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This strengthened the calls made in the Harare and Abuja declarations, and by the RBM initiative, for a globally funded partnership to fight malaria, to save lives and to accelerate economic growth in affected countries.In 2000, in response to reduced efficacy of CQ and SP for the treatment of clinical malaria, WHO published recommendations for the use of ACTs (35).
In 2001, the initial evidence of delayed parasite clearance with artesunate was reported in Cambodia (36). | 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 previous year, WHO also recommended the use of RDTs in health facilities, as increasingly accurate and affordable tests became available (37).
This led to a major shift away from what had been a predominantly syndromic approach – with the presumptive treatment of all fevers for malaria – to an approach based on pretreatment parasitological confirmation of malaria.
This improved the rational use of ACTs and has also subsequently enhanced the value of routinely reported data on malaria burden. | 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, parasitological diagnosis continues to be used at modest levels, especially in sub-Saharan Africa (Section 7).In 2000, the Bill & Melinda Gates Foundation was established; it is now one of the largest private foundations in the world (38). | 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 its work on malaria, the foundation has focused on development of new vaccines, diagnostics, medicines and vector control products and their delivery and use in public health, while advancing improved surveillance systems and data analytics.Several new institutions, programmes and initiatives soon followed. | 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 May 2001, the European Union launched the “Programme for accelerated action on HIV/AIDS, malaria and tuberculosis in the context of poverty reduction”, which also led to the creation of the European and Developing Countries Clinical Trials Partnership (EDCTP).
Founded as a public–public partnership between countries in Europe and sub-4Saharan Africa, the EDCTP is supported by the European Union (39). | 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 EDCTP aims to accelerate clinical development of vaccines, diagnostics and medicines for infectious diseases of the poor, and has been a major investor in malaria clinical trials (40), several of which have contributed to the development of global normative guidance by WHO. | 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 2003, the Foundation for Innovative New Diagnostics (FIND) was established as a global non-profit organization, with the aim of accelerating innovation in the development and delivery of diagnostics of infectious diseases of the poor (41). | 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 |
As a WHO Collaborating Centre for Laboratory Strengthening and Diagnostic Technology Evaluation, FIND has supported the generation of evidence for malaria diagnosis policies, producing regular reports on the quality and performance on RDTs.In 2002, the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) was created, marking the beginning of an unprecedented period for malaria funding (42). | 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 Global Fund was originally conceived as a financing mechanism for HIV/AIDS but ministers of health, especially from the WHO African Region, called for it to be extended to malaria (34, 43).In recognition of the terrible toll of malaria on children and pregnant women, UNICEF stepped up its key role in the malaria response, in addition to being one of the founders of RBM.
UNICEF’s focus was on strengthening community-based and local action to improve child health and nutrition. | 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 the early 2000s, it was one of the world’s largest global procurers of ACTs, ITNs and subsequently long-lasting insecticidal nets (LLINs), supporting the delivery of nets during routine and mass vaccination campaigns (44). | 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 |
UNICEF continues to support the scale-up of diagnosis and treatment of malaria at the community level, through integrated delivery platforms and support for the delivery of seasonal malaria chemoprevention (SMC) (45).The path from the promising results from the field trials of the efficacy of ITNs and ACTs to scaling these up in malaria endemic countries remained challenging. | 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 |
There were the limited supply of ITNs and ACTs, their high costs and the lack of substantial domestic or external funding for malaria control to scale-up new interventions for prevention and treatment.
In 2002, the WHO RBM initiative published a framework for scaling up ITNs 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 |
The framework proposed two key elements: sustained subsidies strictly targeted to vulnerable groups, and a strengthened and expanded commercial market that would provide ITNs at the lowest possible prices for the general population (46).
The consensus at the time was not in favour of delivering ITNs to the whole population or providing ITNs at no cost, even to vulnerable groups, mainly because of concerns about the financial sustainability of doing so. | 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 |
Instead, subsidized distribution through social marketing and mother and child clinics became the norm.
The overarching aim was to catalyse the growth of commercial markets to meet the demand for ITNs and reduce commodity prices (46).The Africa malaria report, a precursor to the world malaria report, was published in 2003 (47).
Despite many important developments, by the end of 2004, most mosquito nets were still conventional ITNs (i.e. | 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 |
they required frequent retreatment), and their use by children aged under 5 years was only 2% (48). | 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 recommended by WHO since 1998, IPTp scale-up had barely started, only 42% of children with fever sought treatment and received antimalarials, and most malaria treatment was presumptive and predominantly with CQ or SP, which were no longer recommended for treatment by WHO.5WORLD MALARIA REPORT 2020WORLD MALARIA REPORT 2020 2.3In March 2005, the first meeting on the replenishment of the Global Fund took place in Stockholm, Sweden (49). | 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 end of the replenishment process, US$ 3.7 billion was pledged to the Global Fund for the period 2006–2007, of which about US$ 760 million was eventually committed to malaria control (50).
