World Malaria Day, 25 April 2013

25 April 2013

Invest in the Future. Defeat malaria.

On April 25, people across the globe will take part in a wide range of activities to mark World Malaria Day 2013. These activities will no doubt look back at the remarkable progress that the global development community has made in combatting malaria and other infectious diseases over the years. Since 2000, malaria mortality rates have fallen by more than 25%, and 50 of the 99 countries with ongoing malaria transmission are now on track to meet the 2015 World Health Assembly target of reducing incidence rates by more than 75%.

In Africa, malaria deaths have been reduced by one third within the last decade. In countries where access to malaria control interventions has improved most significantly, overall child mortality rates have fallen by approximately 20%. A major scale-up of insect control interventions, coupled with increased access to diagnostic testing and quality-assured treatment, has been key to this progress.

Malaria still kills an estimated 660 000 people worldwide, mainly children under the age of five in sub-Saharan Africa. Every year, more than 200 million cases occur; most of these cases are never tested or registered. A recent plateauing of international funding has slowed down progress, and emerging drug and insecticide resistance threaten to reverse recent gains. If the world is to maintain and accelerate progress against malaria more funds are urgently required.

World Malaria Day goals

World Malaria Day was instituted by World Health Organisation (WHO) Member States during the World Health Assembly of 2007. It is an occasion to focus on the need for continued investment and sustained political commitment for malaria prevention and control. WHO uses this opportunity to illustrate best practices in a range of settings where malaria is a major health challenge, and facilitates the sharing of experiences between countries to adapt and strengthen malaria control efforts.

WHO emergency response to antimalarial drug resistance

On World Malaria Day, 2013, WHO is also using the opportunity to highlight the threat of antimalarial drug resistance in south-east Asia’s Greater Mekong subregion, where an emergency response is now being launched. This subregion includes Cambodia, China’s Yunnan province and Guangxi Zhuang Autonomous Region, Lao PDR, Myanmar, Thailand and Vietnam.

“In recent years endemic countries, including countries in sub-Saharan Africa, have made major headway in reducing new cases and deaths from malaria,” says Dr Hiroki Nakatani, WHO’s Assistant Director-General for HIV, TB, Malaria and Neglected Tropical Diseases. “But that progress could now be at risk. We are increasingly concerned by signs in the south-east Asia region that the malaria parasite is becoming resistant to some of the drugs that have helped make so much progress.”

Antimalarial drug resistance

Antimalarial drug resistance – the ability of the malaria parasite to survive drugs – first became a global problem in the 1960s when the parasite developed resistance to chloroquine, the then widely-used antimalarial. Resistance first emerged in the Greater Mekong subregion and later spread to Africa, triggering a dramatic increase in malaria-related illness and death – particularly among children.

Today the treatment of choice is artemisinin-based combination therapies (ACTs).Resistance to artemisinins – the core component of the combination – has now been identified in Cambodia, Myanmar, Thailand, and Vietnam. National efforts to contain resistance have had some impact, but urgent action is needed to fully eliminate resistant strains of the parasite and to ensure that ACTs remain effective.

“The consequences of widespread resistance to artemisinins would be catastrophic,” says Dr Robert Newman, Director of WHO’s Global Malaria Programme. “We must act now to protect south-east Asia today and sub-Saharan Africa tomorrow.”

Although major efforts are under way to develop new classes of antimalarials, there are no replacement products on the immediate horizon.

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