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m a l ari a a t l a s p r o j e ctWORLD MALARIA REPORT20200202TROPERAIRALAMDLROWFor further information please contact:Global Malaria ProgrammeWorld Health Organization20, avenue AppiaCH-1211 Geneva 27Web: www.who.int/malariaEmail: infogmp@who.intY EA R S O F GL O B A L P R O G R E S S & C H A L L E N G ES World malaria report 2020: 20 years of global progress and challengesISBN 978-92-4-001579-1 (electronic version)ISBN 978-92-4-001580-7 (print version)© World Health Organization 2020Some rights reserved. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
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In no event shall WHO be liable for damages arising from its use.Map production: WHO Global Malaria Programme and WHO Public Health Information and Geographic Systems.Layout: Claude Cardot/designisgood.infoCover design: Lushomo (Cape Town, South Africa)Please consult the WHO Global Malaria Programme website for the most up-to-date version of all documents (https://www.who.int/teams/global-malaria-programme).Printed in LuxembourgContentsForeword Acknowledgements Abbreviations and acronyms This year’s report at a glance 1. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Introduction 2.
Malaria milestones, 2000–2020 Laying the foundations 2.1 2.2 2000–2004 2.3 2005–2010 2.4 2011–2015 2.5 2016–2019 viixxiixiv122468123. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Global trends in the burden of malaria 18183.1 Global estimates of malaria cases and deaths, 2000–2019 223.2 Estimated malaria cases and deaths in the WHO African Region, 2000–2019 3.3 Estimated malaria cases and deaths in the WHO South-East Asia Region, 2000–2019 243.4 Estimated malaria cases and deaths in the WHO Eastern Mediterranean Region, 2000–2019 26283.5 Estimated malaria cases and deaths in the WHO Western Pacific Region, 2000–2019 3.6 Estimated malaria cases and deaths in the WHO Region of the Americas, 2000–2019 30313.7 Estimated malaria cases and deaths in the WHO European Region, 2000–2019 323.8 Cases and deaths averted since 2000, globally and by WHO region 343.9 Burden of malaria in pregnancy 4. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Elimination 4.1 Malaria elimination certification 4.2 E-2020 initiative 4.3 The Greater Mekong subregion 4.4 Prevention of re-establishment 5. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
High burden to high impact approach Improving WHO’s malaria policy-making and dissemination processes 5.1 Galvanizing political will, mobilizing resources and mobilizing community response 5.2 Using strategic information to drive impact 5.3 5.4 Coordinated response 5.5 Malaria in HBHI countries since 2018 5.6 Reported malaria cases in HBHI countries since 2018 and comparisons with estimated cases 6. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Investments in malaria programmes and research 6.1 Funding trends for malaria control and elimination 6.2 Investments in malaria-related R&D 7.
Distribution and coverage of malaria prevention, diagnosis and treatment 7.1 Distribution and coverage of ITNs 7.2 Population protected with IRS 7.3 Scale-up of SMC 7.4 Coverage of IPTp use by dose 7.5 Malaria diagnosis and treatment 8. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Global progress towards the GTS milestones 8.1 Global progress 8.2 WHO African Region 8.3 WHO Region of the Americas 8.4 WHO Eastern Mediterranean Region 8.5 WHO South-East Asia Region 8.6 WHO Western Pacific Region 38383840414242454848484852525658586263646570707476787980iiiWORLD MALARIA REPORT 2020 9. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Biological threats 9.1 Deletions in P. falciparum histidine-rich protein 2 and protein 3 genes 9.2 Therapeutic efficacy of ACTs 9.3 The global prevalence of PfKelch13 molecular mutations 9.4 Vector resistance to insecticides 10. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Malaria response during the COVID-19 pandemic 10.1 The 2020 COVID-19 pandemic 10.2 Global workstreams on sustaining the malaria response during the COVID-19 pandemic 10.3 Global highlights in the malaria response during the COVID-19 pandemic 10.4 Country responses to mitigate global service disruptions 10.5 Levels of service disruption by country and implications for delivery of interventions 10.6 The consequences of service disruptions during the COVID-19 pandemic 11. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Key results, context and conclusion 11.1 Key results 11.2 The enabling environment and threats to the malaria progress 11.3 Consequences of the COVID-19 pandemic 11.4 Building a more prosperous future 11.5 Concluding remarks References Annexes 82828388889292959698100104106106107112113115116123ivvWORLD MALARIA REPORT 2020 ForewordDr Tedros Adhanom GhebreyesusDirector-GeneralWorld Health OrganizationIn this year’s World malaria report, WHO reflects on key milestones that have shaped the global response to the disease over the last 2 decades – a period of unprecedented success in malaria control that saw 1.5 billion cases averted and 7.6 million lives saved.Following the end of the Global Malaria Eradication Programme in 1969, reduced political commitment and funding for malaria control led to resurgences of the disease in many parts of the world – particularly in Africa. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
While reliable data are scarce, hundreds of millions of people were likely infected with malaria, and tens of millions died.Beginning in the 1990s, senior health leaders and scientists charted a course for a renewed response to malaria. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Stepped-up investment in research and innovation led to the development of new disease-cutting tools, such as insecticide-treated nets, rapid diagnostic tests and more effective medicines.The creation of new financing mechanisms – notably the Global Fund to Fight AIDS, Tuberculosis and Malaria and the US President’s Malaria Initiative – coupled with a steep increase in malaria funding, enabled the wide-scale deployment of these tools, contributing to reductions in disease and death on a scale that had never been seen before.Robust political commitment in Africa was key to success. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Through the landmark 2000 Abuja Declaration, African leaders pledged to reduce malaria mortality on the continent by 50% over a 10-year timeframe.According to our report, global malaria mortality fell by 60% over the period 2000 to 2019.