In June 2005, the United States President’s Malaria Initiative (PMI) was launched, targeting support to Angola, Uganda and the United Republic of Tanzania (51).
By the end of the decade, PMI had extended its support to 12 additional countries in Africa (52).The injection of funding came at an important time. | 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 end of 2005, WHO released the first world malaria report, presenting global progress on malaria in the period 2000–2004 (48).
The report showed that the malaria burden remained high, with 1 million estimated deaths, mainly in sub-Saharan Africa, and that access to malaria prevention and treatment had barely improved since 2000.
In 2005, the WHO RBM initiative published a strategy for improving access to treatment through home management of malaria (53). | 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 year, WHO also published a recommendation to use artesunate and artemisinin suppositories for pre-referral treatment of severe malaria (54).Measuring the burden of malaria and progress in intervention was proving to be a difficult task.
Also, as funding increased, a credible measure of the impact of the investment was increasingly seen as critical to make the case for further funding. | 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 |
Surveillance systems in malaria endemic countries remained weak, and most reported malaria case data were not based on parasitological diagnosis.
There was limited understanding of the subnational malaria epidemiology to effectively guide investments.
In 2004, the RBM Monitoring and Evaluation Reference Group (MERG), with funding support from the United States Agency for International Development (USAID), began the process of developing a malaria indicator survey toolkit (55). | 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 toolkit was intended to support standalone malaria-specific surveys or malaria modules included in standard demographic and health surveys (DHS) (56) or UNICEF-supported multiple indicator cluster surveys (MICS) (57).
These surveys have since been the backbone of understanding infection prevalence and malaria intervention coverage in communities in Africa, and in the tracking of global progress annually through the world malaria 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 |
Since 2006, over 100 surveys with malaria-related information have been conducted, mainly in sub-Saharan Africa.62000–20042005–20102011–20152016–2019Creation of new partnerships and initiatives continued.
To respond to the threat of insecticide resistance, innovation was needed to develop new vector control solutions.
In 2005, the Innovative Vector Control Consortium (IVCC) was established as a partnership of industry, the public sector and academia (58). | 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 |
As the main product development partnership for malaria vector control, IVCC has worked with a range of partners to facilitate the development of novel and improved public health insecticides, formulations and products to address these challenges.
It has also supported field research and efforts to improve access to these tools through its global access strategy (59). | 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 2006, Unitaid was established as an agency that is hosted and administered by WHO; Unitaid’s mission is to scale up access to treatment for HIV/AIDS, malaria and tuberculosis in developing countries through price reductions of drugs and diagnostics, and improved availability (60).
Unitaid has used an innovative financing approach – the solidarity levy on airline tickets imposed by France and other 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 |
Since its establishment, Unitaid’s investment in malaria prevention, diagnosis and treatment has developed into a large portfolio (61).Faced with weak health systems and low domestic funding, approaches to scale-up of interventions remained challenging.
Until 2007, the recommendation was still to prioritize coverage of ITNs to key target groups in sub-Saharan Africa; however, it was estimated that by 2007 only 15% of children aged under 5 years and pregnant women were sleeping under an ITN (50). | 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 dominant channels for ITN distributions were social marketing of nets and continuous distributions in health facilities, with the latter moving from being highly subsidized to being free in some countries from around this time (62). | 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 |
General case management practice was also to treat any febrile child as a malaria case, often presumptively, because RDTs had not been widely scaled up and microscopy was limited mainly to large urban health facilities.In August 2007, supported by evidence from Kenya (63), the WHO Global Malaria Programme (GMP) released a position statement in which it recommended that “insecticidal nets be long-lasting, and distributed either free or highly subsidized and used by all community members” and noted that “... free mass distribution of LLINs is a powerful way to quickly and dramatically increase coverage, particularly among the poorest people” (64). | 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 statement laid the foundation for ITNs becoming by far the largest investment in a single malaria intervention.
Free mass campaigns to cover individuals of all ages with LLINs, and continuous distribution channels to sustain coverage, were launched and marked the beginning of a rapid increase in ITN coverage in sub-Saharan Africa (Section 7). | 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 studies showed significant reduction in parasite prevalence following universal coverage, the decision to implement universal coverage was driven primarily by coverage and equity aims rather than comprehensive cost–benefit analysis.For decades, fuelled by the sense of failure following the first eradication campaign of the 1950s and 1960s, the world had shied away from placing eradication of malaria within its goals (24). | 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, buoyed by the increasing global commitment to fight malaria, the opportunities to rapidly expand the scale-up of interventions and results from the development of new tools, including vaccines – Bill and Melinda Gates (of the Bill & Melinda Gates Foundation) made a global call for a renewed commitment to eradicate malaria (65) and WHO Director-General Dr Margaret Chan publicly endorsed that vision. | 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 triggered a global discussion on the feasibility of malaria eradication and its critical dependence on the development of new and improved tools.
