Briefs

WHAT YOU SHOULD KNOW

Malaria is a serious and often fatal disease caused by a bite from a mosquito infected with the malaria parasite. People with malaria suffer from high fevers, shaking chills, flu-like symptoms, and — in severe cases — meningitis and even death. Malaria typically occurs in tropical and subtropical areas of the world, putting more than half of the world’s population at risk.

In 2016 alone, there were an estimated 216 million new cases of malaria, resulting in approximately 445,000 deaths worldwide, an increase from the previous year. Children under age 5 accounted for 64% of these fatalities. One child dies every two minutes for lack of simple, cost-effective tools such as an insecticide-treated net or a course of treatment.[1]

Broader use of cost-effective malaria interventions between 2000 and 2016 including insecticide-treated bed nets to protect against mosquitos, indoor residual spraying, antimalarial medication, and rapid diagnostic tests helped reduce malaria mortality rates by 62% and disease incidence rates by 41% globally.   

Since its launch in 2005, the President’s Malaria Initiative (PMI) has procured more than 268 million long-lasting insecticide-treated bed nets to prevent infection, 350 million rapid diagnostic tests, and more than 479 million antimalarial treatments.[2]

As of 2017, the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) had distributed 795 million insecticide-treated bed nets[3] and treated 668 million cases of the disease.

RECOMMENDATIONS FOR CONGRESS

Maintain strong, bipartisan support for PMI and the Global Fund. Malaria elimination efforts are at a crossroads, as progress has stalled for the first time since the global community came together to fight the disease. Sustained support is needed to address issues and regain momentum.

Build on the progress achieved to create a malaria-free future and eliminate the threat of resurgence. The worldwide effort to eliminate malaria is at a tipping point. While many of the 91 countries where malaria is endemic are progressing toward disease elimination, others are unfortunately experiencing plateaued progress or even regression.

Encourage donors and the administration to support country- and region-specific malaria elimination efforts. The end of malaria also means the end of recurring costs for treatment and control of the disease, an end to missed school and work days, and an end to the needless deaths and disability of millions of children and adults. With new tools on the horizon and strong partnerships and programs in endemic countries, renewed enthusiasm and funding are both critical to reaching the long-term goal of disease eradication.

Continue investing in the research and development (R&D) of new tools and approaches that hold the promise of controlling and eliminating the disease, including those needed to combat drug and insecticide resistance. Consideration must be given to the long-term benefits of U.S. leadership in R&D and the need for new tools to accelerate progress towards ending malaria, such as next-generation diagnostics, novel insecticides, and vaccines.

The U.S. Agency for International Development (USAID) must continue to raise awareness of the links between malaria and other leading causes of death for children under age 5. Linking malaria elimination programs with malnutrition-, pneumonia-, and diarrhea-prevention efforts will help maximize efficiencies and achieve greater results.

Credit: United Nations Foundation/Stuart Ramson

WHY THIS INVESTMENT IS IMPORTANT

The United States is the global leader in the fight against malaria. Under the leadership of President George W. Bush, PMI was launched in 2005 as a five-year, $1.265 billion expansion of the U.S. government contribution to malaria control. Due to its marked success, PMI has expanded to include programs in 27 high-burden sub-Saharan African countries and in the Greater Mekong Subregion of Southeast Asia under Presidents Obama and Trump. The United States is also a major contributor to the Global Fund, which has provided more than 795 million insecticide-treated nets[4] and treated more than 668 million cases of malaria to date.[5]

U.S. funding supports the implementation of malaria prevention and treatment activities around the world, as well as the development of malaria vaccines, antimalarial drugs, diagnostics, insecticides, and other malaria-related research. The world now has the opportunity to end malaria once and for all, within a generation. It is imperative that the United States continues to lead and support all countries working to eliminate malaria and the needless death it causes around the world.

The remarkable progress achieved to date in fighting malaria is the result of coordinated action between U.S. government bilateral and multilateral programs, country-coordinating mechanisms, multilateral agencies, and private-sector partners. The accessibility and availability of lifesaving malaria interventions have played a particularly important part in this progress, thanks to increased funding and political support from the United States and other major donors. Investments in R&D have resulted in the drugs, insecticides, and diagnostic tools in use today, which have brought the world closer to the first-ever malaria vaccine. Bilateral and multilateral malaria prevention programs have also been crucial for protecting U.S. military personnel serving in countries where malaria is endemic. Disease intervention efforts have also helped to strengthen health systems in endemic countries.

Globally, the gains made against malaria are fragile; retreating on investment now would not only stall the progress realized to date, but create a pathway for the disease to return. The 2017 World Health Organization (WHO) report on world malaria showed a stagnation of progress in defeating the disease, due to political instability, domestic donor decline, and insecticide and drug resistance, among other issues. Although not new to the malaria fight, drug resistance looms ever larger as a deadly threat today. Artemisinin is considered the gold standard for antimalarial drugs and is currently the basis of first-line treatment around the world. However, the emergence of artemisinin resistance in the Greater Mekong Subregion threatens the sustainability of recent progress, not only in the region but worldwide.

The benefits of ending malaria would be significant: lower health care costs, higher productivity, increased capacity to respond to disease outbreaks, and a blueprint that could be used against other diseases of poverty. Only with sustained support of U.S. government malaria programs, coupled with the use of existing tools and the creation of new ones, will we be able to eradicate malaria altogether.

Resources

  1. WHO World Malaria Report 2017 https://bit.ly/2jy03Dd
  2. PMI 12th Annual Report to Congress 2018 https://bit.ly/2ME7Qvy
  3. PMI by the Numbers 2018 https://bit.ly/2QDj3Qk
  4. Global Fund Statistics on Malaria https://bit.ly/2sPULFz

Contributors

Brandon Ball, PATH, bball@path.org
Jodie Curtis, American Society of Tropical Medicine & Hygiene, jodie.curtis@dbr.com
Jacci Guy, United Nations Foundation, jguy@unfoundation.org


Citations

[1] “Key points: World malaria report 2017,” WHO. https://bit.ly/2jy03Dd.

[2] “The President’s Malaria Initiative: 12th Annual Report to Congress,” PMI, 2018. https://bit.ly/2ME7Qvy.

[3] “The Fight Against Malaria,” The Global Fund, 2018. http://bit.ly/2RYgloK.

[4] “The Fight Against Malaria,” The Global Fund, 2018. http://bit.ly/2RYgloK.

[5] “President’s Malaria Initiative by the Numbers,” PMI, 2018. https://bit.ly/2QDj3Qk.

©2019 Global Health Council