World Malaria Day 2024
Message of the WHO Regional Director for Africa, Dr Matshidiso Moeti
Malaria has been a priority health problem in the African region over the past decades. It remains a leading cause of illness, hospital admissions, and deaths, especially in young children and pregnant women.
We appreciate the progress made over the last two decades.
Since 2000, the world has mobilized more than US$50 billion to support malaria control and elimination efforts, and as a result, 2.1 billion malaria cases and 11.7 million malaria deaths were averted in the period 2000–2022.
This investment reduced the malaria mortality rate by half, from about 29 deaths per 100 000 population at risk in 2000 to 14.3 in 2022—despite the COVID-19 pandemic. We’ve recorded milestones toward malaria elimination; Cabo Verde was recently certified in January 2024, after Algeria in 2017.
In 2023, WHO approved the second malaria vaccine, R21/MatrixM, after RTS,S in 2021. Both vaccines will be rolled out in 19 countries in the African region this year; they’ll provide new hope for hundreds of thousands of children at risk of dying from malaria.
As countries make progress, families are yielding dividends in terms of well-being.
Charity Damoah, a 36-year-old woman, lost count of the number of times she was admitted to hospital with malaria while growing up in Sunyani, in Ghana’s Bono region. But things are different now for her two-year-old son, John, who has never had malaria because he has been on preventive medicines, uses a treated bed net and has received vaccines.
However, the African region has reached a crossroad in controlling the disease: Twenty of the most affected countries3 - that contribute more than 85% of cases and deaths - are in our region. Multiple challenges account for this, such as extreme weather events, conflict and humanitarian crises, resource constraints, biological threats, and inequities.
With the international community, we commemorate this 17th World Malaria Day under the theme: “Advancing health equity, gender equality and human rights”, This year’s theme highlights the need to ensure continuous and equitable delivery of malaria services to all who need them despite funding constraints, ensuring adequate coverage of the most vulnerable and at-risk populations with effective interventions.
The last World Malaria Report demonstrates how malaria disproportionately affects vulnerable populations such as young children, pregnant women, rural communities, and displaced populations.
Infants and young children represent about 80% of the mortality, while studies show that children under the age of five from the poorest households in sub-Saharan Africa are five times more likely to be infected with malaria than those from the wealthiest households.
In addition to children and women, other high-risk groups have been identified in some areas, such as refugees, migrants, and internally displaced populations.
In 2019-2022, 41 malaria-endemic countries suffered humanitarian and health emergencies, and about 258 million people needed assistance because of health and humanitarian emergencies in 2022 alone. These populations have poor access to health services and require tailored interventions to fit their needs.
Empowering people to understand and exercise their rights to health through meaningful participation, accountability, and transparency in decision-making processes can improve the demand for quality health services and increase the impact of interventions.
The WHO African Region has been supporting strategic initiatives to maintain and sustain the equitable deployment of malaria control and elimination services.
First, in 2018, WHO and the RBM Partnership catalyzed the “High Burden High Impact” (HBHI) approach, a targeted, data-driven approach to sustainably and equitably address malaria in countries hardest hit by the disease. Through HBHI, malaria affected countries have been tackling the disease by identifying the people who suffer most and making a purposeful effort to reach them with customized packages of interventions and services based on local data and the local disease setting.
The Ministers of Health representing HBHI countries gathered in Yaounde in March 2024 to renew their commitment to the fundamental principle that no one should die from malaria, given the tools and systems available.
With our partners, we will support these countries and others in adapting national monitoring and evaluation frameworks to translate these commitments into concrete actions.
Second, with our partners, we have implemented proven interventions guided by evidence and their amenability to local settings. In 2022, 260 million insecticide treated nets (ITNs) were delivered to sub-Saharan Africa, resulting in 70% of households with at least one ITN and 56% percentage of children under five years and pregnant women sleeping under an ITN. IRS has also been implemented in a few countries in the region. To date, 35 African countries have adopted intermittent preventive treatment in pregnant women (IPTp), with an estimated 42% of pregnant women at risk of malaria receiving three doses of the preventive therapy.
Still, coverage remains well below the target of 80%. Seasonal Malaria Chemoprevention has been implemented in 17 of our Member States, with the average number of children treated per cycle reaching 49 million in 2022. The availability of rapid diagnostic tests (RDTs) and artemisinine based combination therapies (ACTs) increased in 2022, with 90% and 97% of global quantities distributed in sub-Saharan Africa.
Third, with our partners, we support innovation and research to ensure that new strategies and tools that target vulnerable groups can be developed, approved, and rapidly deployed for public health use. In this light, we will continue supporting the malaria vaccine roll out through our strategic initiative, the Accelerated Malaria Vaccine Introduction and Rollout in Africa (AMVIRA), a multi-partner platform designed to mobilize technical and financial assistance to countries to ensure optimal coverage for all eligible children. We will equally support our Member States in implementing two newly recommended classes of dual-ingredient ITNs and other vector control interventions to increase the effect against pyrethroid-resistant malaria vectors.
Finally, we made all this progress thanks to the leadership of governments, global solidarity, and essential resources mobilized by countries and their partners.
I thank the Global Fund, the US President’s Malaria Initiative, GAVI, the Bill and Melinda Gates Foundation, and other bilateral development partners that have mobilized financial and technical resources to support our Member States in continuing to deliver malaria services to affected communities. We will foster effective partnerships and strengthen coordination of the regional malaria response.
World Malaria Day allows us to renew political commitments and bolster malaria prevention and control investments.
I call on the governments of our Member States, affected communities, and partners to keep investing in malaria control and build resilient health systems while strengthening primary health care to ensure that quality services are available to all.
I urge countries to develop surveillance, monitoring and evaluation systems to generate reliable and sub-national data to target interventions and adapt services to the most at-risk groups, accelerating progress toward achieving the SDGs.
Together, we can accelerate our efforts to get back on track and achieve a malaria free Africa.