overcome these barriers and accelerate progress,” a statement accompanying the report said.
Highlighting the steps that helped to curb infection rates, the report said that about one billion insecticide-treated nets had been distributed in Africa since 2000. At the start of the millennium, less than 2% of children under five were sleeping under the specialised nets. That figure had risen to 68% over the last 15 years.
With mosquitoes largely circulating at night, the report indicated that this mass distribution of nets in high malaria areas had helped significantly to bring down infections, especially among children.
— UNICEF (@UNICEF) April 24, 2015
Nets had also got better, the report said, citing new technology developed since 2000 that eliminated the need for insecticide to be re-applied every few years.
Great Britain has been a leading proponent of bed nets and Justine Greening, its minister for international development, promised that the country would continue to invest in programmes in Africa “to end malaria once and for all”.
Greening also called on the governments of the countries worst affected by the disease to boost their own efforts. “We want to see countries stand on their own two feet.”
One of the more prevalent hindrances to treating the disease in Africa had been a tendency among patients and medical workers to treat all fever-like symptoms as malaria, which had hurt the supply of treatment available to those who actually had the disease.
But the introduction of new testing kits that gave fast and accurate results had helped medical workers in the developing world distinguish between malarial and non-malarial fevers more quickly, “enabling more timely and appropriate treatment”, the report said.
Increased urbanisation worldwide had also helped as people living in cities were often closer to health services.
Funding for malaria had increased 20-fold since 2000, said Unicef and WHO. It included a significant contribution from the Bill and Melinda Gates Foundation, which invested over $2-billion (R27.3-billion today) in prevention and research, plus another $2-billion in the Global Fund to Fight Aids, Tuberculosis and Malaria, which provides about 50% of international funding for malaria control worldwide. But the report noted that more resources were needed to step up the fight against the disease and advocate for sustained and increased funding of malaria-related efforts by donor governments and endemic countries.
The two UN agencies set a target to reduce infections by another 90% by 2030.
“We know how to prevent and treat malaria,” Unicef executive director Tony Lake said at the London presentation. “Since we can do it, we must.”
Also attending the presentation was former Namibian health minister and malaria campaigner Richard Kamwi, who warned that the “biggest mistake we can make is to pat ourselves on the back. We have not won the war.”