About two-thirds of global malaria cases and deaths are now concentrated in 11 African countries: Nigeria, Sudan, Tanzania, Uganda, Mozambique, Niger, Ghana, Mali, Cameroon, Burkina Faso and the Democratic Republic of the Congo. A health worker administers the malaria vaccine to a child in Yenagoa, Nigeria, on Dec. 9.Sunday Alamba/The Associated Press
Despite a growing arsenal of global tools to fight malaria, the disease caused nearly 600,000 deaths last year as expanding war zones and worsening climate change have thwarted progress against one of the world’s biggest killers, a new report says.
Health workers have mobilized a wave of innovative technologies against the mosquito-borne disease in recent years, including seasonal drug regimes, new vaccines and billions of bed nets treated with insecticide. But the number of new malaria cases has climbed steadily over the past decade, reaching 263 million last year, according to the report by the World Health Organization.
Mosquitoes are becoming more resistant to insecticide-treated bed nets, while malaria parasites are developing resistance to the standard treatment drugs, experts say. “Instead of dying on bed nets, we’ve seen mosquitos dancing on bed nets,” said Michael Charles, chief executive officer of a global partnership against malaria, at a briefing this week.
Wars and extreme weather are among the other key factors blocking progress, the WHO report said. Malaria was endemic in two-thirds of the 65 countries affected by violent conflicts last year, and those conflicts hampered access to drugs and treatment for many people with the disease, according to the report. Tens of millions of refugees and displaced people fleeing conflict are especially vulnerable to the disease, it said.
Climate change, meanwhile, is bringing higher levels of heat and humidity to many countries. “These are good conditions for mosquitoes to increase their numbers,” said Daniel Ngamije, director of the WHO global malaria program, at the media briefing.
Massive flooding in Pakistan in 2022 was an example of how extreme weather events can trigger devastating surges in malaria. “After the floods receded, pools of standing water created ideal breeding grounds for mosquitoes, leading to an eight-fold increase in malaria cases between 2021 and 2023, from 506 000 to 4.3 million,” the report said.
“These events are expected to become even more severe and more common as a result of climate change.”
Because of these factors, the world is far behind targets the WHO had set for the battle against malaria. The number of malaria deaths per capita last year was more than twice the target level, while the incidence rate was nearly three times higher than the goal, the report said.
The annual number of new malaria cases has jumped from 226 million in 2015 to 263 million last year. There were 597,000 deaths last year – down slightly from the peak of the COVID-19 pandemic when anti-malaria campaigns were hobbled, but significantly higher than the years before the pandemic. About 95 per cent of these deaths were in Africa.
The global response is still much less than what is needed, the report said. About US$4-billion was invested in the fight against malaria last year, less than half of the funding target of US$8.3-billion. And this gap has widened over the past five years. Global funding in 2019, by comparison, was US$2.6-billion below the target.
At the same time, substantial progress has been recorded in some countries, showing that the global efforts are creating hope. Of the 83 countries where malaria is endemic, 25 are now reporting fewer than 10 cases of malaria a year, a dramatic improvement from just four countries in 2000. The global mortality rate for the disease has been cut in half in that same period. And nine countries have been certified malaria-free since 2015.
“Investments in malaria interventions are working,” said Arnaud Le Menach, a WHO malaria expert and the lead author of the latest annual report, in a statement. “We are still making progress.”
The report estimates that malaria control efforts have helped to avert 2.2 billion cases and 12.7 million deaths this century.
About two-thirds of global malaria cases and deaths are now concentrated in 11 African countries: Nigeria, Sudan, Tanzania, Uganda, Mozambique, Niger, Ghana, Mali, Cameroon, Burkina Faso and the Democratic Republic of the Congo.
In these countries, the mortality rate from the disease has declined by 13 per cent over the past six years, although it is still more than double the target level, the report said. The 11 countries held a conference earlier this year to intensify their efforts against the disease. “No one should die from malaria, given the tools and systems available,” they said in a joint statement.