The African Region achieved impressive reductions in its annual malaria death toll – from 680 000 in 2000 to 386 000 in 2019.Countries in South-East Asia made particularly strong progress, with reductions in cases and deaths of 73% and 74%, respectively. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
India contributed to the largest drop in cases region-wide – from approximately 20 million to about 6 million.Twenty-one countries have eliminated malaria over the last 2 decades and, of these, 10 countries were officially certified by WHO as malaria free. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Countries of the Greater Mekong continue to make major gains, with a staggering 97% reduction in cases of P. falciparum malaria seen since 2000 – a primary target in view of the ongoing threat posed by antimalarial drug resistance.A plateau in progressProgress made since the beginning of the millennium has been truly astonishing. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
However, as seen in this report, the gains have levelled off – a trend observed over recent years.In 2017, WHO warned that the global response to malaria had reached a “crossroads”, and that key targets of WHO’s global malaria strategy would likely be missed. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Three years on, we continue to see a plateau in progress; according to our latest report, the strategy’s 2020 targets for reductions in disease and death will be missed by 37% and 22%, respectively.In 2020, COVID-19 emerged as an added – and formidable – challenge to malaria responses worldwide.
In line with WHO guidance, many countries have adapted the way they deliver nets, diagnostics and medicines to ensure the safety of frontline health workers and communities. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
I wholeheartedly applaud these efforts, without which we would have likely seen much higher levels of mortality.However, according to new WHO projections, even moderate disruptions in access to effective treatment could lead to a considerable loss of life. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
The report finds, for example, that a 25% disruption in access to effective antimalarial treatment in sub-Saharan Africa could lead to 46 000 additional deaths.Reigniting progressTo reinvigorate progress, WHO catalysed the “high burden to high impact” (HBHI) approach in 2018, together with the RBM Partnership to End Malaria. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
The response is led by 11 countries – including 10 in sub-Saharan Africa – that account for approximately 70% of the world’s malaria burden.HBHI countries are moving away from a one-size-fits-all approach to malaria control – choosing instead to implement tailored responses based on local data and intelligence. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
While it is too early to evaluate the impact of this approach on malaria burden, important groundwork has been laid.A recent analysis from Nigeria, for example, found that through an optimized mix of interventions the country could avert tens of millions of additional cases and thousands of additional deaths by the year 2023, compared with a business-as-usual approach.A better targeting of malaria interventions and resources – particularly in countries like Nigeria, where the disease strikes hardest – will help speed the pace of progress towards our global malaria targets. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Increased funding is also needed at domestic and international levels, together with innovations in new tools and approaches.Crucially, efforts to combat malaria must be integrated with broader efforts to build strong health systems based on people-centred primary health care, as part of every country’s journey towards universal health coverage.It is time for leaders across Africa – and the world – to rise once again to the challenge of malaria – just as they did when they laid the foundation for the progress made since the beginning of this century. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Through joint action, and a commitment to leaving no one behind, we can achieve our shared vision of a world free of malaria.viviiWORLD MALARIA REPORT 2020 AcknowledgementsWe are very grateful to the numerous people who contributed to the production of the World malaria report 2020. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
The following people collected and reviewed data from both malaria endemic and malaria free countries and areas:Ahmad Mureed Muradi, Lutfullah Noori and Mohammad Shoaib Tamim (Afghanistan); Lammali Karima and Houria Khelifi (Algeria); Fernanda Francisco Guimarães and Fernanda Isabel Martins Da Graça Do Espirito Santo Alves (Angola); Malena Basilio and Yael Provecho (Argentina); Raja Alsaloom and Hasan Shuaib (Bahrain); Afsana Khan, Mya Ngon and Anjan K. Saha (Bangladesh); Kim Bautista (Belize); Telesphore Houansou and Aurore Ogouyomi-Hounto (Benin); Tobgyel Drukpa, Phurpa Tenzin and Sonam Wangdi (Bhutan); Raúl Marcelo Manjón Tellería (Bolivia [Plurinational State of]); Kentse Moakofhi, Mpho Mogopa, Davis Ntebela and Godira Segoea (Botswana); Cristianne Aparecida Costa Haraki, Franck Cardoso de Souza, Keyty Costa Cordeiro, Anderson Coutinho da Silva, Poliana de Brito Ribeiro Reis, Paloma Dias de Sousa, Francisco Edilson Ferreira de Lima Júnior, Klauss Kleydmann Sabino Garcia, Gilberto Gilmar Moresco, Marcela Lima Dourado, Paola Barbosa Marchesini, Márcia Helena Maximiano de Almeida, Joyce Mendes Pereira, Ronan Rocha Coelho, Edília Sâmela Freitas Santos, Pablo Sebastian Tavares Amaral and Marcelo Yoshito Wada (Brazil); Cheick S. Compaore and Laurent Moyenga (Burkina Faso); Dismas Baza and Juvénal Manirampa (Burundi); Carolina Cardoso da Silva Leite Gomes and Antonio Lima Moreira (Cabo Verde); Tol Bunkea (Cambodia); Abomabo Moise Hugue Rene and Etienne Nnomzo’o (Cameroon); Aristide Désiré Komangoya-Nzonzo and Christophe Ndoua (Central African Republic); Mahamat Idriss Djaskano and Honoré Djimrassengar (Chad); Wei Ding and Li Zhang (China); Eduin Pachón Abril (Colombia); Affane Bacar, Mohamed Issa Ibrahim and Ahamada Nassuri (Comoros); Hermann Ongouo and Jean-Mermoz Youndouka (Congo); Teresita Solano Chinchilla (Costa Rica); Tanoh Méa Antoine and N’goran Raphaël N’dri (Côte d’Ivoire); Kim Yun Chol, Nam Ju O and Gagan Sonal (Democratic People’s Republic of Korea); Patrick Bahizi Bizoza, Hyacinthe Kaseya Ilunga, Bacary | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Bahizi Bizoza, Hyacinthe Kaseya Ilunga, Bacary Sambou and Eric Mukomena Sompwe (Democratic Republic of the Congo); Basimike Mulenda (Djibouti); Keyla Urena (Dominican Republic); Monica Caňas Benavides and Julio Rivera (Ecuador); Angela Katherine Lao Seoane and Mathilde Riloha Rivas (Equatorial Guinea); Selam Mihreteab and Assefash Zehaie (Eritrea); Quinton Dhlamini, Kevin Makadzange and Zulisile Zulu (Eswatini); Henock Ejigu, Mebrahtom Haile and Bekele Worku (Ethiopia); Alice Sanna (French Guiana); Ghislaine Nkone Asseko and Okome Nze Gyslaine (Gabon); Momodou Kalleh and Sharmila Lareef-Jah (Gambia); Keziah Malm and Felicia Owusu-Antwi (Ghana); Ericka Lidia Chávez Vásquez (Guatemala); Siriman Camara and Nouman Diakite (Guinea); Inacio Alveranga and Paulo Djatá (Guinea-Bissau); Helen Imhoff (Guyana); Antoine Darlie (Haiti); Engels Banegas, Jessica Henriquez, Carlos Miranda, Jose Orlinder Nicolas, Raoul O’Connor and Nely Romero (Honduras); Neeraj Dhingra and Roop Kumari (India); Guntur Argana, Sri Budi Fajariyani, Herdiana Hasan Basri and M. Kez (Indonesia); Leila Faraji, Fatemeh Nikpoor and Ahmad Raeisi (Iran [Islamic Republic of]); James Kiarie and James Otieno (Kenya); Viengxay Vanisaveth (Lao People’s Democratic Republic); Najib Achi (Lebanon); Moses Jeuronlon and Oliver J. Pratt (Liberia); Mauricette Andrianamanjara, Henintsoa Rabarijaona and Urbain Rabibizaka (Madagascar); Wilfred Dodoli, Austin Gumbo and Michael Kayange (Malawi); Jenarun Jelip (Malaysia); Sidibe Boubacar and Idrissa Cisse (Mali); Lemlih Baba and Sidina Mohamed Ghoulam (Mauritania); Frédéric Pages (Mayotte); Santa Elizabeth Ceballos Liceaga and Gustavo Sánchez Tejeda (Mexico); Balthazar Candrinho, Eva de Carvalho and Guidion Mathe (Mozambique); Md Rahman, Badri Thapa, Aung Thi and Tet Toe Tun (Myanmar); Rauha Jacob, Wilma Soroses and Petrina Uusiku (Namibia); Basu Dev Pandey, Subhash Lakhe and Prakash Prasad Shah (Nepal); Holvin Martin Gutierrez Perez (Nicaragua); Fatima Aboubakar and Hadiza Jackou (Niger); Audu Bala-Mohammed and Lynda Ozor | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Jackou (Niger); Audu Bala-Mohammed and Lynda Ozor (Nigeria); Hammad Habib (Pakistan); Lizbeth Cerezo and Santiago Cherigo (Panama); John Deli (Papua New Guinea); Cynthia Viveros (Paraguay); Cesar Bueno Cuadra (Peru); Raffy Deray, Kate Lopez and Maria Santa Portillo (Philippines); Jeong-Ran Kwon (Republic of Korea); Michee Kabera Semugunzu (Rwanda); Claudina Augusto da Cruz and Jose Alvaro Leal Duarte (Sao Tome and Principe); Mohammed viiiixWORLD MALARIA REPORT 2020 Hassan Al-Zahrani (Saudi Arabia); Ndella Diakhate and Medoune Ndiop (Senegal); Louisa Ganda and Samuel Juana Smith (Sierra Leone); John Leaburi (Solomon Islands); Abdi Abdillahi Ali, Ali Abdulrahmann, Abdikarim Hussein Hassan and Fahim Yusuf (Somalia); Mary Anne Groepe, Patrick Moonasar and Mbavhalelo Bridget Shandukani (South Africa); Harriet Akello Pasquale, Moses Jeuronlon and Moses Nganda (South Sudan); Navaratnasingam Janakan, Sumudu Karunaratna, Prasad Ranaweera and Preshila Samaraweera (Sri Lanka); Mariam Adam, Doha Elnazir and Abdalla Ibrahim (Sudan); Loretta Hardjopawiro (Suriname); Deyer Gopinath and Suravadee Kitchakarn (Thailand); Maria do Rosario de Fatima Mota, Rajesh Pandav and Manel Yapabandara (Timor-Leste); Kokou Mawule Davi and Tchassama Tchadjobo (Togo); Bayo Fatunmbi, Charles Katureebe, Paul Mbaka, John Opigo and Damian Rutazaana (Uganda); Abdullah Ali, Mohamed Haji Ali, Jovin Kitau, Anna Mahendeka, Ally Mohamed, Irene Mwoga and Ritha Njau (United Republic of Tanzania); Wesley Donald (Vanuatu); Licenciada América Rivero (Venezuela [Bolivarian Republic of]); Nguyen Quy Anh (Viet Nam); Moamer Mohammed Badi and Ryboon Saeed Al-Amoudi (Yemen); Japhet Chiwaula, Freddie Masaninga and Mutinta Mudenda (Zambia); and Anderson Chimusoro, Joseph Mberikunashe, Jasper Pasipamire and Ottias Tapfumanei (Zimbabwe).We are grateful to the following people for their contribution: Patrick Walker (Imperial College) contributed to the analysis of exposure to malaria infection during pregnancy and attributable low birthweight. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Andre Marie Tchouatieu and Celine Audibert (Medicines for Malaria Venture [MMV]), and Paul Milligan (London School of Hygiene & Tropical Medicine) contributed to updating the section on seasonal malaria chemoprevention with the most up-to-date information on implementation and coverage.
Manjiri Bhawalkar and Lisa Regis (Global Fund to Fight AIDS, Tuberculosis and Malaria [Global Fund]) supplied information on financial disbursements from the Global Fund. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Adam Aspden and Nicola Wardrop (United Kingdom of Great Britain and Northern Ireland [United Kingdom] Department for International Development), and Adam Wexler and Julie Wallace (Kaiser Family Foundation) provided information on financial contributions for malaria control from the United Kingdom and the United States of America, respectively.
