The 2016 World Malaria Report (WMR) follows a familiar theme: a positive accounting of successes to-date with a strong undercurrent regarding the need for better funding. In her foreword to the report, Dr. Margaret Chan, Director-General for the World Health Organization, highlights the progress in sub-Saharan Africa as people gain access to bed nets and other tools to fight the disease. At the same time, she stresses that if the World Health Organization is to meet its 2030 goals set in 2015, global funding needs to increase on a drastic scale.
INCIDENCE AND MORTALITY PROGRESS
According to the 2016 report, the global tally of malaria incidence reached 212 million cases resulting in 429,000 deaths compared to the previous year’s report citing 214 million new cases of malaria and 438,000 deaths. This amounts to a <1% decrease in malaria cases and a 2% reduction in deaths vs. 2015 numbers. Once again, the incidence decline is attributed to a number of interventions, particularly the increase of bed net usage throughout sub-Saharan Africa. The report states that more than half (53%) of the at-risk population in sub-Saharan Africa slept under a treated net in 2015 compared to 30% in 2010.
To accelerate and track the fight against Malaria, the 2015 World Health Assembly endorsed the World Health Organization (WHO) Global Technical Strategy for Malaria, a 15-year malaria framework for all countries working to control and eliminate malaria. It set ambitious but ostensibly attainable goals for 2030, with milestones along the way to track progress. As part of the 2030 Sustainable Development Goals, one milestone calls for the elimination of malaria in at least 10 countries by 2020 – a goal that would appear to be well within reach. The 2016 report reveals that 10 countries and territories reported fewer than 150 locally-acquired cases of malaria in the previous year. Another nine countries reported between 150 and 1000 cases. However, the progress toward a 40% total reduction in case incidence and mortality by 2020 needs to be accelerated. The 2016 WMR indicates that less than half of the 91 malaria-affected countries are on track to achieve that important milestone.
Threatening the success of the malaria-related Sustainable Development Goals is the significant disparity between needed versus actual funding. To reach the ambitious goals set for 2030, the WHO stated clearly that funding targets would go hand-in-hand with the incidence and mortality milestones. Unfortunately, funding is far short. In 2015, while malaria financing totaled US$ 2.9 billion – increasing by just US$ 0.06 billion since 2010 – this total represents less than half (46%) of the 2020 milestone of US$ 6.4 billion. To achieve the global targets, contributions from both domestic and international sources must increase substantially. With the funding, the WHO will focus on vector-control and strengthening the fragile health systems throughout areas most affected by malaria.
TOWARD THE FUTURE
Despite the funding shortfalls, there are a number of promising indicators in the fight against malaria over the past five years. According to the country profiles within the report, the number of countries recommending larval control as an intervention strategy rose 92% between 2011 and 2016. Looking forward, the emphasis will be on raising more funds while still placing a strong focus on integrated vector-control strategies to reach the 2030 goals.