For millions of people around the world, a simple mosquito bite can have deadly consequences. Malaria is a tropical disease caused by parasites and transmitted through the bite of an infected Anopheles mosquito.
Every year, malaria kills approximately 438,000 people – two-thirds of which are children under five.
One half of the world’s population lives in areas at risk of malaria, and approximately 214 million people become infected each year. 15 countries accounted for 80% of malaria cases and 78% of deaths in 2015; 89% of cases and 91% of deaths, moreover, occurred in sub-Saharan Africa. Since 2000, the decline in malaria incidence in these 15 countries (32%) has lagged behind that of other countries globally (54%).
Control measures such as indoor residual spraying (IRS) with insecticides and insecticide-treated bed nets (ITNs), and antimalarial drugs such as artemisinin-combination therapy (ACT) have successfully reduced malaria cases and deaths. But insecticide and drug resistance is a growing threat as these interventions continue to be scaled up.
Malaria doesn’t just cause illness and deaths around the world; it decreases productivity and increases the risk of poverty for the communities and countries affected. For example, infection rates are highest during the rainy season, often resulting in decreased agricultural production. In total, malaria costs sub-Saharan Africa an estimated $12 billion in economic productivity, foreign investment, tourism and trade every year, which economists believe may slow economic growth by up to 1.3% per year. Malaria also puts a serious strain on public health systems. In heavily affected sub-Saharan African countries, malaria accounts for as much as 40% of public health spending.
Malaria is an entirely preventable and treatable disease. For just $10, a bed net treated with insecticide can be bought and distributed, with training given on how best to use it. Combining bed nets with other simple actions such as spraying homes with insecticides could prevent millions of people from getting sick. For those who do become infected with malaria, treatments costing $2 each are highly effective and can dramatically cut deaths.
Big increases in the resources available to fight malaria have had huge positive health impacts. Initiatives such as the Global Malaria Action Plan (GMAP), Global Fund to Fight AIDS, Tuberculosis and Malaria, the US President’s Malaria Initiative (PMI) and the World Bank’s Malaria Booster Program have significantly expanded coverage of bed nets and access to treatment. Between 2004 and 2015, the Global Fund alone distributed 548 million bed nets and treated 515 million malaria cases. Since 2000, one billion insecticide-treated mosquito nets have been distributed in Africa and today an estimated 68% of under-fives in sub-Saharan Africa are sleeping under insecticide-treated nets, compared to less than 2% in 2000.
This support is producing results. Between 2000 and 2015, global malaria death rates fell by 60% and global malaria incidence decreased by 37%. In 2014, 16 countries reported no cases of the disease and in 201533 countries reported fewer than 1000 cases. Certainly, Dr Margaret Chan, director-general of WHO, has said that “global malaria control is one of the great public health success stories of the past 15 years”. In her words, “It’s a sign that our strategies are on target, and that we can beat this ancient killer, which still claims hundreds of thousands of lives, mostly children, each year”.
However, increased funding for malaria control and treatment is still needed to build on the progress made in the last few years. In 2014, funding for malaria control and elimination totalled $2.4 billion. Although this was one of the highest funding totals to date, it was less than half the estimated $5.1 billion needed and left a funding gap of $2.7 billion.
As the world moves from the MDGs to the Sustainable Development Goals (SDGs), it is imperative that the fight against malaria continues. A range of new tools and promising malaria vaccines currently in development will be critical to counter threats like growing insecticide resistance and a drop in external funding for public health. With a coordinated global effort, we can continue to make progress and ultimately ensure the virtual elimination of malaria deaths.