No timeline for that effort was defined.Shortly after, the RBM Partnership – by now a partnership entity hosted within WHO – released the Global Malaria Action Plan for a malaria free world (GMAP) (66).
This plan built on the WHO call for universal coverage and the emerging discussions on malaria eradication. | 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 |
A 2010 target was assigned to achieve universal coverage, reduce malaria morbidity and mortality by half from a 2000 baseline, and eliminate malaria in 8–10 countries.
Also explicitly stated in the GMAP was a target of achieving near-zero preventable deaths by 2015, and of malaria eradication through progressive elimination in countries, without a defined date for its achievement. | 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 plan outlined three strategic components with research as a supporting component: scale-up for impact, sustained control and elimination.Following the first, second and third replenishments (in 2005, 2007 and 2010, respectively), Global Fund resources for malaria increased considerably (67).
External investment in malaria was estimated to be US$ 450 million in 2005, with an estimated US$ 1 billion spent in the period 2000–2005 (Section 6).
Increasing access remained the key challenge. | 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 |
Increasing access remained the key challenge.
Although ITNs were moving from a social marketing scheme towards mass distribution campaigns, new delivery mechanisms were being developed with regard to ACTs (68, 69). | 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 2008, the Global Fund assumed funding responsibilities, with support from Unitaid, for the Affordable Medicines Facility-malaria (AMFm) as a pilot programme that aimed to take advantage of the relative high use of the private retail sector for treatment of fever, and thus expand access to quality-assured ACTs (68, 69). | 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 |
An evaluation funded by the Global Fund showed that positive achievements included increased availability of ACTs, reduced prices, increased market share and minimal disruption of supplies to the public sector (70). | 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, given the low levels of parasitological diagnosis and by not subsidizing diagnostic testing in the private sector, the AMFm failed to fully target the subsidized ACTs to those with malaria.In 2007, confirmation of what was then called partial artemisinin resistance was established in the area of the Thai–Cambodia border, and in 2008 the first clinical cases due to malaria parasites containing gene deletions causing false negative RDTs were described in Peru (36, 71). | 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 |
Since then, monitoring and mitigating ACT resistance has become a major focus of the global malaria community; also, deletions in the P. falciparum genes for HRP2 (pfhrp2) have emerged in sub-Saharan Africa, and recent evidence suggests worrying levels of prevalence in Horn of Africa countries (Section 9.1).In 2009, the African Leaders Malaria Alliance (ALMA) was established as a forum to provide visibility at high levels of political leadership for the response against malaria in Africa (72).On the policy front, WHO released a recommendation on the use of intermittent preventive treatment in infants with SP (IPTi-SP) in 2010, following evidence of modest efficacy from pooled analysis of randomized control trials in Gabon, Ghana, Kenya, Mozambique and the United Republic of Tanzania (73).In 2010, the US National Institute of Allergy and Infectious Diseases established 10 International Centers for Excellence for Malaria Research to support multidisciplinary malaria research across diverse settings in Africa, Asia Pacific and South America (74). | 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 high-level attention, increased funding and successful implementation of technical strategies were beginning to contribute to a positive impact.
By 2010, it was estimated that, globally, substantial reductions in malaria morbidity and mortality had been reported (75). | 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 |
WHO certified United Arab Emirates in 2007 and Morocco and Turkmenistan in 2010 as malaria free (Section 4).7WORLD MALARIA REPORT 2020WORLD MALARIA REPORT 2020 2.42000–20042005–20102011–20152016–2019In 2011, WHO established the Malaria Policy Advisory Committee (MPAC) to provide independent advice to WHO on developing policy recommendations to control and eliminate malaria, and thus improve the quality and independence of the malaria policy-making process. | 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 MPAC is an independent advisory group that aims to bring together the world’s foremost experts on malaria to provide strategic technical guidance to the WHO Director-General as part of a transparent, responsive and credible policy-setting process on malaria (76).In 2011, PMI added the countries of the Greater Mekong subregion (GMS), the Democratic Republic of the Congo, Guinea, Nigeria and Zimbabwe to its list of countries to receive support; this brought its tally of support to 20 high burden African countries (52).By the end of 2011, global sales of ACTs had exceeded 500 million treatment doses, marking a period of sustained scale-up of effective malaria interventions (77). | 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, artemisinin resistance was expanding in the GMS and was considered as a potential threat to the global malaria enterprise (36, 78).
