Malaria

Key messages: World Malaria Report 2009

Financing

  • 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%

Impact

  • 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.
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