Global fight to defeat malaria

TOOLS ARE now available to end deaths from malaria and move towards malaria elimination. Since 2000, global malaria deaths have fallen by 42 per cent, but continued investment and sustained political support is needed to defeat malaria. Investments have created more than 90 countries malaria-free and another 26 nearly achieving a similar status. According to the World Malaria Report 2013, malaria killed an estimated 482 000 children under five years of age in 2012. That is 1300 children every day, or one child almost every minute. On the occasion of World Malaria Day, 25 April 2014, the World Health Organization (WHO) and partners sought to further increase public awareness about malaria and help promote proven prevention and control measures. Countries with improved malaria control interventions have seen child mortality rates fall by 20 per cent. Forty-three endemic countries in the WHO African Region and 22 in other WHO Regions have received financial support from WHO for developing their malaria programmes. WHO is currently collaborating with UNICEF to strengthen the malaria programmes in Eritrea, Namibia, Uganda and United Republic of Tanzania. Malaria is also one of the major public health challenges undermining the 2015 Millennium Development Goals (MDGs). Fifty-nine countries are on track but international targets will not be achieved unless considerable progress is made in the 18 most affected countries – most in sub-Saharan Africa – that account for 80 per cent of malaria cases. Significant progress has been made in the early diagnosis and treatment of malaria. The use of Malaria Rapid Diagnostic Tests (RDTs) assists in detecting evidence of malaria parasites in human blood. RDTs have been especially useful in confirming malaria cases in rural settings and ensuring people get timely treatments. According to the WHO, “an estimated 136 million long-lasting insecticidal nets (LLINs) were delivered to endemic countries, a major increase over the 70 million bed nets that were delivered in 2012. About 200 million LLINs have been funded for delivery in 2014, suggesting an even stronger pipeline for 2014”. As a basic guideline for protection against malaria, United Against Malaria recommends having at least two long-lasting insecticide-treated nets (LLINs) in a household. Bed nets prevent malaria by creating a protective barrier against mosquitoes at night – when most transmissions occur. LLINs typically provide two to five years of protection for a family. The level of protection is based on the size of the family, the type of net, the number of washings and the degree of care given. Indoor residual spraying (IRS), or spraying on the inside walls of homes has also been found to kill mosquitoes and reduce the rate of malaria transmission. The WHO recommends IRS but it remains underutilized, as it requires proper timing, frequent spraying and it is most effective when used in combination with LLINs. Artemisinin-based combination therapies (ACTs) are the frontline treatment for malaria and can cure a child in one to three days. However, one setback is that drug-resistant strains of malaria are now surfacing in high-risk populations. In 2012, researchers found that the most effective drugs are becoming less effective and over 20 per cent of patients have begun to show a form of treatment resistance. WHO re-affirms “ACTs remain effective in almost all settings, so long as the partner drug in the combination is locally effective. The Global plan for artemisinin resistance containment, released in 2011, contains strategic guidance from WHO on how to manage this global threat.” Experts are also optimistic about the possibility of the world’s first malaria vaccine. The good news comes after a new trial showed that a vaccine had cut the number of cases of malaria after 18 months by 46 per cent in children aged five to 17 months. Younger infants aged six to 12 weeks also benefited with a 27 per cent malaria reduction when compared to unvaccinated children. These findings were presented earlier this year at the sixth Pan-African Conference of the Multilateral Initiative on Malaria in Durban, South Africa. Let’s move toward a malaria-free future! Join the global #WorldMalariaDay conversation and mention what you’re doing to #DefeatMalaria. Tweet a photo with ‘I raise my hand to Defeat Malaria’ written on your palm. Don’t forget to include the #DefeatMalaria hashtag in your post! Dr Couillard works in collaboration with the World Health Organization’s goals of disease prevention and control. Twitter: DrCoryCouillard