Policy Cures Research used its G-FINDER data in the analysis of financing for malaria research and development, and wrote the associated section. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
John Milliner (Milliner Global Associates) provided information on long-lasting insecticidal nets delivered by manufacturers.
The estimates of Plasmodium falciparum parasite prevalence and incidence in sub-Saharan Africa were produced by Daniel Weiss and Ewan Cameron of Malaria Atlas Project (MAP, led by Peter Gething, Curtin University and Telethon Kids Institute) and Samir Bhatt (Imperial College). | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Samir Bhatt, Amelia Bertozzi-Villa (Institute for Disease Modelling) and MAP collaborated to produce the estimates of insecticide-treated mosquito net (ITN) coverage for African countries using data from household surveys, ITN deliveries by manufacturers and ITNs distributed by national malaria programmes (NMPs).
This research was funded by the Bill & Melinda Gates Foundation. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
With support from WHO, Bala Mohammed Audu, Ibrahim Maikore and Perpetua Uhomoibhi of the Nigeria National Malaria Elimination Programme (NMEP) led the subnational tailoring of interventions in Nigeria and Jaline Gerardin, Aadrita Nandi, Kamaldeen Okuneye, Ifeoma D. Ozodiegwu, Neena Parveen Dhanoa and Manuela Runge of Northwestern University, USA and Monique Ambrose and Caitlin Bever of Institute for Disease Modelling, USA assisted with the modelling of intervention impact projections in support of the Nigeria NMEP. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Modelling of the impact of COVID-19 was contributed to by Peter Gething and Daniel Weiss with inputs from Samir Bhatt, Susan Rumisha (MAP) and Amelia Bertozzi-Villa.
This research was funded by the Bill & Melinda Gates Foundation.
Victor Alegana and Laurissa Suiyanka of Kenya Medical Research Institute (KEMRI) - Wellcome Trust Research Programme provided results of subnational analysis of concentration indices for socioeconomic equity in coverage of interventions, ITNs and treatment seeking. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Tom McLean and Jason Richardson (Innovative Vector Control Consortium [IVCC]) provided national indoor residual spraying coverage and implementation data complementary to reported country information.
Melanie Renshaw (African Leaders Malaria Alliance) and Marcy Erskine (Alliance for Malaria Prevention) provided information on the status of national ITN campaigns during the COVID-19 pandemic. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Richard Steketee (United States President’s Malaria Initiative [PMI]) reviewed the section on the malaria response during the COVID-19 pandemic.
George Jagoe (MMV), Lisa Hare (PMI) and Andrea Bosman (World Health Organization [WHO] Global Malaria Programme [GMP]) contributed to the documentation of the global efforts to mitigate disruptions to diagnostics and antimalarials.
Jennifer Armistead (PMI) Acknowledgementsprovided insecticide resistance data on behalf of PMI. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Gildas Yahouedo (WHO consultant) assisted with data compilation from publications.
Colin Mathers (WHO consultant) and Bochen Cao (WHO Division of Data, Analytics and Delivery for Impact [DDI]) prepared estimates of malaria mortality in children aged under 5 years, on behalf of the Child Health Epidemiology Reference Group. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Yonas Tegegn (WHO Country Representative to Uganda), Bayo Segun Fatunmbi (WHO Uganda Country Office) and Jimmy Opigo (NMP, Uganda) contributed to the documentation on the Mass Action Against Malaria (MAAM) initiative in Uganda.The following WHO staff in regional and subregional offices assisted in the design of data collection forms; the collection and validation of data; and the review of epidemiological estimates, country profiles, regional profiles and sections: ■ Ebenezer Sheshi Baba, Emmanuel Chanda, Akpaka A. Kalu, Steve Kubenga Banza and Jackson Sillah (WHO Regional Office for Africa [AFRO]); ■ Spes Ntabangana (AFRO/Inter-country Support Team [IST] Central Africa); ■ Khoti Gausi (AFRO/IST East and Southern Africa); ■ Abderrahmane Kharchi Tfeil (AFRO/IST West Africa); ■ Maria Paz Ade, Janina Chavez, Rainier Escalada, Blanca Escribano, Roberto Montoya, Dennis Navaroo Costa, Eric Ndofor and Prabhjot Singh (WHO Regional Office for the Americas); ■ Samira Al-Eryani and Ghasem Zamani (WHO Regional Office for the Eastern Mediterranean); ■ Elena Chulkova and Elkhan Gasimov (WHO Regional Office for Europe); ■ Risintha Premaratne and Neena Valecha (WHO Regional Office for South-East Asia); and ■ James Kelley (WHO Regional Office for the Western Pacific).The maps for country and regional profiles were produced by MAP’s Data Engineering team funded by the Bill & Melinda Gates Foundation. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
The map production was led and coordinated by Jen Rozier, with help from Joe Harris and Suzanne Keddie. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Tolu Okitika coordinated MAP’s contribution to this report.We are also grateful to Kevin Marsh (University of Oxford), Emelda Okiro (Kenya Medical Research Institute – Wellcome Trust Research Programme) and Larry Slutsker (PATH) who graciously reviewed all sections and provided substantial comments for improvement; Nelly Biondi, Diana Estevez Fernandez and Jessica Chi Ying Ho (WHO) for statistics review; Tessa Edejer and Agnès Soucat (WHO) for review of economic evaluation and analysis; Egle Granziera and Claudia Nannini (WHO) for legal review; Martha Quiñones (WHO consultant) and Beatriz Galatas (WHO) for the translation of the foreword and key points into Spanish, and Amélie Latour (WHO consultant) and Laurent Bergeron (WHO) for the translation into French; and Hilary Cadman and the Cadman Editing Services team for technical editing of the report.On behalf of the WHO Global Malaria Programme (GMP), the publication of the World malaria report 2020 was coordinated by Abdisalan Noor. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Significant contributions were made by Pedro Alonso, Laura Anderson, John Aponte, Maru Aregawi, Amy Barrette, Yuen Ching Chan, Tamara Ehler, Lucia Fernandez Montoya, Beatriz Galatas, Mwalenga Nghipumbwa, Peter Olumese, Edith Patouillard, Alastair Robb, David Schellenberg and Ryan Williams.
