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in terms of granularity, frequency and quality) is the clear path towards a better understanding of the malaria burden.TABLE 5.2.Comparisons of estimated malaria cases (millions) using the parasite rate-to-incidence model (Annex 1) and the reported data from the routine public health sector in high burden countries of the WHO African Region, 2019 Sources: WHO estimates and NMP reports.CountryBurkina FasoaCameroonDemocratic Republic of the CongoGhanaMaliMozambiqueNigerNigeriaUgandaUnited Republic of TanzaniaEstimated cases using parasite rate-to-incidence model (population-wide estimate)Reported cases from the routine system (public health sector)Reported cases adjusted for reporting and testing rates (public health sector)Population at risk 2019Reported cases adjusted for reporting and testing rates and treatment seeking (population-wide estimate)7.96.328.34.96.69.48.061.011.66.510.31.220.55.02.711.73.717.812.35.991.012.21.521.65.63.112.53.922.814.06.314.96.380.914.09.015.76.372.033.811.8103.5264.820.325.986.830.419.730.423.3201.044.358.0540.0Total 150.3a For Burkina Faso, monthly data from 2018 was used due to major disruptions of the surveillance system due to the 2019 health workers’ strikes in 2019.5051WORLD MALARIA REPORT 2020 6Investments in malaria programmes and researchThe GTS sets out estimates of the funding required to achieve milestones for 2020, 2025 and 2030. | 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 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) (4).
Section 6.1 presents the most up-to-date funding trends for malaria control and elimination (by source and channel of funding) for the period 2000–2019, where permitted through available data, both globally and for major country groupings. | 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 |
Section 6.2 presents investments in malaria-related R&D for the period 2007–2018.s s s6.1 FUNDING TRENDS FOR MALARIA CONTROL AND ELIMINATIONMalaria-related annual funding from donors through multilateral agencies was estimated from donors’ contributions to the Global Fund from 2010 through 2019.
Organisation for Economic Co-operation and Development (OECD) contributions were available from 2011 through 2018, with 2010 estimates using 2011 data and 2019 estimates using 2018 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 |
In addition, contributions from malaria endemic countries to multilateral agencies were allocated to governments of endemic countries for the years 2010 through 2019.For the 91 countries analysed in this section, 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 (4).
Moreover, the funding gap between the amount invested and the resources needed has continued to widen significantly 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 US, the United Kingdom of Great Britain and Northern Ireland (United Kingdom) and France over this period (Fig.
6.1).
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 United States of America (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 (Fig.
6.2).
Governments of malaria endemic countries contributed 31% of the total investments nearing funding (Fig. | 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 |
6.1), with US$ 0.9 billion in 2019 (Fig.
6.2).
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.To analyse malaria investment since 2000, international bilateral funding data were obtained from several sources, with the historical availability varying across donors. | 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 |
From the USA, data on total annual planned funding from the Centers for Disease Control and Prevention (CDC), Department of Defense and USAID are available from 2001 through 2019.
Total annual planned funding for USAID was utilized from 2001 through 2005, until the introduction of country-specific funding in 2006.
The country recipient for funding has been labelled as “unspecified” for all years where country-specific data are not available.52FIG. | 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 |
6.1.Funding for malaria control and elimination, 2010–2019 (% of total funding), by source of funds (constant 2019 US$) Sources: ForeignAssistance.gov, Global Fund, NMP reports, OECD CRS database, United Kingdom Department for International Development, WHO estimates and World Bank DataBank.Governments of endemic countries 31%United States of America 35%Netherlands 1%Norway 1%Australia 1%Sweden 1%European Commission 2%Bill & Melinda GatesFoundation 2%Canada 2%Other funders 3%Japan 3%Germany 3%France 5%United Kingdom 10%Global Fund: Global Fund to Fight AIDS, Tuberculosis and Malaria; NMP: national malaria programme; OECD: Organisation for Economic Co-operation and Development; United Kingdom: United Kingdom of Great Britain and Northern Ireland; WHO: World Health Organization.FIG. | https://docs-lawep.s3.us-east-2.amazonaws.com/1710417610444.pdf | https://cdn.who.int/media/docs/default-source/malaria/world-malaria-reports/9789240015791-double-page-view.pdf?sfvrsn=2c24349d10 | Zambia |
6.2.Funding for malaria control and elimination, 2010–2019, by source of funds (constant 2019 US$) Sources: ForeignAssistance.gov, United Kingdom Department for International Development, Global Fund, NMP reports, OECD CRS database, the World Bank Data Bank and WHO estimates.■ Governments of endemic countries ■ United States of America ■ United Kingdom ■ France ■ Germany ■ Japan■ Bill & Melinda Gates Foundation ■ Canada ■ European Commission ■ Sweden ■ Netherlands ■ Norway ■ Australia ■ Other funders201020112012201320142015201620172018201900.51.01.52.02.53.03.5US$ (billion)CRS: creditor reporting system; Global Fund: Global Fund to Fight AIDS, Tuberculosis and Malaria; NMP: national malaria programme; OECD: Organisation for Economic Co-operation and Development; United Kingdom: United Kingdom of Great Britain and Northern Ireland; WHO: World Health Organization.53WORLD MALARIA REPORT 2020WORLD MALARIA REPORT 2020 6Investments in malaria programmes and researchData on annual disbursements by the Global Fund to malaria endemic countries are available from 2003 through 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 |
For the government of the United Kingdom, funding data towards malaria control are available from 2007 through 2019: for the years 2007 through 2016, disbursement data were obtained through the OECD creditor reporting system (CRS) on aid activity; for 2017 through 2019, disbursement data were sourced from Statistics on International Development: final UK aid spend 2019 (130).