Learning from the experience of poor mitigation of resistance to previous antimalarials, WHO mobilized the global community by launching the Global Plan for Artemisinin Resistance Containment (GPARC) (79). | 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 |
is a multi-country (Cambodia, China, Lao People’s Democratic Republic, Myanmar, Thailand and Viet Nam) programme to fight artemisinin resistance, primarily through accelerated progress towards malaria elimination by 2025, focusing especially on P. falciparum malaria.
To support the MME programme, the Global Fund launched the Mekong Regional Artemisinin-resistance Initiative (RAI) in 2013, and has invested considerable resources (nearly US$ 600 million) in the subregion since then (81). | 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 |
Dramatic progress has been achieved in the GMS since the launch of the MME programme, and most countries are on target to achieve P. falciparum elimination by 2025 (Section 4); also, there is to date no evidence of a spread of artemisinin resistance from the GMS to other parts of the world (Section 9).In 2012, the Global Fund launched its second strategy for achieving impact through its investments across five strategic objectives: invest more strategically, evolve the funding model, actively support grant implementation success, protect and promote human rights, and sustain the gains and mobilize resources (82). | 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 |
Also in 2012, the Global Fund decided to integrate AMFm into core grant management processes through an orderly transition in 2013, allowing countries to use some of their core grants to implement AMFm as part of a co-payment mechanism (83).In 2012, WHO and partners launched the Mekong Malaria Elimination (MME) programme (78, 80). | 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 On the global policy front, in 2012 WHO published a recommendation for the use of SMC in children in high burden and highly seasonal malaria transmission areas, in response to evidence of the strong impact on malaria morbidity (84). | 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 support of the scale-up of SMC, Unitaid launched the ACCESS-SMC project in 2013 (85), the Global Fund mainstreamed the intervention into core grants in 2017 (86), and PMI expanded its support for SMC activities in Benin, Burkina Faso, Cameroon, Ghana, Guinea, Mali, Niger, northern Nigeria and Senegal (87).In 2012, WHO published the Global Plan for Insecticide Resistance Management in Malaria Vectors (88) as a response to mitigate the spread of insecticide resistance. | 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 |
Adding to the list of biological threats to the global malaria fight, 2014 saw the first evidence of the presence of an Anopheles stephensi, an efficient urban malaria species in Asia and Persian Gulf, being reported in sub-Saharan Africa, in Djibouti, where it was implicated in a malaria epidemic (89).
Since then, 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 |
stephensi has been reported to be established in Ethiopia and is efficient in transmission of both P. vivax and P. falciparum (90).Following the call for malaria eradication by Bill and Melinda Gates, several scientific publications – for example, those from the Malaria Eradication Scientific Alliance published in PLoS Medicine (91) and the Lancet series on malaria elimination (92) – re-energized the debate on feasibility, approaches and innovation its eventual towards malaria elimination and eradication. | 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 same time, the application of novel geospatial methods to the growing number of community parasite prevalence surveys in sub-Saharan Africa began to create a clearer picture of the geographical distribution of P. falciparum malaria subnationally (93–96). | 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 increased granularity of malaria risk mapping exposed underlying heterogeneity and the need for strategic planning and resource allocation at subnational levels (Section 5).Some 15 years after the launch of the MDGs, analysis presented in the World malaria report 2015 (97) suggested that the target of reversing the malaria trends had been achieved.
It was estimated that malaria case incidence had reduced by 37% and mortality rate by 60% between 2000 and 2015. | 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 |
An estimated 438 000 people had died of malaria in 2015; thus, the near-zero death target of the GMAP had not been achieved (66).
These major declines in the malaria burden were considered conclusive evidence of achieving, or even surpassing, the MDG target 6C, and were hailed as showing the remarkable strides that could be made with adequate investment and political commitment. | 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 earlier, in anticipation of the end of the MDGs, the UN Conference on Sustainable Development was convened in Rio de Janeiro, Brazil, where Member States decided to develop a set of SDGs to build on the MDGs, and to establish the UN High-level Political Forum on Sustainable Development (98). | 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 |
Progress in malaria incidence and mortality rate were recognized as key indicators in SDG Goal 3, target 3.3, which stated “By 89WORLD MALARIA REPORT 2020WORLD MALARIA REPORT 2020 2000–20042005–20102011–20152016–20192030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, waterborne diseases and other communicable diseases”; that goal had a target of halving malaria case incidence by 2020, and contributing to the ending of preventable deaths of neonates and children aged under 5 years by 2030, from a baseline of 2015 (3, 99).Among the global malaria community, there was now consensus on the need to develop a coherent and even more ambitious global strategy, not only to sustain the gains, but also to ensure accelerated progress and align with the SDGs. | 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 2012, the MPAC discussed the proposal to develop a global technical strategy, and recommended it to the WHO Director-General.
