The War on Malaria is Far from Being Won

World Malaria Day, 2016

Malaria remains a big public health challenge and a leading cause of death, with 400,000 deaths annually across the globe. Africa is the most affected continent in this respect, bearing 91% of all malaria deaths and a similar percentage of malaria cases.

Malaria is responsible for a significant proportion of the health care burden in Africa, with the most affected people being the most vulnerable – young children under five and pregnant mothers. The World Malaria Day will be marked on April 25, and while it is important to take stock of how far we have come in the war against this deadly infection, we must now take concrete steps to end it once and for all.

Global efforts in the past 15 years of the Millennium Development Goals – including distribution of insecticide-treated nets, improved diagnostics and access to treatment – saw a significant reduction of 65% in malaria-related deaths between 2000 and now.

Despite the huge gains, we are still losing a thousand people to malaria every day in Africa. The WHO’s global strategy for malaria aims to reduce the current number of cases by 90% by the year 2030. For us to achieve this certain things need to be done.

One of these vector interventions that have so far provided the biggest success in reducing malaria cases – up to 60-65% of the reduction – is the distribution and use of insecticide-treated nets to communities. We know that about 55% of the population in Africa sleeps under insecticide-treated nets, which has gone a long way in decreasing the incidence of malaria.

Vector control through residual spraying has been quite effective too, both driven by government or done regularly by individuals in their homes. Beyond that, we have made a lot of progress in diagnostics; for many years identification of malaria was done microscopically, a service that was not available in many rural health facilities, making it inaccessible for many people and communities. The design and deployment of rapid diagnosis test kits, which are cheap and easy to use with minimal training has contributed significantly to correct diagnosis and treatment for malaria. Together with WHO-recommended artemisinin-based combination therapy, these measures have brought down malaria deaths significantly.

Eventually, vaccines will be the final deathbed for malaria and we applaud efforts to develop a malaria vaccine like the one recently endorsed by WHO advisory committee for limited demonstrations through the efforts of GlaxoSmithKline and Bill and Melinda Gates Foundation.

While we celebrate these successes, it is worrying that funding for malaria has declined in recent years as focus and financial support shifts to HIV and maternal child health funding. Amref Health Africa believes that strengthening of health systems and training of health workers to tackle these and other health challenges are important, but we will also continue to ensure provision of nets, test kits and artemisinin combination therapy. If we do not continue the onslaught on malaria, we risk rolling back and losing all the gains made so far.

Amref Health Africa is in a vantage position in Africa to understand the challenge of malaria. We are headquartered in Africa and are currently working with governments in Uganda, Kenya, Tanzania and Ethiopia to strengthen health systems in order to reduce death and illness caused by malaria.

Amref Health Africa was awarded A1 Ranking by the Global Fund for its high project performance and contribution towards improvement of health outcomes at the community level and is Principal Recipient of the Global Fund for Malaria and TB working with communities in the endemic area of western Kenya to improve case management, treatment, surveillance and also to train communities on prevention of malaria.

We are calling upon the world and national governments to continue funding malaria programmes so that together with other players in the health care and development sectors we can safeguard the gains made and move towards elimination of malaria. Besides external donor funding, domestic funding and building of partnerships with the private sector are critical to ensuring progress and sustainability. The private sector has everything to gain by reduced malaria cases which result in enormous time lost from work.

In conclusion, we know that to achieve the WHO Global Malaria Strategy by 2030, we have to reduce the deaths and malaria cases by 90% each. It is estimated that to do this, we will need to triple the current budget; which is about US$2.7 billion dollars and only % of health sector funding, to about US$9 billion. Using a combination of domestic resources through government and private sector as well as global funding we can ensure that the work we have started continues and that we end malaria for good.

Dr Githinji Gitahi
Group CEO
Amref Health Africa