The war on malaria has been a victory for human health, driving deaths down and life expectancy up. But experts fear that the positive trajectory is starting to shift.
The global fight against malaria is grinding to a halt, the World Health Organization warned on Wednesday, amid flat-lining funding and political complacency.
Malaria infected an estimated 216 million people last year — about 5 million more than in 2015 — potentially reversing a six-year trend of decreasing infection cases. The majority of the 440,000 lives claimed by the mosquito-borne disease were young children in sub-Saharan Africa.
WHO Director General Tedros Adhanom Ghebreyesus said “progress appears to have stalled” in the fight against the tropical disease.
“Although there are some bright spots in the data, the overall decline in the global malaria burden has unquestionably levelled off,” Ghebreyesus said. “And, in some countries and regions, we are beginning to see reversals in the gains achieved.”
Fall in funding
Experts fear financial shortfalls and government complacency have thrown progress off track.
“At the current level of funding and coverage of current tools, we have reached the limits of what can be achieved in the fight against the disease,” said Abdisalan Noor, lead author of the WHO’s annual malaria report.
Investment into malaria prevention — a third of which came from the US last year — has leveled off since 2010. Analysis by the WHO found that funding in countries with a high risk of malaria had dropped to an average of less than two dollars per person per year.
The WHO says a minimum annual investment of $6.5 billion (€5.5 billion) is required to meet its ambitious 2030 targets.
Funding in 2016 stood at just $2.7 billion.
Change in fortunes
The long-term global decline in malaria-related deaths has helped cut child mortality, driving a sharp increase in global life expectancy.
The WHO has repeatedly made announcement on “the massive roll-out of effective disease-cutting tools” and “impressive reductions in cases and deaths.”
Mosquito nets soaked in insecticide — mostly delivered through mass distribution campaigns — are the primary method of protection. But in sub-Saharan Africa fewer than half of households have sufficient access to them.
“If we continue with a business-as-usual approach — employing the same level of resources and the same interventions — we will face near-certain increases in malaria cases and deaths,” Ghebreyesus said.
Some 80 percent of malaria deaths take place in just 15 countries — 14 sub-Saharan African nations and India.
Emergency work is underway in Nigeria, South Sudan, Venezuela and Yemen, where ongoing humanitarian crises pose further public health risks.
Several countries in the Middle East and central Asia have been certified as malaria-free in the last decade, including Morocco, Armenia and Turkmenistan. Last year, Kyrgyzstan and Sri Lanka joined their ranks, having gone three years without recording an indigenous case of malaria.
“We are up against a tough adversary,” Ghebreyesus said. “But I am also convinced that this is a winnable battle.”