A new malaria framework for Africa

WHO Member States in the African Region have unanimously adopted a new malaria framework that is aligned with the goals of the WHO Global Technical Strategy for Malaria 2016-2030. Endorsed at the 66th Session of the WHO Regional Committee for Africa, the framework will guide African countries and their partners as they implement the Global Technical Strategy across the region.

The framework proposes priority actions for malaria-endemic countries as they work towards the vision of “an African Region free of malaria”. Its objectives for 2030 include:

1. Reducing malaria mortality rates by at least 90%;
2. Reducing malaria case incidence by at least 90%;
3. Eliminating malaria from at least 20 malaria-endemic countries;
4. Preventing re-establishment of malaria in all Member States that are malaria-free.

• Framework for implementing the Global Technical Strategy for Malaria 2016–2030 in the African Region

Substantial progress

Speaking at the meeting on 21 August in Addis Ababa, Ethiopia, Dr Matshidiso Moeti, WHO Regional Director for Africa, noted the substantial progress in controlling malaria across the region, including a 42% decline in malaria cases and a 66% decline in malaria deaths since 2000. “Malaria is no longer the leading cause of death among children in sub-Saharan Africa,” she added.

In 2015, malaria was the fourth leading cause of mortality in sub-Saharan Africa among children under five, accounting for 10% of deaths. Fifteen years ago, it was the leading cause of mortality in this age group, accounting for 17% of deaths. (Figure 1).

Progress in reducing Africa’s malaria burden was made possible, in large part, through the massive deployment of effective and low-cost malaria control tools. According to the World Malaria Report, insecticide-treated mosquito nets (ITNs) have been the most important intervention, accounting for an estimated 68% of malaria cases prevented since 2000.

Artemisinin-based combination therapies (ACTs) – introduced widely in Africa over the last decade – have been highly effective against P. falciparum, the most prevalent malaria parasite on the African continent. In 2014, 337 million ACT treatments courses were deployed globally, up from just 11 million in 2005; most of these treatment courses (98%) were delivered to the African Region.

Figure 1. Leading causes of death among children aged under 5 years in sub-Saharan Africa, 2000-2015

Key challenges

Despite major progress, the African Region continues to shoulder the heaviest malaria burden, with approximately 190 million cases (89% of the global total) and 400 000 deaths (91% of the global total) in 2015 alone. More than 800 million people in the region remain at risk of malaria.

Fifteen countries, mainly in Africa, account for 78% of malaria cases and 80% of deaths globally. Two countries, Nigeria and the Democratic Republic of Congo, together account for more than 35% of global malaria deaths.

In many countries, weak health systems and gaps in access to effective interventions continue to impede efforts to control and eliminate malaria. Emerging biological threats such as mosquito resistance to insecticides and parasite resistance to artemisinin have the potential to seriously weaken malaria responses.

Global Technical Strategy for Malaria

“Progress in malaria control in Africa is crucial to the attainment of the goals of the Global Technical Strategy,” said Dr Pedro Alonso, Director of the Global Malaria Programme. This Strategy sets ambitious but attainable goals for 2030, including:

1. Reducing the rate of new malaria cases by at least 90%;
2. Reducing malaria death rates by at least 90%;
3. Eliminating malaria in at least 35 countries;
4. Preventing a resurgence of malaria in all countries that are malaria-free.

Endorsed by the World Health Assembly in May 2015, the Strategy was the result of an extensive collaborative process that involved the participation of more than 400 malaria experts from 70 countries. Its timeline of 2016-2030 is aligned with the 2030 Agenda for Sustainable Development, the global development framework adopted by all UN Member States in September 2015.