The GTS was formally adopted by the Sixty-eighth World Health Assembly in May 2015, in resolution WHA68.2 (4).
With a vision of a world free of malaria, and underpinned by five guiding principles, the GTS included three pillars, two supporting elements and four impact goals across three milestone years (2020, 2025 and 2030) using a 2015 baseline (Table 2.1). | 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 |
For the first time, transforming surveillance systems was affirmed as a core intervention, recognizing the critical function of reliable information in improving the efficiency and effectiveness of interventions to prevent and treat malaria.As an investment case for the GTS, the RBM Partnership to End Malaria developed the investment plan AIM (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 |
Anchored in a strong partnership, with a multisectoral and coordinated approach, the plan outlines core areas of focus: mobilizing resources; strengthening multisectoral and intercountry collaboration; keeping people at the centre of the response; strengthening the enabling environment; fostering and sharing innovations and solutions; and facilitating change. | 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 |
Both the GTS and the AIM acknowledged that strengthened health systems would be needed, because these would determine the rate of progress towards the bold targets.
It was hoped that the adoption by countries of the GTS and AIM would also contribute to the post-2015 SDGs.By 2015, over 1 billion ITNs had been distributed globally, accounting for the largest proportion of donor investment in 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 |
Modelling analysis suggested that, among malaria interventions, use of ITNs was the largest contributor to the reduction in the burden of malaria in sub-Saharan Africa (93).
By the end of this period, however, pyrethroid resistance had increased both in terms of geography and intensity (100).Armenia and Maldives were certified by WHO as free of malaria in 2011 and 2015, 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 |
The Malaria Elimination Strategy in the GMS 2015–2030 was endorsed by the MPAC and adopted by health ministers in GMS countries in 2015; its goals were to eliminate P. falciparum malaria in 2025 and all malaria in 2030 in the subregion (101).TABLE 2.1.GTS: global targets for 2030 and milestones for 2020 and 2025 Source: GTS (4).Vision – A world free of malariaPrinciples1.
All countries can accelerate efforts towards elimination through combinations of interventions tailored to local contexts2. | 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 |
Country ownership and leadership, with involvement and participation of communities, are essential to accelerating progress through a multisectoral approach3.
Improved surveillance, monitoring and evaluation, as well as stratification by malaria burden, are required to optimize the implementation of malaria interventions 4.
Equity in access to health services, especially for the most vulnerable and hard-to-reach populations, is essential5. | 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 |
Innovation in tools and implementation approaches will enable countries to maximize their progression along the path to eliminationPillarsPillar 1Pillar 2Pillar 3Supporting elementsEnsure universal access to malaria prevention, diagnosis and treatmentAccelerate efforts towards elimination and attainment of malaria free statusTransform malaria surveillance into a core interventionSupporting element 1.
Harnessing innovation and expanding researchSupporting element 2. | 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 |
Strengthening the enabling environmentGoalsMilestones 20202025Targets 2030 1.
Reduce malaria mortality rates globally compared with 20152.
Reduce malaria case incidence globally compared with 20153.
Eliminate malaria from countries in which malaria was transmitted in 2015At least 40%At least 75%At least 90%At least 40%At least 75%At least 90%At least 10 countriesAt least 20 countriesAt least 35 countries 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 |
Prevent re-establishment of malaria in all countries that are malaria freeRe-establishment preventedRe-establishment preventedRe-establishment preventedGTS: Global technical strategy for malaria 2016–2030.1011WORLD MALARIA REPORT 2020WORLD MALARIA REPORT 2020 2.52000–20042005–20102011–20152016–2019Following the launch of the GTS and AIM, many WHO regions and national programmes launched their own aligned strategies. | 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 June 2016, the RBM initiative previously hosted by WHO was renamed the RBM Partnership to End Malaria, with new hosting arrangements under the UN Office for Project Services (102).
In 2017, the Global Fund launched its new strategy for the period 2017–2022, titled Investing to end epidemics, with four strategic objectives: maximizing impact, promoting and protecting human rights and gender equality, building resilient and sustainable systems for health for all, and mobilizing increased resources (103). | 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 |
Building on the ALMA experience, the Asia Pacific Leaders Malaria Alliance (APLMA) was launched in 2017 (104).
In the same year, PMI extended its support to include the GMS and five additional African countries (52).Paraguay to become the next country in the WHO Region of the Americas to be certified. | 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 Ministerial Declaration on Accelerating and Sustaining Malaria Elimination in South-East Asia Region was signed in November 2017, to accelerate malaria elimination in this region (106).In contrast to the impressive progress on the GTS elimination goal, estimates published in the World malaria report 2017 showed that the morbidity and mortality goals were off track, and that gains were beginning to reverse in some countries (107). | 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 main theme of the report was that the malaria world was at a “crossroads”, and an urgent response was required to kickstart the stalling progress (8, 104).