Laurent Bergeron (WHO GMP) provided programmatic support for overall management of the project. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
The editorial committee for the report comprised Pedro Alonso, Andrea Bosman, Jan Kolaczinski, Kimberly Lindblade, Leonard Ortega, Pascal Ringwald, Alastair Robb and David Schellenberg from the WHO GMP.
Additional reviews were received from colleagues in the GMP: Jane Cunningham, Xiao Hong Li, Charlotte Rasmussen, Silvia Schwarte, Erin Shutes and Saira Stewart. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Report layout, design and production were coordinated by Laurent Bergeron.Funding for the production of this report was gratefully received from the Bill & Melinda Gates Foundation; the Global Fund; the Government of China; the Spanish Agency for International Development Cooperation; Unitaid; the United Nations Office for Project Services (UNOPS); and the United States Agency for International Development (USAID).xxiWORLD MALARIA REPORT 2020 Abbreviations and acronymsACT AIDS AIM AL ALMA AMFm An. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
ANC AQ AS BAU CDC CI CQ CRS DAC artemisinin-based combination therapyacquired immunodeficiency syndromeAction and investment to defeat malaria 2016–2030artemether-lumefantrineAfrican Leaders Malaria AllianceAffordable Medicines Facility-malariaAnopheles antenatal careamodiaquine artesunatebusiness as usualCenters for Disease Control and Preventionconfidence interval chloroquinecreditor reporting systemDevelopment Assistance CommitteeDHA-PPQ dihydroartemisinin-piperaquineDHIS2 DHS E-2020 EDCTP FIND GDP Global Fund GMAP District Health Information Software 2demographic and health surveyeliminating countries for 2020 European and Developing Countries Clinical Trials PartnershipFoundation for Innovative New Diagnosticsgross domestic productGlobal Fund to Fight AIDS, Tuberculosis and MalariaGlobal Malaria Action Plan for a malaria free worldGMP GMS GPARC GTS HBHI HCQ HIV HRP IPTi IPTp IQR IRS IST ITN IVCC LBW LGA LLIN LMIC LSHTM MAAM MAP MCEE MDG MEDB MIS MME MMV Global Malaria ProgrammeGreater Mekong subregionGlobal Plan for Artemisinin Resistance ContainmentGlobal technical strategy for malaria 2016–2030high burden to high impacthydroxychloroquinehuman immunodeficiency virushistidine-rich proteinintermittent preventive treatment in infants intermittent preventive treatment in pregnancyinterquartile range indoor residual sprayingInter-country Support Teaminsecticide-treated mosquito netInnovative Vector Control Consortium low birthweightlocal government authoritylong-lasting insecticidal netlow- and middle-income countriesLondon School of Hygiene & Tropical MedicineMass Action Against MalariaMalaria Atlas ProjectMaternal and Child Health Epidemiology Estimation GroupMillennium Development GoalMalaria Elimination Database malaria indicator surveyMekong Malaria EliminationMedicines for Malaria VentureTES UHC UN UNDP UNICEF therapeutic efficacy studiesuniversal health coverageUnited NationsUnited Nations Development ProgrammeUnited Nations Children’s FundUnited Kingdom United Kingdom of Great US USA USAID Britain and Northern IrelandUnited StatesUnited States of AmericaUnited States Agency for International DevelopmentWHO World Health OrganizationWHO-CHOICE WHO-CHOosing Interventions that are Cost-EffectiveMPAC MQ NMEP NMP NMSP OECD P. PBO pfhrp pLDH PMI PPE PQ PY R&D RAI RDT SAGme SARS-CoV2 SDG SMC SP TDR Malaria Policy Advisory Committeemefloquine National Malaria Elimination Programme national malaria programmenational malaria strategic planOrganisation for Economic Co-operation and DevelopmentPlasmodiumpiperonyl butoxidePlasmodium falciparum histidine-rich proteinPlasmodium lactate dehydrogenasePresident’s Malaria Initiativepersonal protective equipmentprimaquinepyronaridineresearch and developmentRegional Artemisinin-resistance Initiativerapid diagnostic testStrategic Advisory Group for Malaria Eradicationsevere acute respiratory syndrome coronavirus 2Sustainable Development Goalseasonal malaria chemopreventionsulfadoxine-pyrimethamineSpecial Programme for Research and Training in Tropical DiseasesxiixiiiWORLD MALARIA REPORT 2020 This year’s report at a glanceTRENDS IN THE BURDEN OF MALARIAMalaria cases ■ Globally, there were an estimated 229 million malaria cases in 2019 in 87 malaria endemic countries, declining from 238 million in 2000. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
At the Global technical strategy for malaria 2016–2030 (GTS) baseline of 2015, there were 218 million estimated malaria cases.
■ The proportion of cases due to Plasmodium vivax reduced from about 7% in 2000 to 3% in 2019.
■ Malaria case incidence (i.e.
cases per 1000 population at risk) reduced from 80 in 2000 to 58 in 2015 and 57 in 2019 globally. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Between 2000 and 2015, global malaria case incidence declined by 27%, and between 2015 and 2019 it declined by less than 2%, indicating a slowing of the rate of decline since 2015.
■ Twenty-nine countries accounted for 95% of malaria cases globally.
Nigeria (27%), the Democratic Republic of the Congo (12%), Uganda (5%), Mozambique (4%) and Niger (3%) accounted for about 51% of all cases globally. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ The World Health Organization (WHO) African Region, with an estimated 215 million cases in 2019, accounted for about 94% of cases.
