World Malaria Day looks at the success and the key challenges in the fight against malaria.
The Roll Back Malaria Partnership strives for near zero deaths from malaria by 2015.
"We have shown that current malaria control efforts work, " said Dr. Robert Newman" We know exactly what we need to do. The key is to maintain the financial and political commitments to fighting malaria over the next 5 years so that we can reach these ambitious RBM targets and the health-related Millennium Development Goals.
According to the WHO World Malaria Report 2010, In the last five years 11 countries in Africa have slashed their malaria cases and deaths by more than 50% and malaria has moved from the first cause of death among children under five in 2000 in sub-Saharan Africa to third cause of death in 2010.
Despite this progress, WHO reports that over 780,000 people died of malaria in 2009, most of them children under the age of five. The disease perpetuates a vicious cycle of poverty in the developing world and malaria-related illnesses and mortality cost Africa’s economy alone approximately USD 12 billion per year.
Some of the key challenges in the fight against malaria include:
- treating children with severe malaria – This week WHO updated the guidelines for the treatment of severe malaria. WHO now recommends parenteral artesunate as first line treatment in the management of severe falciparum malaria in african children. The challenge is to ensure that the changes are implemented.(see update to treatment guidelines below)
- fighting the spread of artemisinin resistance - A major threat to sustaining malaria control and elimination is the emergence of malaria parasites that are resistant to artemisinin – the essential ingredient of artemisinin-based combination therapies (ACTs) - the most potent weapon in treating falciparum malaria, the deadliest form malaria
“Policymakers need to act quickly to avoid the spread or emergence of artemisinin resistance in new areas," said Dr Robert Newman, Director of the WHO Global Malaria Programme. "The way forward is outlined in The Global Plan for Artemisinin Resistance Containment (GPARC) – but we will need everyone on board if we are to protect ACTs as our most effective antimalarial treatment“.
GPARC outlines the necessary actions to contain and prevent resistance. This includes the banning of oral artemisinin monotherapies, ensuring diagnostic testing of suspected malaria and rational treatment of confirmed cases, and strengthening surveillance to monitor the threat of drug resistance. which are the critical component of artemisinin-based combination therapies (ACTs).
Resistance to artemisinins has already emerged in areas on the Cambodia-Thailand border. There is also concern that resistance could spread from the Cambodia-Thailand border to Africa, as it did with antimalarial drugs such as chloroquine and sulfadoxine-pyrimethamine in the 1960s and 1970s. Although ACTs are currently more than 90% efficacious around the world, quick action is essential. If these treatments fail, many countries will have nothing to fall back on.