Malaria cases surged to 263 million last year amid stalled progress to stop mosquito-borne illness
The number of malaria cases worldwide reached 263 million last year, an increase of 11 million cases from 2022 amid stalled progress to eliminate the mosquito-borne illness, according to a new report.
While an estimated 2.2 billion malaria cases and 12.7 million deaths have been averted since 2000 due to global health efforts, in recent years a lack of funding, the COVID-19 pandemic’s effect on health systems, political instability in countries battling malaria, and other challenges have all stymied the response.
“We are here because of the substantial progress that has been made,” Dr James Tibenderana, an epidemiologist and chief executive of the UK-based Malaria Consortium, told Euronews Health.
In 2023, Azerbaijan, Belize, Cape Verde, and Tajikistan were all certified malaria-free, while Egypt gained the designation this year and Georgia and Turkey appear close behind.
Related
Still, an estimated 597,000 people died from malaria in 2023, a level that was on par with the year before, according to the report from the World Health Organization (WHO). Nearly all of the deaths were in Africa.
“The rest of this journey is more complicated than we have seen in the past 20 years,” Tibenderana said.
That’s because malaria, which is still endemic in 83 countries, spreads to people through mosquitoes infected with a parasite, making it more complex to eliminate than other diseases that spread between people.
In 2023, global funding for malaria control was $4 billion (€3.79 billion), less than half of the $8.3 billion (€7.87 billion) that the UN health agency says is needed. That gap is leading to shortages of medicines and insecticide-treated nets to protect against mosquitoes, the report found.
Related
“I don't see, given the current global financial situation, that there's going to be a new angel funder coming into the space,” Dr Regina Rabinovich, director of the malaria elimination initiative at the Barcelona Institute for Global Health, told Euronews Health.
“There's too many needs, there's climate [change], there's wars, and it's really a challenge”.
Climate change can also exacerbate the problem. In Pakistan, for example, extreme rainfall and floods caused a “malaria epidemic” in 2022, with cases rising fivefold, according to the report.
Antimalarial resistance is a growing threat
Another growing issue is the threat of resistance to antimalarial drugs, which is when a malaria-carrying parasite evolves, raising the risk that treatments will fail and making it more likely that patients with severe illness will die.
This happened with chloroquine, which was once a frontline malaria treatment, in the late 1970s and 1980s, and it could happen again today.
Related
Recently, there have been signs that children in Uganda with a severe form of malaria are experiencing partial resistance to artemisinin, a life-saving antimalarial drug, according to a small study in the medical journal JAMA.
Artemisinin resistance has also been confirmed in Eritrea, Rwanda, and Tanzania, and the WHO suspects that Ethiopia, Sudan, Namibia, and Zambia are also grappling with it.
There is also a risk that mosquitoes are becoming immune to insecticides used on bed nets and that the parasites are evolving to evade diagnostic tests, meaning an infected person would not test positive and receive malaria treatment, Tibenderana said.
To combat antimalarial resistance and ensure people can get effective medical care, Tibenderana said that doctors should take steps to stretch the existing drugs for as long as possible, such as by using different combinations of medicines.
Related
That’s because the next generation of antimalarial drugs likely won’t be available in the next three to five years, and if the current drugs stop working sooner, people could lose trust in the medicines and potentially the medical system, he said.
“It is a crisis,” Tibenderana said. “We don't know how long that window is, but I prefer not to find out”.
Improvements in malaria control
Other recent developments are more positive, according to the WHO report.
For example, a new type of insecticide-treated mosquito net that offers better protection against malaria is becoming more widely available.
In 2023, 78 per cent of the 195 million nets that were delivered to sub-Saharan Africa were the new type of net, up from 59 per cent in 2022, the WHO report found.
Further, 17 countries have introduced WHO-recommended malaria vaccines as part of their routine childhood immunisations.
Related
About two million children got the vaccines as part of pilot studies in Ghana, Kenya, and Malawi between 2019 and 2023, resulting in a 22 per cent decline in hospitalisation for severe malaria among eligible children and a 13 per cent decline in deaths from any cause, injuries excluded.
Dr Mary Hamel, who works on malaria vaccines at the WHO, told reporters this week that a combination of vaccines, treatments, and other tools are needed to eventually stamp out malaria.
“None of these tools are standalone tools, so it’s really important that as the vaccine is rolled out, we continue to roll out bed nets and scale up bed nets and other interventions,” Hamel said.