■ Although there were fewer malaria cases in 2000 (204 million) than in 2019 in the WHO African Region, malaria case incidence reduced from 363 to 225 cases per 1000 population at risk in this period, reflecting the complexity of interpreting changing disease transmission in a rapidly increasing population. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
The population living in the WHO African Region increased from about 665 million in 2000 to 1.1 billion in 2019.
■ The WHO South-East Asia Region accounted for about 3% of the burden of malaria cases globally.
Malaria cases reduced by 73%, from 23 million in 2000 to about 6.3 million in 2019.
Malaria case incidence in this region reduced by 78%, from about 18 cases per 1000 population at risk in 2000 to about four cases in 2019. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ India contributed to the largest absolute reductions in the WHO South-East Asia Region, from about 20 million cases in 2000 to about 5.6 million in 2019.
Sri Lanka was certified malaria free in 2015, and Timor-Leste reported zero malaria cases in 2018 and 2019.
■ Malaria cases in the WHO Eastern Mediterranean Region reduced by 26%, from about 7 million cases in 2000 to about 5 million in 2019.
About a quarter of the cases in 2019 were due to P. vivax, mainly in Afghanistan and Pakistan. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ Over the period 2000–2019, malaria case incidence in the WHO Eastern Mediterranean Region declined from 20 to 10.
Sudan is the leading contributor to malaria in this region, accounting for about 46% of cases.
The Islamic Republic of Iran had no indigenous malaria cases in 2018 and 2019.
■ The WHO Western Pacific Region had an estimated 1.7 million cases in 2019, a decrease of 43% from the 3 million cases in 2000. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Over the same period, malaria case incidence reduced from five to two cases per 1000 population at risk.
Papua New Guinea accounted for nearly 80% of all cases in this region in 2019.
China has had no indigenous malaria cases since 2017.
Malaysia had no cases of human malaria in 2018 and 2019.
■ In the WHO Region of the Americas, malaria cases reduced by 40% (from 1.5 million to 0.9 million) and case incidence by 57% (from 14 to 6). | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
The region’s progress in recent years has suffered from the major increase in malaria in Venezuela (Bolivarian Republic of), which had about 35 500 cases in 2000, rising to over 467 000 by 2019.
Brazil, Colombia and Venezuela (Bolivarian Republic of) account for over 86% of all cases in this region.
■ Since 2015, the WHO European Region has been free of malaria.Malaria deaths ■ Globally, malaria deaths have reduced steadily over the period 2000–2019, from 736 000 in 2000 to 409 000 in 2019. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
The percentage of total malaria deaths among children aged under 5 years was 84% in 2000 and 67% in 2019.
The global estimate of deaths in 2015, the GTS baseline, was about 453 000.
■ Globally, the malaria mortality rate (i.e.
deaths per 100 000 population at risk) reduced from about 25 in 2000 to 12 in 2015 and 10 in 2019, with the slowing of the rate of decline in the latter years.
■ About 95% of malaria deaths globally were in 31 countries. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Nigeria (23%), the Democratic Republic of the Congo (11%), the United Republic of Tanzania (5%), Mozambique (4%), Niger (4%) and Burkina Faso (4%) accounted for about 51% of all malaria deaths globally in 2019.
■ Malaria deaths in the WHO African Region reduced by 44%, from 680 000 in 2000 to 386 000 in 2019, and the malaria mortality rate reduced by 67% over the same period, from 121 to 40 deaths per 100 000 population at risk. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ In the WHO South-East Asia Region, malaria deaths reduced by 74%, from about 35 000 in 2000 to 9 000 in 2019.
■ India accounted for about 86% of all malaria deaths in the WHO South-East Asia Region.
■ In the WHO Eastern Mediterranean Region, malaria deaths reduced by 16%, from about 12 000 in 2000 to 10 100 in 2019, and the malaria mortality rate reduced by 50%, from four to two deaths per 100 000 population at risk. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ In the WHO Western Pacific Region, malaria deaths reduced by 52%, from about 6600 cases in 2000 to 3200 in 2019, and the mortality rate reduced by 60%, from one to 0.4 malaria deaths per 100 000 population at risk.
Papua New Guinea accounted for over 85% of malaria deaths in 2019.
■ In the WHO Region of the Americas, malaria deaths reduced by 39% (from 909 to 551) and mortality rate by 50% (from 0.8 to 0.4). | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Over 70% of malaria deaths in 2019 in this region were in Venezuela (Bolivarian Republic of).Malaria cases and deaths averted ■ Globally, an estimated 1.5 billion malaria cases and 7.6 million malaria deaths have been averted in the period 2000–2019. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ Most of the cases (82%) and deaths (94%) averted were in the WHO African Region, followed by the WHO South-East Asia Region (cases 10% and deaths 3%).Burden of malaria in pregnancy ■ In 2019, in 33 moderate to high transmission countries in the WHO African Region, there were an estimated 33 million pregnancies, of which 35% (12 million) were exposed to malaria infection during pregnancy. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ By WHO subregion, Central Africa had the highest prevalence of exposure to malaria during pregnancy (40%), closely followed by West Africa (39%), while prevalence was 24% in East and Southern Africa.
■ It is estimated that malaria infection during pregnancy in these 33 countries resulted in 822 000 children with low birthweight. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ If up to 80% of pregnant women who reported using antenatal care (ANC) services once were to receive one dose of intermittent preventive treatment in pregnancy (IPTp), an additional 56 000 low birthweights would be averted in these 33 countries.xivxvWORLD MALARIA REPORT 2020 MALARIA ELIMINATION AND PREVENTION OF RE‑ESTABLISHMENT ■ Globally, the number of countries that were malaria endemic in 2000 and that reported fewer than 10 000 malaria cases increased from 26 in 2000 to 46 in 2019. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ In the same period, the number of countries with fewer than 100 indigenous cases increased from six to 27.
■ In the period 2010–2019, total malaria cases in the 21 E-2020 countries reduced by 79%.
■ There were more cases in 2019 than in 2018 in Comoros, Costa Rica, Ecuador and Suriname, which reported 1986, 25, 150 and 66 additional cases, respectively.
