Malaria features

WHO AFRO Brazza20day2004200631The 31% decline in malaria incidence and 49% drop in numbers of malaria deaths in the period 2000–2012 has been largely due to the expanded use of insecticide-treated nets (ITNs). This is a highly cost–effective intervention, with nets usually provided free or at a heavily subsidized price.

Scale up of ITN use in the Region was deployed in two steps.

Between 2005 and 2008, a mortality reduction objective was pursued through targeting ITN distribution to the two most vulnerable populations – pregnant women and children less than 5 years of age. As a result, ITN distribution was linked with other effective interventions such as antenatal care services and routine immunization.

By 2009, the strategy of universal access was introduced to better scale up ITN ownership and use. Thus nationwide distribution of ITN to all populations at risk was adopted. Therefore by the end of 2012, all countries had adopted a policy on universal coverage with ITNs defined as two ITNs for two people at risk of malaria.

This better scale-up strategy resulted in ITNs being distributed free in 39 of the 44 malaria-endemic countries of the Region,  including distribution through antenatal clinics in 34 countries and through Expanded Programme on Immunization clinics in 26 countries.

The percentage of households owning at least one ITN was estimated to be 53% at the end of 2012, while the population sleeping under an ITN was estimated as 36% in 2012. The proportion of the population sleeping under an ITN remained an estimated 36% in 2013. However, the percentage of children and pregnant women using nets still remains significantly below the 80% target set by the World Health Assembly.

    1. African populations are extremely affected by malaria
      Malaria is caused by blood parasites transmitted from person to person through the bites of infected mosquitoes. In the absence of prompt and effective treatment, malaria often causes death.
      Most malaria cases (88%) and deaths (90%) occurred in the WHO African Region in 2015.

      Malaria causes avoidable and often catastrophic spending for households and is an obstacle to the development of affected African communities and nations.

    2. Mothers and children
      Malaria remains a major killer of children, particularly in sub-Saharan Africa, taking the life of a child every 2 minutes. In 2015, there were 438 000 deaths from malaria globally, and about 306 000 of these were in children under 5 years of age.

      In the African Region, the estimated number of malaria deaths in children under 5 fell from 694 000 in 2000 (range: 569 000–901 000) to 292 000 in 2015 (range: 212 000–384 000).

      Malaria episodes in pregnant women cause anemia, and other complications in the mother and newborn child.

    3. People living with HIV/AIDS
      People living With HIV/AIDS have a higher risk of recurrent malaria episodes and severe malaria.

    4. Fighting malaria contributes to the attainment of several Millenium Development Goals (MDGs)
      Reducing malaria burden contributes in particular to the attainment of the Millennium Development Goal 4 target of reducing under-five mortality by two-thirds by 2015 but also to MDGs related to poverty reduction, education, and maternal health.

    5. African leaders committed to the reduction of malaria burden
      African heads of states and governments have committed to leading the reduction of malaria burden through ensuring universal access of exposed populations to essential malaria prevention and treatment interventions.

    6. Malaria burden can be reduced in Africa
      Between 2000 and 2015, the estimated number of malaria cases declined by 88% while malaria death rates declined by 90% in the African Region. This is as a result of the scale-up of use of insecticide-treated nets, indoor residual spraying, intermittent preventive treatment during pregnancy and artemisinin-based combination therapy.

    7. Health systems strengthening and malaria control have reciprocal beneficial effects.
      Access to services and prevention and treatment interventions, procurement and supply of quality medicines and commodities, diagnostic capacity; routine surveillance, monitoring and evaluation concur to systems strengthening and progress towards national and international targets.

    8. Engagement of all stakeholders is critical to intensify the fight against malaria
      The support of all development partners to malaria control and other disease control programmes, maternal and child healt as well as education must be integrated in the broader context of a sustainable environment and development.

    9. WHO advocates for the scale-up of proven cost/effective malaria control interventions.
      WHO in collaboration with international, continental and regional partners advocates and provides normative guidance and technical assistance for the scale-up of essential interventions in order to reverse the incidence of malaria.

    10. Primary health care and community empowerment and involvement are critical for the success of malaria control and progress towards its elimination
      All African communities must own and take part in the fight against malaria, provide human and financial resources and develop alliances to conquer the scourge of malaria.