Maintaining the malaria fight

By Jainarine Deonauth

The World Malaria Report 2012 just released, summarises information received from 99 countries with on-going transmission and other sources, and updates the analyses presented in the 2011 report. Malaria is an entirely preventable and treatable vector-borne disease. In 2010, an estimated 219 million cases occurred globally, while the disease killed about 660,000 people, mostly children under five years of age.
In Guyana, the government and other partners have been working tirelessly to reduce malaria rates. For example, the multi-therapy drug, Coartem – which is recognised as the most effective malaria treatment – has been introduced to treat malaria-infected persons; special treated nets have been introduced; and medical outreaches have been held to obtain malaria smears from persons. However, so far, there has been a four per cent increase in malaria cases in the country, compared with the figure for the corresponding period in 2011.
According to a news release from the World Health Organisation (WHO), during the past decade, a concerted effort by endemic countries, donors and global malaria partners led to strengthened malaria control around the world. However, after a rapid expansion between 2004 and 2009, global funding for malaria prevention and control levelled off between 2010 and 2012, and progress in the delivery of some life-saving commodities has slowed. According to the 2012 report, these developments are signs of a slowdown that could threaten to reverse the remarkable recent gains in the fight against one of the world’s leading infectious killers.
For example, the report notes that 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. This means that many households will be unable to replace existing bed nets when required, exposing more people to the potentially deadly disease.
The expansion of indoor residual spraying programmes also levelled off, with coverage levels in the WHO African Region staying at 11 per cent of the population at risk (77 million people) between 2010 and 2011.
According to the report, 50 countries around the world are on track to reduce their malaria case incidence rates by 75 per cent by 2015 – in line with World Health Assembly and Roll Back Malaria targets. However, these 50 countries only represent three per cent, or seven million, of the malaria cases that were estimated to have occurred in 2000, the benchmark against which progress is measured. Dr Robert Newman, Director of the WHO Global Malaria Programme in Geneva, was quoted as saying that global targets for reducing the malaria burden will not be reached unless progress is accelerated in the highest burden countries. These countries are in a precarious situation and most of them need urgent financial assistance to procure and distribute life-saving commodities, he explained.
“The multi-pronged strategy to fight malaria, outlined in the Global Malaria Action Plan, is working. However, 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,” says Dr Fatoumata Nafo-Traoré, Executive Director of the Roll Back Malaria Partnership. Further, the report indicates that international funding for malaria appears to have reached a plateau well below the level required to reach the health-related Millennium Development Goals and other internationally-agreed global malaria targets.
The report estimates that US$5.1 billion will be needed every year between 2011 and 2020 to achieve universal access to malaria interventions in the 99 countries with on-going malaria transmission. While many countries have increased domestic financing for malaria control, the total available global funding remained at 2.3 billion in 2011 – less than half of what is needed.  Of importance too is the need for tracking progress in malaria control on a continuous basis. The report mentions the fact that, at present, malaria surveillance systems detect only one-tenth of the estimated global number of cases. In as many as 41 countries around the world, it is not possible to make a reliable assessment of malaria trends due to incompleteness or inconsistency of reporting over time.
Hence, stronger malaria surveillance systems are urgently needed to enable a timely and effective malaria response in endemic regions, to prevent outbreaks and resurgences and to ensure that interventions are delivered to areas where they are most needed. It is hoped that all malaria affected countries, including Guyana, will not only make bold commitments, but will take concrete action to sustain the malaria fight.