The Director-General of WHO, Dr Tedros Ghebreyesus, declared:As part of the commitment to achieving Goal 3 of the GTS (i.e.
ensuring at least 10 countries reach malaria elimination by 2020), in April 2017, WHO launched the “eliminating countries for 2020” (E-2020) initiative (105). | 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 |
Twenty-one countries that had made substantial progress over the past decade and were considered close to elimination were selected to take part in the E-2020 (Section 4).
By 2018, the Goal 3 milestone for 2020 was already on target, with 10 countries that were malaria endemic in 2015 expected to be malaria free by 2020 (77).
Since 2015, Kyrgyzstan (2016), Sri Lanka (2016) and Uzbekistan (2018) have been 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 |
Paraguay (2018) and Algeria (2019), both E-2020 countries, each became the first country in their respective region to be certified malaria free since 1973.
Argentina (2019) followed The data showed that less than half of countries with ongoing transmission were on track to reach critical targets for reductions in the death and disease caused by malaria.
Progress appeared to have stalled … The choice before us is clear. | 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 we continue with a ‘business as usual’ approach – employing the same level of resources and the same interventions – we will face near-certain increases in malaria cases and deaths.This call led to the formation of the high burden to high impact (HBHI) response coordinated by WHO and the RBM Partnership to End Malaria and led by endemic countries (108).
The formal launch of the HBHI approach was held in Maputo, Mozambique, in November 2018, during the 20th anniversary of the RBM Partnership. | 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 approach is based on four response elements: galvanizing political will nationally and globally to reduce malaria deaths; using strategic information to drive impact; implementing best global guidance, policies and strategies suitable for all malaria endemic countries; and applying a coordinated country response (108). | 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 approach has been led by 11 countries that accounted for 70% of the global burden of malaria: Burkina Faso, Cameroon, the Democratic Republic of the Congo, Ghana, India, Mali, Mozambique, Niger, Nigeria, Uganda and the United Republic of Tanzania.
Since then, the launch of the HBHI approach has been formally initiated in all countries except in Mali (where HBHI-related activities are underway). | 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 all initiation meetings, there was high-level government and partnership participation, with strong commitment to support the approach.set of statements to instead providing problem-solving tools for countries to adapt, and inculcating an approach of subnational tailoring of interventions based on local data. | 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 |
As a first step, WHO published a compendium of all policies, clarifying the distinction between actual recommendations, which are based on thorough, systematic reviews of the evidence by a guideline development group (109), and best practice statements, which are designed to help countries implement policies but should not be considered restrictive. | 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 |
These concepts were further crystallized through a technical brief (110) to countries, to support national malaria programmes (NMPs) making funding requests to the Global Fund and other organizations.In October 2019, during its Sixth Replenishment Conference in Lyon, France, the Global Fund managed to raise the highest level of funding since its inception, with a commitment of US$ 14 billion (111). | 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, US$ 4.8 billion was allocated to malaria, an increase of over US$ 1 billion from the previous allocation period. | 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 |
PMI funding also increased to US$ 755 billion in 2019 (52).Since 2018, WHO, the RBM Partnership to End Malaria and collaborating partners have supported the HBHI countries to develop robust national malaria strategic plans (NMSPs), and to prioritize resources using subnational tailoring of interventions, driven by epidemiological, ecological and health system data, and other information (Section 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 |
WHO has embarked on a process to improve the predictability, timeliness and transparency of its policy-making process, and to produce the first set of WHO consolidated malaria guidelines. | 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 aim is to re-position its policy recommendations, moving away from a prescriptive Incremental improvements to the tools available for malaria control have continued; for example, another ACT (pyronaridine-artesunate) has been developed (112), as have mosquito nets treated with insecticides other than pyrethroids (these are currently undergoing evaluation). | 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 2016, WHO released a position paper on the world’s first malaria vaccine to have received a positive recommendation from the European Medicines Agency (EMA). | 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 |
As part of a collaboration between WHO, PATH, GlaxoSmithKline (GSK), the Global Fund, Gavi and Unitaid, GSK’s RTS,S vaccine is undergoing a phased pilot introduction through routine 1213WORLD MALARIA REPORT 2020WORLD MALARIA REPORT 2020 2000–20042005–20102011–20152016–2019childhood immunization services in parts of Malawi, Ghana and Kenya, which started in 2019.
