Progress in malaria and future challenges

Global efforts to control and eliminate malaria have saved an estimated 3.3 million lives since 2000, reducing malaria mortality rates by 45% globally, according to the World Malaria Report 2013 published recently by the World Health Organisation (WHO).
An expansion of prevention and control measures has been mirrored by a consistent decline in malaria deaths and illness, despite an increase in the global population at risk of malaria between 2000 and 2012. Increased political commitment and expanded funding have helped to reduce incidence of malaria by 29% globally, and by 31% in Africa. But there is still a huge scope for further progress and more needs to be done.
Malaria prevention suffered a setback after its strong build-up between 2005 and 2010. The new WHO report notes a slowdown in the expansion of interventions to control mosquitoes for the second successive year, particularly in providing access to insecticide-treated bed nets. This has been primarily due to lack of funds to procure bed nets in countries that have ongoing malaria transmission.
Only 70 million new bed nets were delivered to malaria-endemic countries in 2012, below the 150 million minimum needed every year to ensure everyone at risk is protected. However, in 2013, about 136 million nets were delivered, and the pipeline for 2014 looks even stronger (approximately 200 million), suggesting that there is real chance for a turnaround.
There was no such setback for malaria diagnostic testing, which has continued to expand in recent years. Between 2010 and 2012, the proportion of people with suspected malaria who received a diagnostic test in the public sector increased from 44% to 64% globally.
Access to WHO-recommended artemisinin-based combination therapies (ACTs) has also increased, with the number of treatment courses delivered to countries rising from 76 million in 2006 to 331 million in 2012.
Despite this progress, millions of people continue to lack access to diagnosis and quality-assured treatment, particularly in countries with weak health systems. The roll-out of preventive therapies — recommended for infants, children under 5 and pregnant women — has also been slow in recent years. In order to win this fight, sustainable and increased the International funding for malaria control is crucial.
Without adequate and predictable funding, the progress against malaria is also threatened by emerging parasite resistance to artemisinin, the core component of ACTs, and mosquito resistance to insecticides. Artemisinin resistance has been detected in 4 countries in south-east Asia, and insecticide resistance has been found in at least 64 countries. Although international funding has increased from less than US$ 100 million in 2000 to almost US$ 2 billion in 2012, it is less than half the US$ 5.1 billion needed each year to achieve universal access to interventions.
Dying from mosquito bites is one of the greatest tragedies of the 21st century. To win the fight against malaria we need to ensure everyone has the access to diagnosis, treatment and prevention tools.

Source: World Health Organisation