Malaria is on the rise according to the 2023 World malaria report published by WHO. An array of factors including drug resistance, climate change and humanitarian crises contributed to some 249 million cases of malaria last year - a rise from 223 million cases 3 years previously before the start of the COVID pandemic, which also helped increase cases.
“The World Malaria Report shows that progress towards key global targets for reducing malaria case incidence and death rates is off track by a wide margin. Given current trends, continuing with the status quo will only lead us further off track. We highlight a number of key actions in the report that are needed to get “back on track.” First, we need to step up financing. In 2022 alone, there was a global malaria funding gap of 3.7 billion US dollars. Second, we need robust political will. Countries must translate their political commitment to universal health coverage into tangible actions and resources that will save lives," says Dr Daniel Ngamije, Director, WHO Global Malaria Programme:
One of the biggest threats, according to the report, is climate change. Rising temperatures, increased humidity and rainfall can influence the behaviour and survival of the malaria-carrying Anopheles mosquito. Increased heatwaves and flooding due to extreme weather can also increase the chance of transmission. The report cites the 2022 floods in Pakistan which led to a five-fold increase in malaria cases in the country.
“Climate change poses one of the biggest threats to human health. Diseases such as malaria are sensitive to changes in temperature, humidity and rainfall. As temperatures rise across the planet, some environments will become more favourable for mosquito breeding and survival – and some less favourable," says Ngamije.
The pandemic caused significant disruption to malaria services, leading to a rise in cases and deaths. Similarly, natural disasters also translate into reduced access to life saving malaria services and disruptions to the supply chain of insecticide-treated nets, medicines and vaccines, according to the report.
Globally there were five million more cases of malaria in 2022 than the previous year with Pakistan suffering the largest increase. There were about 2.6 million cases in the country compared to 500,000 in 2021. Ethiopia, Nigeria, Papua New Guinea and Uganda also saw cases rise.
“We need to use data strategically. Instead of deploying the same malaria control tools in all areas, interventions should be tailored to the local context to maximize impact. Next, we need to harness innovation and support the development of more effective, efficient and affordable tools. Processes for bringing products to market need to be accelerated while maintaining safety, efficacy and quality. And, lastly, we need to take urgent action globally on climate change and health,” says Ngamije.
However rates have levelled in the 11 countries that have the highest cases rates of new infections and deaths following an initial surge in 2020. These countries, supported through the WHO “High burden to high impact” programme had an estimated 167 million malaria cases and 426,000 deaths in 2022.
A roll out of the RTS,S/AS01 malaria vaccine in Africa showed a 13% drop in early childhood deaths from all causes in the areas where the vaccine has been administered and nets, insecticides and other child health interventions were already in use.
In October 2023, WHO recommended a second safe and effective malaria vaccine, R21/Matrix-M. The availability of two malaria vaccines is expected to increase supply and make broad-scale deployment across Africa possible.
The elimination of malaria in some countries has also seen success. In 2022, 34 countries reported fewer than 1,000 cases compared to13 countries two years previously. This year Azerbaijan, Belize and Tajikistan were certified by WHO as malaria-free, and several others are on track to be rid of the disease in the coming year.