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At an event on the eve of World Malaria Day in Nairobi, the World Health Organization (WHO) called today for accelerated scale-up of efforts to prevent malaria and save lives. In sub-Saharan Africa, which shoulders 90 percent of the global malaria burden, more than 663 million cases have been averted since 2001. Insecticide-treated nets have had the greatest impact, accounting for an estimated 69 percent of cases prevented through control tools.
Together with diagnosis and treatment, WHO recommends a package of proven prevention approaches, including insecticide treated nets, spraying indoor walls with insecticides, and preventive medicines for the most vulnerable groups: pregnant women, under-5s and infants.
"WHO-recommended tools have made a measurable difference in the global malaria fight," said Dr. Margaret Chan, director-general of WHO. "But we need a much bigger push for prevention – especially in Africa, which bears the greatest burden of malaria."
WHO's latest report spotlights critical gaps in prevention coverage, particularly in sub-Saharan Africa. An estimated 43 percent of people at risk of malaria in the region were not protected by either a net or indoor insecticide spraying in 2015. Approximately 69 percent of pregnant women in 20 African countries did not have access to the recommended three or more doses of preventive treatment.
Some targeted prevention approaches have been adopted by countries as policy, but the actual uptake has been slow. Preventive treatment for infants, for example, which is safe, cost-effective and well accepted by health workers and communities, is currently only being implemented in Sierra Leone.
Across the Sahel, where most malaria cases and deaths among children occur in the rainy season, WHO recommends seasonal malaria chemoprevention (SMC), a preventive therapy shown to reduce new cases of severe malaria in young children by approximately 75 percent. As of 2015, 10 countries -- Burkina Faso, Chad, Gambia, Guinea, Guinea Bissau, Mali, Niger, Nigeria, Senegal and Togo -- had adopted WHO’s SMC policy and begun implementing it.
According to the World Malaria Report 2016, the rate of new malaria cases fell by 21 percent globally between 2010 and 2015. Malaria death rates fell by 29 percent in the same five-year period. In sub-Saharan Africa, case incidence and death rates fell by 21 percent and 31 percent, respectively.
Other regions have made substantial gains in their malaria responses, but the disease remains a major public health threat. In 2015, the global tally of malaria reached 429 000 malaria deaths and 212 million new cases. One child died from malaria every 2 minutes.
"Any death from malaria – a preventable and treatable disease – is simply unacceptable," said Dr. Pedro Alonso, director of WHO’s Global Malaria Program. "Today we are urging countries and partners to accelerate the pace of action, especially in low-income countries with a high malaria burden."
Ninety-one countries reported ongoing malaria transmission in 2015; all are working to reduce their malaria burden through the deployment and use of WHO-recommended preventive, diagnostic and treatment tools.
In May 2015, the World Health Assembly approved WHO’s Global Technical Strategy for Malaria 2016–2030, a 15-year blueprint for all countries working to control and eliminate malaria. The strategy set ambitious targets for 2030, including reducing malaria case incidence and death rates by at least 90 percent, eliminating malaria in at least 35 countries, and preventing the reintroduction of malaria in all countries that are malaria free.
Interim 2020 targets call for 40 percent reductions in malaria case incidence and death rates and for the elimination of malaria in at least 10 countries. Less than half of the world’s 91 countries with malaria transmission are on track to achieve these interim targets for case incidence and mortality reductions.
However, prospects for achieving the 2020 elimination target are bright: WHO’s “Eliminating Malaria” report, published in 2016, identified 21 countries with the potential to achieve at least one year of zero indigenous cases of malaria by 2020.
In recent years, 7 countries have been certified by the WHO director-general as having eliminated malaria: United Arab Emirates (2007), Morocco (2010), Turkmenistan (2010), Armenia (2011), Maldives (2015), Sri Lanka (2016) and Kyrgyzstan (2016). This certification is granted by WHO when countries achieve at least 3 consecutive years of zero locally-acquired cases of malaria.
In 2015, the WHO European Region achieved interruption of indigenous malaria transmission and was declared malaria-free the following year. The region has maintained this status since and countries at risk of malaria reintroduction are strengthening their efforts to protect their populations from the risk of re-exposure to malaria.
Future progress in the fight to prevent malaria will likely be shaped by technological advances and innovations in new tools, including new vector control interventions, and possibly a vaccine.
The WHO African Region will announce today the three countries that will take part in a WHO-coordinated malaria vaccine pilot program in selected areas, beginning in 2018. The injectable vaccine, known as “RTS,S,” was developed to protect young children in Africa. It will be assessed in the pilots as a complementary malaria control tool that could potentially be added to the core package of WHO-recommended measures for malaria prevention, diagnosis, and treatment.
World Malaria Day falls within World Immunization Week, April 24-30, which celebrates the widespread use of vaccines that protect people against 26 diseases. Overall, vaccines prevent an estimated 2 million to 3 million deaths each year.