For all other donors, disbursement data were also obtained from the OECD CRS database for the period 2002–2018. | 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 |
For years with no data available for a particular funder, no imputation was conducted; hence, the trends presented throughout Figs 6.3–6.5 should be interpreted carefully.Contributions from governments of endemic countries were estimated as the sum of contributions reported by NMPs for the world malaria report of the relevant year plus the estimated costs of patient care delivery services at public health facilities. | 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 |
From 2000 to 2019, where available, government expenditures were used for their contributions (if unavailable, then government budgets or estimates were used), whereas patient care delivery costs were estimated using unit cost estimates from WHO-CHOosing Interventions that are Cost-Effective (WHO-CHOICE) 2010, with values included for the years 2010 through 2019.
Of the US$ 3.0 billion invested in 2019, nearly US$ 1.2 billion (39%) was channelled through the Global Fund (Fig.
6.4). | 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 |
6.4).
Compared with 2018, the Global Fund’s disbursements to malaria endemic countries increased by about US$ 0.2 billion in 2019.
This difference reflects the cyclical distribution of ITNs supported by the Global Fund combined with an increase in disbursements in 2019, which corresponded to the end of most malaria grants in that year (Fig. | 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 |
6.4).Planned bilateral funding from the government of the USA amounted to US$ 0.8 billion in 2019, which matched the levels of funding in 2017 and 2018, but is higher than the levels of all other annual planned contributions from 2001, when data first became available, to 2016 (Fig.
6.3).
The United Kingdom remains the second largest bilateral funder, with less than US$ 0.1 billion in 2019, followed by the World Bank and other Development Assistance Committee members (Fig.
6.3). | 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 |
6.3).
The total contribution from governments of malaria endemic countries remained constant, at US$ 0.9 billion invested, in both 2018 and 2019. from Fig.
6.3 shows the substantial variation across country income groups in the share of funding received from domestic and international sources. | 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 27 low-income countries accounted for 41% of total malaria funding in 2019, down from 47% in 2018 (corresponding to >90% of global malaria cases and deaths), with 84% of their funding coming international sources.
International funding also dominated in the group of 37 lower-middle-income countries (48% of total funding in 2019), accounting for 69% of the amount invested in these 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 contrast, in the group of 20 upper-middle-income countries (10% of the total funding in 2019), 13% of their malaria funding came from international sources, and 87% from domestic public 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 |
Lastly, the three high-income countries accounted for 1% of total malaria funding, with 100% of their funding coming from domestic sources.Of the US$ 3.0 billion invested in 2019, 73% benefited the WHO African Region, 9% went 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 (Fig.
6.5). | 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 |
6.5).
Funding flows for which no geographical information on recipients was available represented 4% of the total funding in 2019 (Fig.
6.5).FIG. | 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 |
6.3.Funding for malaria control and elimination, 2000–2019, by World Bank 2019 income group and source of funding (constant 2019 US$)a Sources: ForeignAssistance.gov, Global Fund, NMP reports, OECD creditor reporting system database, United Kingdom Department for International Development, WHO estimates and World Bank DataBank.■ Domestic ■ InternationalLow-income countriesLower-middle-income countriesUpper-middle-income countries)noillib($SU1.21.00.80.60.40.20)noillib($SU1.21.00.80.60.40.20)noillib($SU1.21.00.80.60.40.2000025002010251029102000250020102510291020002500201025102910254Global Fund: Global Fund to Fight AIDS, Tuberculosis and Malaria; NMP: national malaria programme; OECD: Organisation for Economic Co-operation and Development; United Kingdom: United Kingdom of Great Britain and Northern Ireland; WHO: World Health Organization.a Domestic excludes out-of-pocket spending by households.61027102FIG. | 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 |
6.4.Funding for malaria control and elimination, 2000–2019, by channel (constant 2019 US$) Sources: ForeignAssistance.gov, Global Fund, NMP reports, OECD creditor reporting system database, United Kingdom Department for International Development, WHO estimates and World Bank DataBank.■ Governments of endemic countries ■ Global Fund ■ USA bilateral ■ United Kingdom bilateral ■ World Bank ■ Other funders 20002001200220032004200520062007200820092010201120122013201420152016201720182019)noillib($SU3.53.02.52.01.51.00.50Global Fund: Global Fund to Fight AIDS, Tuberculosis and Malaria; NMP: national malaria programme; OECD: Organisation for Economic Co-operation and Development; United Kingdom: United Kingdom of Great Britain and Northern Ireland; USA: United States of America; WHO: World Health Organization.FIG. | 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 |
6.5.Funding for malaria control and elimination, 2000–2019, by WHO region (constant 2019 US$)a Sources: ForeignAssistance.gov, United Kingdom Department for International Development, Global Fund, NMP reports, OECD creditor reporting system database, World Bank Data Bank and WHO estimates.■ African ■ Americas ■ South-East Asia ■ Eastern Mediterranean ■ Western Pacific ■ Unspecified)noillib($SU3.53.02.52.01.51.00.5020002001 2002 2003 2004 2005 2006 2007 2008 200920102011201220132014201520162017 20182019Global Fund: Global Fund to Fight AIDS, Tuberculosis and Malaria; NMP: national malaria programme; OECD: Organisation for Economic Co-operation and Development; United Kingdom: United Kingdom of Great Britain and Northern Ireland; WHO: World Health Organization.a “Unspecified” category refers to funding flows, with no information on the geographical localization of their recipients.55WORLD MALARIA REPORT 2020 6Investments in malaria programmes and research6.2 INVESTMENTS IN MALARIA‑RELATED R&D6.2.1 Overarching trendsBetween 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 (Fig.
