Introduction
The World Health Organization (WHO) recently released its World Malaria Report 2024, providing a comprehensive overview of the global progress and challenges in combating malaria. This year’s report, titled Addressing Inequity in the Global Malaria Response, underscores the urgent need for a more inclusive and equitable approach to malaria control and elimination. Despite significant strides over the past two decades, malaria remains a formidable public health challenge, particularly in vulnerable populations and regions. In this Blog, we will delve into the key findings, trends, and recommendations from this critical report.
Global Malaria Trends: Progress and Plateaus
The report reveals that an estimated 263 million malaria cases and 597,000 deaths occurred worldwide in 2023, marking an increase of 11 million cases compared to 2022. While the global malaria mortality rate has halved since 2000, progress has slowed in recent years, with the world falling short of the 2030 elimination targets. The WHO African Region continues to bear the brunt of the disease, accounting for 95% of malaria deaths, with children under five and pregnant women being the most affected groups.
On a positive note, the report highlights that 2.2 billion malaria cases and 12.7 million deaths have been averted since 2000, thanks to scaled-up interventions such as insecticide-treated nets (ITNs), diagnostics, and treatments. Countries like Azerbaijan, Belize, Cabo Verde, and Tajikistan were certified malaria-free in 2023, and Egypt joined them in 2024, showcasing the potential for elimination with sustained efforts.
The Inequity Challenge: Reaching the Most Vulnerable
A groundbreaking feature of the 2024 report is its emphasis on health equity. Malaria disproportionately affects marginalized groups, including women and girls, Indigenous Peoples, migrants, and people with disabilities. Harmful gender norms, socioeconomic disparities, and limited access to healthcare exacerbate these inequities. For instance, in many malaria-endemic countries, women and girls often require permission to seek healthcare, further delaying diagnosis and treatment.
The report calls for tailored interventions to address these barriers, such as improving access to preventive measures like seasonal malaria chemoprevention (SMC) and intermittent preventive treatment in pregnancy (IPTp). In 2023, 53 million children received SMC, and 44% of eligible pregnant women received IPTp, reflecting incremental progress.
Innovations and Interventions: Tools for the Future
The report highlights several promising innovations in malaria control. New-generation ITNs, which combine multiple active ingredients to combat insecticide resistance, are becoming the standard in sub-Saharan Africa. Additionally, malaria vaccines like RTS,S and R21 are showing encouraging results, with 17 countries incorporating them into routine immunization programs by December 2024.
Other advancements include long-acting injectables for malaria prevention and novel treatments for vulnerable groups, such as babies under five kilograms. However, challenges like drug and insecticide resistance, particularly in East Africa, threaten to undermine these gains.
Climate Change and Malaria: A Growing Threat
The 2024 report builds on last year’s focus on climate change, highlighting its profound impact on malaria transmission. Extreme weather events, such as the catastrophic floods in Pakistan in 2022, have led to dramatic spikes in malaria cases. Changes in temperature and rainfall patterns also influence mosquito behavior, complicating control efforts.
To mitigate these effects, the report emphasizes the need for resilient health systems and data-driven strategies to adapt to shifting transmission patterns.
Funding Gaps and the Path Forward
One of the most pressing challenges is the widening funding gap. In 2023, only $4 billion was invested in malaria control, less than half of the $8.3 billion needed to meet global targets. This shortfall has grown from $2.6 billion in 2019 to $4.3 billion in 2023, underscoring the need for increased political and financial commitment.
The Yaoundé Declaration, signed by health ministers from 11 high-burden African countries, represents a promising step forward. The declaration commits to bolstering malaria control programs, improving data systems, and fostering multisectoral collaboration.
The World Malaria Report 2024 serves as both a reminder of the progress made and a call to action to address the persistent inequities and challenges in the fight against malaria. Eliminating malaria will require a multifaceted approach that prioritizes health equity, invests in innovative tools, and strengthens health systems. As Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, aptly stated, “No one should die of malaria.” By working together, we can turn this vision into reality
References
World Health Organization. World Malaria Report 2024.