The remarkable gains made in the treatment of malaria over the past decade are under threat because of insufficient increases in funding over the past two years, a report by the World Health Organisation has revealed.
According to the World malaria report 2012, after a rapid expansion between 2004 and 2009, global funding for malaria prevention and control levelled off between 2010 and 2012. Last year US$2.3bn was made available, but that is less than half the $5.1bn estimated to be needed to control malaria every year.
As a result, the report says the number of long-lasting insecticidal nets (LLINs) delivered to endemic countries in sub-Saharan Africa dropped from a peak of 145 million in 2010 to an estimated 66 million in 2012, exposing more people to the potentially deadly disease.
The expansion of indoor spraying programmes have also levelled off, with coverage levels in the WHO African Region staying at 11% of the population at risk (77 million people) between 2010 and 2011.
Efforts to prevent the emergence and spread of parasite resistance to antimalarial medicines and mosquito resistance to insecticides are also constrained by inadequate funding, the report says.
During the past eight years, scaled-up malaria control helped us avert over a million deaths
‘During the past eight years, scaled-up malaria control helped us avert over a million deaths. We must maintain this momentum and do our utmost to prevent resurgences,’ said Ellen Johnson Sirleaf, president of Liberia and chair of the African Leaders Malaria Alliance.
The report says 50 countries are on track to reduce their malaria case incidence rates by 75% by 2015 – in line with World Health Assembly and Roll Back Malaria targets. However, these 50 countries only represent 3%, or 7 million, of the malaria cases that were estimated to have occurred in 2000, the benchmark against which progress is measured.
‘Global targets for reducing the malaria burden will not be reached unless progress is accelerated in the highest burden countries,’ said Dr Robert Newman, director of the WHO Global Malaria Programme in Geneva. ‘These countries are in a precarious situation and most of them need urgent financial assistance to procure and distribute life-saving commodities.’
In order to prevent a resurgence of malaria in some countries, we urgently need fresh ideas on new financing mechanisms
The report reveals that an estimated 80% of deaths from malaria are concentrated in 14 endemic countries. The Democratic Republic of the Congo and Nigeria are the most affected countries in sub-Saharan Africa, while India is the most affected country in South-East Asia.
‘In order to prevent a resurgence of malaria in some countries, we urgently need fresh ideas on new financing mechanisms that will reap greater resources for malaria,’ said Dr Fatoumata Nafo-Traoré, executive director of the Roll Back Malaria Partnership.
‘We are exploring many options – financial transaction taxes, airline ticket taxes together with UNITAID, and a “malaria bond”, among others.’
While the levelling off of funding is affecting the scale-up of some interventions, the report reveals a major increase in sales of rapid diagnostics tests, from 88 million in 2010 to 155 million in 2011, as well as a substantial improvement in the quality of tests in recent years. Deliveries to countries of artemisinin-based combination therapies (ACTs), the treatment recommended by the WHO for falciparum malaria, also increased substantially, from 181 million in 2010 to 278 million in 2011.
However, the report says stronger malaria surveillance systems are still urgently needed to prevent outbreaks and resurgences and to ensure that interventions are delivered to areas where they are required most.
