Malaria is back on the rise as lack of financial stalls push to wipe out disease

The WHO director general, Tedros Adhanom Ghebreyesus, warned of a “troubling shift” in the downward trajectory of malaria, one of the biggest killers in poorer countries, and until recently, one of the greatest public health success stories. There is a real chance malaria could be eliminated, this year’s world malaria report suggests, but only if funding increases.

Inadequate investment in controlling the disease in high-burden countries, which have been reducing funding for at risk populations, represents the “greatest threat” to gains the world has made, said the report.

Since 2014, investments in malaria control have, on average, declined in many high-burden countries. The WHO estimates that a minimum of $6.5bn will be needed annually by 2020. Last year, just $2.7bn was invested.

Sub-Saharan Africa still accounts for 90% of malaria cases and deaths worldwide, but inefficient implementation of interventions, conflict and other crises – as well as climate change – have shifted attention away from the disease.

Following an unprecedented fall in global malaria cases since 2010, conservative estimates suggest cases have increased by 5m between 2015 and 2016. The global toll of malaria deaths reached 445,000 in 2016, a similar number to that reported in 2015.

Fifteen countries account for 80% all malaria cases globally. Nigeria accounts for the highest proportion of cases, at 27%, followed by the Democratic Republic of the Congo, at 10%.

In a foreword for the report, Tedros, the former Ethiopia health minister, said the malaria response was “at a crossroads”. He urged countries and the global health community to boost funding to save lives.
“The choice before us is clear,” he said. “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.

“As I have said before, countries must be in the driver’s seat; they alone are ultimately responsible for the health of their citizens. Universal health coverage is indeed a political choice – one that takes courage, compassion and long-term vision.”