■ Iran (Islamic Republic of), Malaysia and Timor-Leste reported zero indigenous malaria cases in 2018 and 2019. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
In 2019, Belize and Cabo Verde reported zero indigenous malaria cases for the first time since 2000.
■ China and El Salvador had no indigenous malaria cases for a third consecutive year and have made a formal request for certification.
■ Between 2000 and 2019, in the six countries of the Greater Mekong subregion (GMS) – Cambodia, China (Yunnan Province), Lao People’s Democratic Republic, Myanmar, Thailand and Viet Nam – P. falciparum malaria cases fell by 97%, while all malaria cases fell by 90%. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Of the 239 000 malaria cases reported in 2019, 65 000 were P. falciparum cases.
■ The rate of decline has been fastest since 2012, when the Mekong Malaria Elimination (MME) programme was launched.
During this period, malaria cases reduced sixfold, while P. falciparum cases reduced by a factor of nearly 14.
■ Overall, Cambodia (58%) and Myanmar (31%) accounted for most cases of malaria in the GMS. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ This accelerated decrease in P. falciparum is especially critical because of increasing drug resistance; in the GMS, P. falciparum parasites have developed partial resistance to artemisinin, the core compound of the best available antimalarial drugs. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ Between 2000 and 2019, no country that was certified malaria free has been found to have malaria transmission re-established.HIGH BURDEN TO HIGH IMPACT APPROACH ■ Since November 2018, the high burden to high impact (HBHI) approach has been launched in 10 of the 11 countries (it has not yet been launched in Mali owing to disruptions due to the COVID-19 pandemic).
However, all 11 countries have implemented HBHI-related activities across the four response elements. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ In each HBHI country initiation, there has been high-level political engagement and support.
The Mass Action Against Malaria initiative in Uganda is presented as an example of a country-led process of political engagement at all levels, and multisectoral and community mobilization.
■ Analysis for subnational tailoring of interventions has been completed in all countries except Mali, where this work is in progress.
The example of Nigeria is presented in the report. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
The example of Nigeria is presented in the report.
■ All countries have committed to conduct a comprehensive exercise of urban microstratification to better target interventions and improve efficiencies given the increasing rate of urbanization.
■ The WHO Global Malaria Programme (GMP) updated its technical brief to support countries to better prioritize resources, while adhering to the evidence-based recommendations that have been developed through WHO’s standard, stringent processes. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ Because the HBHI response was launched in November 2018, when countries were coming to the end of their funding cycles, it is too soon to determine the impact of the response.
The numbers of malaria cases in the 11 HBHI countries in 2019 were similar to 2018 (156 million versus 155 million).PROGRESS TOWARDS THE GTS MILESTONES OF 2020 ■ The GTS aims for a reduction in malaria case incidence and mortality rate of at least 40% by 2020, 75% by 2025 and 90% by 2030 from a 2015 baseline. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ The 2000–2019 trends in malaria cases and deaths were used to make annual projections from 2020 to 2030, to track progress towards the targets and milestones of the GTS.
■ The projections presented in this report do not account for potential disruptions due to the COVID-19 pandemic, which – despite commendable global and national efforts to maintain essential malaria services – is likely to lead to higher than expected malaria morbidity and mortality. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ Despite the considerable progress made since 2000, the GTS 2020 milestones for morbidity and mortality will not be achieved globally.
■ Malaria case incidence of 56 cases per 1000 population at risk in 2020 instead of the expected 35 cases per 1000 if the world was on track for the 2020 GTS morbidity milestone means that, globally, we are off track by 37% at the current trajectory. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ Although relative progress in the mortality rate is greater than that in case incidence, globally projected malaria deaths per 100 000 population at risk in 2020 was 9.8, reducing from 11.9 in 2015, implying that the world was off track for the 2020 GTS mortality milestone by 22%. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ Of the 92 countries that were malaria endemic globally in 2015, 31 (34%) were estimated to be on track for the GTS morbidity milestone for 2020, having achieved 40% or more reduction in case incidence or reported zero malaria cases.
■ Twenty-one countries (23%) had made progress in reducing malaria case incidence but were not on track for the GTS milestone. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ Thirty-one countries (34%) are estimated to have increased incidence, with 15 countries (16%) estimated to have an increase of 40% or more in malaria case incidence in 2020 compared with 2015.
■ Malaria case incidence in nine countries (10%) in 2020 was estimated to be at levels similar to those of 2015.
■ Thirty-nine countries (42%) that were malaria endemic in 2015 were on track for the GTS mortality milestone for 2020, with 28 of them reporting zero malaria cases. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ Thirty-four countries (37%) were estimated to have achieved reductions in malaria mortality rates but progress was below the 40% target.
■ Malaria mortality rates remained at the same level in 2020 as 2015 in seven countries (8%), whereas there were estimated increases in another 12 countries (13%), six of which had increases of 40% or more. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ All countries in the WHO South-East Asia Region were on track for both the morbidity and mortality 2020 GTS milestones.INVESTMENTS IN MALARIA PROGRAMMES AND RESEARCH ■ The GTS sets out estimates of the funding required to achieve milestones for 2020, 2025 and 2030.
Total annual resources needed were estimated at US$ 4.1 billion in 2016, rising to US$ 6.8 billion in 2020.
An additional US$ 0.72 billion is estimated to be required annually for global malaria research and development (R&D). | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ Total funding for malaria control and elimination in 2019 was estimated at US$ 3.0 billion, compared with US$ 2.7 billion in 2018 and US$ 3.2 billion in 2017. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
The amount invested in 2019 falls short of the US$ 5.6 billion estimated to be required globally to stay on track towards the GTS milestones.xvixviiWORLD MALARIA REPORT 2020 ■ The funding gap between the amount invested and the resources needed has continued to widen dramatically over recent years, increasing from US$ 1.3 billion in 2017 to US$ 2.3 billion in 2018, and to US$ 2.6 billion in 2019. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ Over the period 2010–2019, international sources provided 70% of the total funding for malaria control and elimination, led by the United States of America (USA), the United Kingdom of Great Britain and Northern Ireland (United Kingdom) and France.
