The paper by Murray and colleagues ‘Global malaria mortality between 1980 and 2010: a systematic analysis’ published in the February 4 issue of The Lancet suggests that the malaria mortality burden was two times higher than previously reported in the WHO Annual Malaria Report 2011. Murray and colleagues use a mathematical model to predict levels and trends of malaria mortality over a 30-year period (1980-2010) using data, variables and assumptions from 105 countries with local malaria transmission. While WHO uses data from countries to build its report, this study uses a different methodology, based on verbal autopsy, to arrive at its conclusion. And knowing the various tropical diseases that malaria symptoms could be associated with, assuming that most deaths from fever are due to malaria is questionable. So these trends might be possibly overestimated in some countries.
Despite all these considerations, the authors confirm that malaria deaths have decreased in all countries, as stated by WHO, and stress important issues that need to be addressed for further effective malaria control. Better surveillance is needed to gather complete and accurate data, including private and community data. All reported malaria cases should be confirmed by microscopy or rapid diagnostic testing; and with the epidemiological transition of the disease in many African countries, more attention is needed to address malaria prevention in older children and adults. Finally, adequate funding and support are crucial to maintain the gains already achieved and sustain efforts to reduce mortality further.
AMREF firmly believes that this study is a call for action. Governments, donors and partners need to reinforce and renew their commitment to scale up interventions, strengthen health and community systems and build strong partnerships at all levels to meet strategic goals and eliminate malaria in Africa.