Key messages: World Malaria Report 2009
- Funding commitments for malaria control increased from US$ 0.3 billion in 2003 to US$ 1.7 billion in 2009.
- Still short of the US$ 5 billion required annually.
- 80% of external funds go to the WHO African Region.
- The South-East Asia Region saw the least money per person at risk for malaria and the smallest increase between 2000 and 2007.
- High levels of external assistance are associated with increased procurement of commodities and decreases in malaria incidence.
- Funds are disproportionately concentrated on smaller countries with lower disease burdens
Program coverage: prevention
- More African households own an ITN: 31% in 2008 compared to 17% in 2006.
– Household ITN ownership reached more than 50% in 13 high burden African countries but the regional average is low because resources for scale-up in several large African are only now being made available.
- More children under 5 years of age use an ITN (24% in 2008)
– The percentage of children using a net is still below the WHA target of 80%.
- The number of people protected by indoor residual spraying in Africa increased from less than 10 million in 2001 to 59 million in 2008.
Program coverage: case management
- Procurement of anti-malarial medicines increased sharply from 2005 to 2008 and use of ACTs increases but remains very low in most African countries.
– Fewer than 15% of children under 5 years of age with fever received an ACT in 11 of 13 countries surveyed 2007–2008, well below the WHA target of 80%.
- In 18 high-burden WHO African Region countries for which data were available, only 22% of the reported suspected malaria cases were confirmed with a parasite-based test in 2008.
- Confirmation of resistance to artemisinins was reported in 2009.
– Despite WHO’s call for a halt to their use, 37 countries still allow use of oral artemisinin-based monotherapies; most are located in the African Region.
- In nine household surveys in 2007–2008, 20% of pregnant women received a second dose of ITPp.
– This is still well below the target of 80%
- More than a third of the 108 malarious countries (9 African countries and 29 outside of Africa) saw reductions in malaria cases of >50% in 2008 compared to 2000.
– The number of cases fell least in countries with the highest incidence rates.
- With high coverage of both bed net and treatment programs 4 high burden African countries recorded decreases in malaria cases and deaths of >50%.
– MDG targets for malaria can be achieved if there is adequate coverage of key interventions.
- Large decreases in malaria cases and deaths are mirrored by steep declines in all-cause deaths among children less than 5 years of age.
– Malaria control can help many African countries reach MDG targets of a two-thirds reduction in child mortality by 2015.
- Ten countries are implementing nationwide elimination programs of which six entered the elimination phase in 2009.