Some 12 months on, about 500 000 children have been reached with their first dose of the vaccine. | 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 |
An ongoing evaluation is assessing the public health value of the vaccine as a complementary tool that could be added to the existing preventive, diagnostic and treatment measures recommended by WHO.At about the same time as evidence was emerging that progress towards GTS milestones for burden reduction had stalled and the global community was grappling with ways to support countries to get back on track, active discussions were happening about whether malaria eradication with a defined timeline was feasible (113). | 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 2016, the then Director-General of WHO, Dr Margaret Chan, established a strategic advisory group tasked with analysing future scenarios for malaria, including the feasibility and expected cost of eradication.
The Strategic Advisory Group for Malaria Eradication (SAGme) concluded its work 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 |
Based on SAGme’s work, WHO reaffirmed its position on malaria eradication and the importance of investing in universal health coverage (UHC) through a statement by the Director-General, Dr Tedros Ghebreyesus:This statement was released as part of the WHO push to renew the momentum, to ensure the WHO continues to unequivocally support the goal of malaria eradication. | 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 |
To achieve this vision, we must deliver on our promises: to increase domestic and international investments in health; reduce malaria in the highest-burden countries; achieve universal health coverage; ensure no child dies from a preventable disease; and leave no one behind in pursuit of health and development goals because they were born poor. | 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 delivering on these promises and investing in the development of transformative new tools, the world can achieve the health-related Sustainable Development Goals and eradicate malaria.establishment of strong primary health care systems through the UHC approach encapsulated in the Astana Declaration of 2018 (114). | 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 declaration was signed by heads of state and government, ministers, and representatives of states and governments during the Global Conference on Primary Health Care held in Astana, Kazakhstan, on 25–26 October 2018. WHO did not define a specific timeline for malaria eradication; instead, it identified a focus on burden reduction and sequential elimination in malaria endemic countries and regions as a logical path forward. | 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 |
To this end, SAGme proposed focused efforts in four areas: research and development of new tools; improved access to affordable, quality, people-centred health services; enhanced surveillance and response; and formulation of subnational, national and regional strategies (113). | 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 around the time that WHO released the SAGme report, the Lancet Commission on Malaria Eradication published a collection of work on the feasibility and affordability of malaria eradication by 2050 (115).In September 2019, at the UN high-level meeting “Universal Health Coverage: Moving Together to Build a Healthier World”, the political commitment was secured for implementing high-impact health interventions to combat diseases, protect women’s and children’s health, and ensure no one suffers financial hardship. | 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 |
There was commitment for investing in everyone’s health, expanding quality health services and reaching the most marginalized populations. | 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 would require improved efficiency and equity in the allocation and use of existing resources – based on local context and priorities, and governed by data to identify those in need of interventions (116).Although major system weaknesses and data quality issues remain, the period 2016–2019 has also been one of considerable progress in the strengthening of health information systems in malaria endemic 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 |
By 2018, more than 50 malaria endemic countries had installed District Health Information Software 2 (DHIS2) either for direct data entry at health facilities or as the backbone of aggregated data systems (77).
Combined with increasing use of RDTs and increased reporting, the volume and quality of data have improved steadily, with DHIS2 offering flexible data analysis and use capabilities. | 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 |
These improvements have been major contributors to the efforts on subnational tailoring of malaria interventions in HBHI countries (Section 5).By the end of 2019, with the emergence of COVID-19 and its subsequent pandemic spread, much of the progress against malaria was under enormous risk, with the potential to wipe out 20 years of malaria gains (117).
To mitigate disruptions of essential malaria services, global and national partners joined forces to support countries to mount a response. | 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 nature of this response and the consequences of the pandemic are described in Section 10.1415WORLD MALARIA REPORT 2020WORLD MALARIA REPORT 2020 FIG.
