Between 2000 and 2013, a major expansion of WHO-recommended interventions helped cut the global malaria mortality rate by almost half, saving an estimated 4.3 million lives.
Still, a staggering 3.3 billion people worldwide remain at risk. There were an estimated 198 million cases and nearly 600 000 deaths in 97 countries in 2013, mostly children under 5 years of age.
In response, WHO launched the "Global technical strategy for malaria 2016–2030", endorsed in May 2015 by the World Health Assembly.
The strategy calls for ambitious but achievable global targets by 2030, including a 90% reduction in malaria incidence and mortality (using 2015 estimates as a baseline) and malaria elimination in at least 35 countries.
The "Global technical strategy for malaria 2016–2030" is built on three pillars with two supporting elements
Pillar 1. Ensure universal access to malaria prevention, diagnosis and treatment.
All core malaria interventions – vector control, chemoprevention, diagnostic testing and treatment – should be scaled up to cover all populations at risk.
Pillar 2. Accelerate efforts towards elimination and attainment of malaria-free status.
All countries should intensify efforts to eliminate the disease, especially in areas with low transmission, and ensure that once they succeed in doing so they remain malaria-free.
Pillar 3. Transform malaria surveillance into a core intervention.
Strengthening malaria surveillance is fundamental to programme planning and implementation, and is a crucial factor for accelerating progress in eliminating malaria.
Supporting element 1. Harnessing innovation and expanding research.
In support of the three pillars, affected countries and the global malaria community should harness innovation and expand basic, clinical and implementation research.
Supporting element 2. Strengthening the enabling environment.
Strong political commitment, sustainable financing and increased multisectoral collaboration hold the key to further progress.
Significant progress has been made in the Western Pacific Region where the malaria burden dropped from almost 400 000 reported cases in 2000 to almost 300 000 in 2012, and from 2400 reported malaria deaths in 2000 to 460 in 2012.
However, the biggest threats that undermine the fight against malaria are the ever-growing resistance of malaria parasites to multiple medicines – including artemisinin-based combination therapies, the most effective medication to combat Plasmodium falciparum and mosquito resistance to insecticides.
“If we lose the ability to fight malaria with the best tools currently in our arsenal, it could be a debacle,” warned Dr Shin Young-soo, WHO Regional Director for the Western Pacific. “We need to speed up our efforts collectively – governments, civil society and global health partners alike – to ensure this does not happen.”
Fighting back against antimalarial drug resistance in the Greater Mekong Subregion
Ground zero in the battle against antimalarial multidrug resistance is the Greater Mekong Subregion (GMS) encompassing Cambodia, China (specifically Yunnan Province and Guangxi Zhuang Autonomous Region), the Lao People’s Democratic Republic, Myanmar, Thailand and Viet Nam.
Responding urgently to the growing crisis of drug resistance, the WHO regional offices for the Western Pacific and South-East Asia have developed the "Strategy for malaria elimination* in the Greater Mekong Subregion (2015–2030)".
Fully aligned with the global strategy, the GMS strategy is a prime example of partnership and collaboration, with six countries, two WHO regions and headquarters, and multiple development partners joining forces to fight a common threat.
GMS strategy at a glance
Vision
A region free of malaria and the continual threat posed by antimalarial drug resistance.
Goals
- Eliminate malaria by 2030 in all GMS countries.
- Eliminate the Plasmodium falciparum parasite, which is increasingly resistant to antimalarial medicine, by 2025.
- Maintain malaria-free status and prevent reintroduction in areas where malaria transmission has been interrupted.
Key principles
- Political and health sector ownership and leadership, in collaboration with communities, are essential to ensure a successful multisectoral approach.
- Countries must significantly strengthen surveillance to respond more swiftly to malaria cases.
- Everyone who needs malaria services must get them, especially the most vulnerable and hard-to-reach populations (e.g. cross-border migrant workers or people living in remote areas).
Milestones and targets
End of 2015: GMS countries have updated their malaria policies and included malaria elimination in their broader national health policies and planning framework based on the GMS strategy.
End of 2016: Transmission of malaria in Thailand interrupted in 60% of districts.
2017: Each GMS country has an established national surveillance system to implement elimination-phase surveillance in areas with low burden and has substantially strengthened malaria case and mosquito surveillance in areas of high burden; universal coverage with long-lasting insecticidal nets achieved for all populations in areas of malaria transmission.
2020 or earlier: Transmission of P. falciparum malaria interrupted in all areas of multidrug resistance.
2020: P. falciparum malaria eliminated in Cambodia and Yunnan Province, China; all first subnational level administrative units (provinces, states and regions) where malaria has not yet been eliminated are in the elimination phase.
2025: P. falciparum malaria eliminated in all GMS countries.
2030: Malaria eliminated in all GMS countries.
Looking ahead
The WHO Western Pacific Regional Office is producing an updated regional action plan for malaria control and elimination 2016–2020, in alignment with the global and GMS strategies. The regional plan will be presented to Member States for endorsement at the sixty-seventh session of the WHO Regional Committee for the Western Pacific in 2016.
“The most important thing is to ensure that our collective efforts to combat malaria are sustained over time,” said Dr Shin. “We cannot afford to be complacent. Our strategy now, and its implementation by all the actors involved, will determine whether we succeed in tackling malaria as a regional and global threat and safeguarding the wellbeing of future generations.”
*Malaria elimination: Reduction to zero of the incidence of locally transmitted malaria caused by human malaria parasites in a defined geographical area as a result of deliberate efforts. Continued measures to prevent re-establishment of transmission are required.