A colossal population of approximately 3.3 billion people, nearly half of size of world population, is at risk of malaria is a clear indication of a silent emergency. The recent World Malaria Report, 2013, released by the World Health Organization shows how far we have come in our fight against malaria and it shows that we may be at the last and hardest mile of the vector viral eradication. It revealed that the global malaria mortality rate has decreased by an impressive 45% within the course of 12 years (from 2000 to 2012), evidently saving an approximate 3.5 million lives. The study also indicated that the malaria-caused mortality rate among children in African has reduced by an impressive 54%. Financing towards the battle against malaria has also substantially increased over the years, especially by the interventions initiated by the Global Fund. The report is encouraging, but more needs to be done.
While these are encouraging improvements and commitments towards the disease eradication, globally, we remain at a long way from universal access to prevention and treatment of the disease. The existence of the drug-resistant severe malarial vector, P. vivax in four countries, including Ethiopia, India, Indonesia and Pakistan indicate that the “remarkable gains against malaria are still fragile”, as emphasized by Dr. Robert Newman, Director of the WHO Global Malaria Program.
In Pakistan, for instance, the report reveals that the funding towards malaria is only provided by the Global Fund which highlights the low state commitment. Despite the significant contributions and commitments towards eradication of malaria, current funding remains below the $5.1 billion benchmark that is required by the Global Malaria Action Plan which includes interventions including diagnostic tests, bed nets and medication for the disease.
The diagnostic testing indicators however have done well in terms of expansion as countries that are plagued by malaria offer free diagnostic tests via public facilities. This is supported by an increase in proportion of people that have received a diagnostic test via state facilities from 44% to 64%.
The report also reveals a setback in the expansion of interventions aimed at controlling mosquitoes globally for the second consecutive year. In Pakistan, the majority of the funding is spent on ITNs (insecticide treated nets). Despite the increase in financing in the global fight against malaria, there remains a lack of funding to procure the “bed nets”, which can significantly reduce disease incidence in countries that harbor a significant fraction of the disease. For instance, in the Sub-Saharan Region, less than 50% have access to insecticide-treated bed nets in 2013. There is an unmet need of a minimum 150 million new bed nets annually in the malaria endemic countries to ensure risk protection to all. However, a promising procurement of 200 million bet nets has been scheduled for 2014 and things may just look up.
There has been an increase in the procurement of the artemisinin-based combination therapies (ACTs), which have been recommended by the WHO. The treatment courses have increased by approximately four-fold from 76 million (2006) to 331 million (2012).
The developments mentioned in the report are illustrative of due commitment and seriousness towards eradication of the plague that is malaria. However, in the words of Raymond G Chambers, the UN Secretary General’s Special Envoy for Financing the Health MDGs and for Malaria, “to win the fight against malaria we must get the means to prevent and treat the disease to every family who needs it,” and added, “Our collective efforts are not only ending the needless suffering of millions, but are helping families thrive and adding billions of dollars to economies that nations can use in other ways.” This is a global health challenge that requires consistency in momentum and resources from various sources are call of the hour. The report is a reminder of what has been achieved and a call for the stakeholders to stay committed as the fight must continue to defeat malaria .
Senior Research and Communications Associate