Progress on malaria deaths at risk without big boost in funding, UN warns

Real progress in driving down infections and deaths from malaria will be at risk if substantially more funding is not forthcoming, according to the latest annual report on the epidemic.

Last year, more than 400,000 people (pdf) – mostly small children and pregnant women – died from malaria. Insecticide-impregnated bed nets to sleep under and effective drug treatments have brought the number of deaths down by nearly 30% worldwide in the five years from 2010 to 2015; the number of new cases over the same period is down by more than 20%. But the report, published by the World Health Organisation, shows there are substantial gaps in the coverage.

Some countries such as Sri Lanka and Kyrgyzstan have eliminated malaria and the WHO says the target of elimination in ten countries by 2020 will be met. Last year at least ten countries had 150 cases or fewer and nine more had between 150 and 1,000.

But the task of reducing the toll of malaria in the heavily endemic countries of sub-Saharan Africa, which have 90% of cases and 92% of deaths, is hard and needs more resources, says the report.

“We are definitely seeing progress,” said Dr Pedro Alonso, director of the WHO Global Malaria Programme. “But the world is still struggling to achieve the high levels of programme coverage that are needed to beat this disease.”

On the positive side, more children are being tested to determine whether they have malaria, so that the treatment is effective, and more pregnant women are being given drugs to prevent them getting malaria.

But an estimated 43% of the population of sub-Saharan Africa was not protected by nets or indoor spraying to kill the mosquitoes that transmit the disease last year. A third of the children with fever in 23 African countries were not taken to a health facility where they could be tested and appropriately treated.

While funding went up steeply between 2000 and 2010, it has flatlined for the last five years. It is estimated that $ 6.4bn (£5bn) per year is needed to keep the global malaria elimination efforts on target in 2020, but in 2015 it was only $ 2.9bn, or 45%. A third of that is provided by the governments of countries where malaria is endemic. Last year the US contributed 35% of the total and the UK put in 16%. The report says that substantially more money is needed both from international donors and from the affected countries.

“If this flatlining remains, we will not be able to achieve the ambitious goals and targets the world agreed on a year ago,” said Alonso. In 2015, the World Health Assembly adopted a global technical strategy for malaria, with milestones every five years until 2030. It calls for a 40% reduction in malaria cases between 2015 and 2020. Only 40 of the 91 countries with endemic malaria are on track to achieve that.

Progress on malaria deaths at risk without big boost in funding, UN warns