■ Of the US$ 3.0 billion invested in 2019, US$ 2.1 billion came from international funders. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
The highest contributions in 2019 were from the government of the USA, which provided a total of US$ 1.1 billion through planned bilateral funding and contributions to multilateral funding agencies. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ This was followed by bilateral and multilateral disbursements from the United Kingdom of US$ 0.2 billion, contributions of over US$ 0.1 billion from each of France, Germany and Japan (totalling US$ 0.4 billion), and a combined US$ 0.4 billion from other countries that are members of the Development Assistance Committee and from private sector contributors.
■ Governments of malaria endemic countries continued to contribute about 30% of the total funding, with investments nearing US$ 0.9 billion in 2019. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
Of this amount, an estimated US$ 0.2 billion was spent on malaria case management in the public sector and US$ 0.7 billion on other malaria control activities.
■ Of the US$ 3.0 billion invested in 2019, nearly US$ 1.2 billion (39%) was channelled through the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund).
Compared with 2018, the Global Fund’s disbursements to malaria endemic countries increased by about US$ 0.2 billion in 2019. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ Of the US$ 3.0 billion invested in 2019, about 73% went to the WHO African Region, 9% to the WHO South-East Asia Region, 5% each to the WHO Region of the Americas and the WHO Western Pacific Region, and 4% to the WHO Eastern Mediterranean Region.
■ Between 2007 and 2018, almost US$ 7.3 billion was invested in basic research and product development for malaria. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ The malaria R&D funding landscape has been led by investment in drugs (US$ 2.6 billion, 36% of malaria funding between 2007 and 2018), followed by relatively similar shares for basic research (US$ 1.9 billion, 26%) and vaccines R&D (US$ 1.8 billion, 25%).
Investments in vector control products and diagnostics were notably lower, reaching overall totals of US$ 453 million (6.2%) and US$ 185 million (2.5%), respectively. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ Between 2007 and 2018, the public sector held a leading role in malaria R&D funding, growing from US$ 246 million in 2007 to a peak of US$ 365 million in 2017.
Within the public sector and among all malaria R&D funders, the US National Institutes of Health was the largest contributor, focusing just over half of its US$ 1.9 billion investment into basic research (US$ 1.02 billion, 54% of its overall malaria investment between 2007 and 2018). | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ The Bill & Melinda Gates Foundation has been another instrumental player, investing US$ 1.8 billion (25% of all malaria R&D funding) between 2007 and 2018, and supporting the clinical development of key innovations such as the RTS,S vaccine.DISTRIBUTION AND COVERAGE OF MALARIA PREVENTION ■ Manufacturers’ delivery data for 2004–2019 show that nearly 2.2 billion insecticide-treated mosquito nets (ITNs) were supplied globally in that period, of which 1.9 billion (86%) were supplied to sub-Saharan Africa. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ Manufacturers delivered about 253 million ITNs to malaria endemic countries in 2019, an increase of 56 million ITNs compared with 2018.
About 84% of these ITNs were delivered to countries in sub-Saharan Africa.
■ By 2019, 68% of households in sub-Saharan Africa had at least one ITN, increasing from about 5% in 2000.
The percentage of households owning at least one ITN for every two people increased from 1% in 2000 to 36% in 2019. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
In the same period, the percentage of the population with access to an ITN within their household increased from 3% to 52%.
■ The percentage of the population sleeping under an ITN also increased considerably between 2000 and 2019, for the whole population (from 2% to 46%), for children aged under 5 years (from 3% to 52%) and for pregnant women (from 3% to 52%). | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ The most recent household survey data from demographic and health surveys (DHS) and malaria indicator surveys (MIS) from 24 countries in sub-Saharan Africa from 2015 to 2019 were used to analyse socioeconomic equity in the use of ITNs.
In most West African countries, ITN use was generally pro-poor or close to perfect equality.
In contrast, ITN use was higher in wealthier households in many parts of Central and East Africa. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ Globally, the percentage of the population at risk protected by indoor residual spraying (IRS) in malaria endemic countries declined from 5% in 2010 to 2% in 2019.
The percentage of the population protected by IRS decreased in all WHO regions.
■ The number of people protected globally fell from 180 million in 2010 to 115 million in 2015, but declined to 97 million in 2019. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ The number of children reached with at least one dose of seasonal malaria chemoprevention (SMC) steadily increased, from about 0.2 million in 2012 to about 21.5 million in 2019.
■ In the 13 countries that implemented SMC, a total of about 21.7 million children were targeted in 2019.
On average, 21.5 million children received treatment.
■ Using data from 33 African countries, the percentage of IPTp use by dose was computed. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
In 2019, 80% of pregnant women used ANC services at least once during their pregnancy.
About 62% of pregnant women received IPTp1 and 49% received IPTp2.
There was a slight increase in IPTp3 coverage, from 31% in 2018 to 34% in 2019.DISTRIBUTION AND COVERAGE OF MALARIA DIAGNOSIS AND TREATMENT ■ Globally, 2.7 billion rapid diagnostic tests (RDTs) for malaria were sold by manufacturers in 2010–2019, with nearly 80% of these sales being to sub-Saharan African countries. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
In the same period, national malaria programmes (NMPs) distributed 1.9 billion RDTs – 84% in sub-Saharan Africa.
■ In 2019, 348 million RDTs were sold by manufacturers and 267 million distributed by NMPs.
RDT sales and distributions in 2019 were lower than those reported in 2018, by 63 million and 24 million, respectively, with most decreases being in sub-Saharan Africa. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
■ More than 3.1 billion treatment courses of artemisinin-based combination therapy (ACT) were sold globally by manufacturers in 2010–2019.
About 2.1 billion of these sales were to the public sector in malaria endemic countries, and the rest were sold through either public or private sector co-payments (or both), or exclusively through the private retail sector. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |