By Chioma Obinna
LAGOS — A total of 11 African countries showed a greater than 50 per cent reduction in either confirmed malaria cases or malaria admissions and deaths over the past decade, a new World Malaria Report has revealed .
The report released yesterday by the World Health Organisation, WHO, also showed a decrease of more than 50 per cent in the number of confirmed cases of malaria found in 32 of the 56 malaria-endemic countries outside Africa between 2008 and 2010, while downward trends of 25 per cent – 50 per cent were seen in eight additional countries.
Morocco and Turkmenistan were certified by the Director-General of WHO in 2009 as having eliminated malaria. In 2009, the WHO European Region reported no cases of plasmodium falciparum malaria for the first time.
Reacting to the report which further proved that a massive scale-up in malaria control programes between 2008 and 2010 resulted in the provision of enough insecticide-treated mosquito nets, ITNs, to protect more than 578 million people at risk of malaria in sub-Saharan Africa,WHO Director-General, Dr Margaret Chan said: “The results set out in the report are the best seen in decades.
“After so many years of deterioration and stagnation in the malaria situation, countries and their development partners are now on the offensive. Current strategies work.”
Further highlighting the transformation that is taking place, Chan noted that the report also showed that indoor residual spraying has also protected 75 million people, or 10 per cent of the population at risk in 2009.
In the views of the UN Secretary_General’s Special Envoy for Malaria, Ray Chambers, “The phenomenal expansion in access to malaria control interventions is translating directly into lives saved, as the WHO World Malaria Report 2010 clearly indicates.”
He said “The strategic scale_up that is eroding malaria’s influence is a critical step in the effort to combat poverty_related health threats. By maintaining these essential gains, we can end malaria deaths by 2015.”
However, the strategies to fight malaria continue to evolve. Earlier this year, WHO recommended that all suspected cases of malaria be confirmed by a diagnostic test before antimalarial drugs are administered. It is no longer appropriate to assume that every person with a fever has malaria and needs antimalarial treatment.
Inexpensive, quality_assured rapid diagnostic tests are now available that can be used by all health care workers, including at peripheral health facilities and at the community level. Using these tests improves the quality of care for individual patients, cuts down the over_prescribing of artemisinin_based combination therapies (ACTs) and guards against the spread of resistance to these medicines.
While progress in reducing the burden of malaria has been remarkable, resurgences in cases were observed in parts of at least three African countries ( Rwanda , Sao Tome and Principe and Zambia ). The reasons for these resurgences are not known with certainty but illustrate the fragility of malaria control and the need to maintain intervention coverage even if numbers of cases have been reduced substantially.
The report stressed that while considerable progress has been made, much work remains in order to attain international targets for malaria control financial disbursements reached their highest ever levels in 2009 at US$1.5 billion, but new commitments for malaria control appear to have levelled_off in 2010, at US$1.8 billion.
The amounts committed to malaria, while substantial, still fall short of the resources required for malaria control, estimated at more than US$6 billion for the year 2010.
It also stated that in 2010, more African households (42%) owned at least one ITN, and more children under five years of age were using an ITN (35%) compared to previous years. Household ITN ownership reached more than 50% in 19 African countries.
The percentage of children using ITNs is still below the World Health Assembly target of 80% partly because up to the end of 2009, ITN ownership remained low in some of the largest African countries.
“The proportion of reported cases in Africa confirmed with a diagnostic test has risen substantially from less than 5 per cent at the beginning of the decade to approximately 35 per cent in 2009, but low rates persist in the majority of African countries and in a minority of countries in other regions.
By the end of 2009, 11 African countries were providing sufficient courses of ACTs to cover more than 100 per cent of malaria cases seen in the public sector; a further 5 African countries delivered sufficient courses to treat 50 per cent–100 per cent of cases. These figures represent a substantial increase since 2005, when only five countries were providing sufficient courses of ACT to cover more than 50 per cent of patients treated in the public sector.
According to the report, “The number of deaths due to malaria is estimated to have decreased from 985 000 in 2000 to 781 000 in 2009. Decreases in malaria deaths have been observed in all WHO Regions, with the largest proportional decreases noted in the European Region, followed by the Region of the Americas . The largest absolute decreases in deaths were observed in Africa.