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Countries have managed to stave off Covid-19-linked setbacks to malaria prevention, testing and treatment in 2021, according to a recent World Health Organization report.
An estimated 6,19,000 malaria deaths were reported in 2021, compared to 6,25, 000 in the first year of the pandemic, said the latest ‘World Malaria Report’. In 2019, before the pandemic struck, the number of deaths stood at 5,68, 000.
Globally, malaria cases continued to rise between 2020 and 2021, but were slower than in the 2019-2020 period. The global tally of malaria cases reached 247 million in 2021, compared to 245 million in 2020 and 232 million in 2019.
India, also a country with a high disease burden, showed a decline in deaths. However, organisations working on malaria control pointed to the difference in the domestic and WHO data on malaria, and called for better reporting (notifying) of cases treated in private institutions.
“Following a marked increase in malaria cases and deaths in the first year of the Covid-19 pandemic, malaria-affected countries redoubled their efforts and were able to mitigate the worst impacts of Covid-related disruptions to malaria services,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.
India numbers
Tags distributed by World Health Organisation (WHO) for awareness to control vector-borne diseases (File photo)
The WHO African Region accounted for the largest burden globally with four nations responsible for over half of all malaria deaths.
The WHO’s South-East Asia Region accounted for about 2 per cent of the malaria cases globally, of which, India was responsible for 79 per cent of cases. India accounted for 82.4 per cent of all malaria deaths in the WHO South-East Asia Region in 2021.
The report reflected the difference between WHO estimates of India’s malaria burden — approximately 4.3 million — and officially reported figures as per government data is pegged at approximately 1,60,000, said a note from Malaria No More (MNM), a US-based non-government organisation.
Pratik Kumar, Country Director (MNM-India) explained, “WHO estimates likely differ from official government figures on account of the majority of cases being diagnosed and treated in the private health sector. Identifying and integrating mechanisms to enforce the notifiable status of malaria and include data from the private health sector is imminent to assess the true disease burden of our country.”
Vector control
India accounted for 82.4 per cent of all malaria deaths in the WHO South-East Asia Region in 2021
On controlling malaria, the report said, insecticide-treated bednets (ITNs) were the primary vector control tool used in most malaria-endemic countries, and in 2020, countries distributed more ITNs than in any year on record. In 2021, of the 171 million ITNs planned for distribution, 128 million (75 per cent) were distributed.
However, eight countries (Benin, Eritrea, Indonesia, Nigeria, Solomon Islands, Thailand, Uganda and Vanuatu) distributed less than 60 per cent of their ITNs, and seven countries (Botswana, Central African Republic, Chad, Haiti, India, Pakistan, and Sierra Leone) did not distribute any ITNs, the WHO said.
Despite supply chain and logistical challenges during the pandemic, malaria-endemic countries distributed a record number of rapid diagnostic tests (RDTs) to health facilities in 2020. In 2021, countries distributed 223 million RDTs, a similar level reported before the pandemic.
Convergence of threats
Disruptions during the pandemic and converging humanitarian crises, health system challenges, restricted funding, rising biological threats and a decline in the effectiveness of core disease-cutting tools threaten the global response to malaria, the report said.
Total funding for malaria in 2021 was $3.5 billion, an increase from the two previous years but well below the estimated $7.3 billion required globally to stay on track to defeat malaria, a note on the report said.
Research pipeline
In 2021, countries distributed 223 million rapid diagnostic tests, a similar level reported before the pandemic
Meanwhile, a robust research and development pipeline is set to bring out a new generation of malaria control tools.
Opportunities included long-lasting bednets with new insecticide combinations and other innovations in vector control, including targeted baits that attract mosquitoes, spatial repellents, and genetic engineering of mosquitoes.
New diagnostic tests are also under development, as are next-generation life-saving medicines to respond to antimalarial drug resistance, the WHO said.
From late 2023, children living in areas of highest risk of illness and death from malaria are also expected to benefit from the life-saving impact of the world’s first malaria vaccine ‘RTS,S’. Other malaria vaccines are in the product development pipeline, it added.
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