2.1. | 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 |
Key milestones in the fight against malaria in the past 2 decadesisegetartSgnikcartdnassergorpfodnaslooTseniliedugevitamron&hcraeseRtnempoevedl0991Africa Malaria Report published (2003)First annual WMRpublished (2005)RBM PartnershipGMAP published(2008)WHO GPARC published(2011)WHO GTS 2016-2030 launched (2015)WHO GPIRM published(2012)WHO SAGme report launched(2019)WHO recommendation of IVM(2004)Development of MIS toolkit RBM, WHO and partners (2004)WHO recommendation on use of artesunate and artemisinin suppositories(2005)WHO 1st Edition MTG(2006)WHO recommendationon universalcoverage of LLIN(2007)WHO 3rd Edition MTG (2015)WHO position paper onRTS,S/AS01 published(2016)WHO recommendation on IPTi-SP(2010)WHO 2nd Edition MTG (2010)WHO Malaria Elimination Framework(2017)WHO recommendation on PBO LLIN published(2017)WHO malaria SME reference manual (2018)WHOrecommendation on SMC(2012)Launch RTS,S/AS01 pilot in Malawi, Ghana and Kenya (2019)WHO VC guidelines (2019)WHO recommendationof IPTp (1998)WHOPES recommendation of ITNs(1999)WHO recommendation on use of ACTs and RDTs (2000)WHO approval of first LLIN (2000)INDEPTH Network established(1998)MMV established(1999)PATH's MVI (1999)0002EDCTP established(2001)FIND established(2003)IVCC established(2005)Unitaid established(2006)5002Ministerial conference on malaria in Amsterdam(1992)49th WHA call for aspecial malaria programof the WHO DG (1996)Harare Declaration onMalaria Prevention and Control (1997)esnopserdnagndnufi,iphsredaellaboGlAbuja Declaration (2000)MDGs adopted (2000)G8 Okinawa summit (2000)The Global Fund established(2002)MIM launched(1997)BMGF established (2000)Creation of the RBM initiativeas special WHO cabinet project(1998)lRBM initiative split into WHO RBM Department and RBM Partnership(2004)Creation of PMI(2005)WHO RBM Department renamed GMP(2006)Bill and Melinda Gates call for eradication(2007)acigooBlistaerhtFirst published evidenceof malaria vector resistance to pyrethroids(1996)First evidence of ACT delayed parasite clearance(2002)First reports ofpfhrp2 deletions(2008)010251029102020252020302WHO launchof MME(2012)Adoption of the SDGs(2015)GTSmilestone 1GTSmilestone 2GTSmilestone 3Global Fundlaunch of RAI(2013)RBM initiative renamed toRBM Partnership to EndMalaria hosted by UNOPS(2016)WHO E-2020initiative launched(2017)Ministerial Call for Actionto Eliminate Malaria in GMS(2018)WHO & RBM HBHI response launched(2018)Astana Declaration(2018)First published evidence ofAn. | 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 |
stephensi invasion of Africa(2014)Malaria cases in SSAMalaria investment(US$, million)Global malaria cases per 1000 populationPopulation in SSA(million)ACT: artemisin-based combination therapy; 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 |
: Anopheles; BMGF: Bill & Melinda Gates Foundation; DG: Director-General; EDCTP: European & Developing Countries Clinical Trials Partnership; FIND: Foundation for Innovative New Diagnostics; G8: Group of Eight; GMAP: Global Malaria Action Plan; GMP: Global Malaria Programme; GMS: Greater Mekong subregion; GPARC: Global Plan for Artemisinin Resistance Containment; GPIRM: Global Plan for Insecticide Resistance Management in Malaria; GTS: Global technical strategy for malaria 2016–2030; HBHI: high burden high impact; IPTi-SP: intermittent preventive treatment in infants using sulfadoxine-pyrimethamine; IPTp: intermittent preventive treatment in pregnancy; IPTp-SP: intermittent preventive treatment in pregnancy using sulfadoxine-pyrimethamine; ITN: insecticide-treated mosquito net; IVCC: Innovative Vector Control Consortium; IVM: integrated vector management; LLIN: long-lasting insecticidal net; MDG: Millennium Development Goal; MIM: Multilateral Initiative on Malaria; MIS: malaria indicator survey; MME: Malaria Mekong Elimination; MMV: Medicines for Malaria Venture; MTG: malaria treatment guidelines; MVI-PATH: Malaria Vaccine Initiative, PATH; PBO: piperonyl butoxide; PMI: President’s Malaria Initiative; RAI: Regional Artemisinin-resistance Initiative; RBM: Roll Back Malaria (before 2016); RDT: rapid diagnostic test; SAGme: Strategic Advisory Group for Malaria Eradication; SDG: Sustainable Development Goal; SMC: seasonal malaria chemoprevention; SME: surveillance, monitoring & evaluation; SSA: sub-Saharan Africa; UNOPS: United Nations Office for Project Services; VC: vector control; WHA: World Health Assembly; WHO: World Health Organization; WHOPES: WHO Pesticides Evaluation Scheme; WMR: world malaria report.17WORLD MALARIA REPORT 2020 the burden of malaria3Global trends in The burden estimates presented in this section are the number of cases and deaths estimated to have occurred between 2000 and 2019, as well as case incidence and malaria mortality rates in the same period. | 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 |
These estimates are then used to compute the number of cases and deaths averted, globally and by WHO region, since 2000.
An analysis of the prevalence of exposure to malaria and low birthweights is also presented.s s sEstimation of the burden of malaria cases and deaths relies on several methods, depending on the quality of the national surveillance systems and the availability of data over time (Annex 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 |
Moderate to high transmission countries in sub-Saharan Africa account for most of the global malaria burden, but they generally have weak surveillance systems.
For these countries, estimates of cases are derived using an approach that transforms modelled community parasite prevalence into case incidence within a geospatial framework. | 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 |