6.6). | 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 |
6.6).
Changes in total malaria funding have largely reflected the progression of the overall pipeline.
For example, a spike in vaccine funding in 2008–2009 – related to a surge of funding for Phase III trials of the RTS,S malaria vaccine candidate – was followed by a sharp drop and some subsequent stagnation in malaria R&D funding between 2010 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 |
Driven in part by increased public sector investments in discovery and preclinical R&D for drugs and vaccines, as well as increased industry investment in several Phase II trials of new chemical entities with potential for single-exposure radical cure, overall funding has climbed again since 2016, steadily returning to near-peak levels in 2018.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. | 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 |
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 into basic research (US$ 1.02 billion, 54% of their overall malaria investment between 2007 and 2018).investment 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. | 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 given more funding to malaria than any other disease-specific investment reported by G-FINDER.The industry sector has played a prominent role in advancing malaria drug development.
From an overall investment of US$ 1.4 billion between 2007 and 2018, most of the funding (US$ 932 million, 68%) went towards drug 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 |
Overall industry investment has increased in recent years, related mainly to an expanded focus on clinical development as drug candidates advanced through clinical trials from 2015 onwards. | 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 change in focus, combined with declines in philanthropic funding during the same period, led to funding from industry surpassing philanthropic funding in 2017 for the first time in the past decade.6.2.2 Funding flowsTwo thirds (US$ 4.9 billion, 67%) of all funding for malaria basic research and product development between 2007 and 2018 was given externally in the form of grants or contracts, with internal investments (US$ 2.4 billion, 33%) making up the remainder (Fig.
6.7). | 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 |
6.7).
Academic and nongovernment research institutes received the largest share of direct, external funding (US$ 2.4 billion, 49%), 54% (US$ 1.3 billion) of which went to basic research between 2007 and 2018.
Most internal investment, on the other hand, was accounted for by industry (US$ 1.4 billion, 58%), followed by the public sector (US$ 972 million, 40%). | 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 |
About 74% (US$ 722 million) of the public sector funds came from intramural funding by the US Department of Defense and US National Institutes of Health.
Product development partnerships and other intermediaries received US$ 1.7 billion (23%) of overall external malaria R&D funding, which was used primarily for investment in drugs (US$ 867 million, 51% of their overall funding) and vaccines (US$ 522 million, 31%). | 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 |
During this period, multiple product development partnerships – including PATH’s Malaria Vaccine Initiative (MVI), MMV, FIND and IVCC – have worked to advance development of key malaria product including numerous drugs, next-innovations, generation vector control tools, and, of course, the world’s first malaria vaccine to provide partial protection against malaria in young children.
FIG.
6.6.FIG. | 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 |
6.7.Funding for malaria-related R&D, 2007–2018, by product type (constant 2019 US$)a Sources: Policy Cures Research G-FINDER data portal (104).Malaria R&D funding from 2007 to 2018, by sector (constant 2019 US$) Source: Policy Cures Research, G-FINDER data portal (104).■ Drugs ■ Basic research ■ Vaccines ■ Vector control ■ Diagnostics ■ Biologics ■ Unspecified400■ Public ■ Industry ■ Philanthropic ■ Other200720082009201020112012201320142015201620172018010020030040050060070056R&D: research and development.a “Unspecified” category refers to funding flows, with no information on the geographical localization of their recipients.US$ (million)300)noillim($SU2001000200720082009201020112012201320142015201620172018R&D: research and development.57WORLD MALARIA REPORT 2020 7Distribution and coverage of malaria prevention, diagnosis and treatmentsurveys were used, together with manufacturer deliveries and NMP distributions, to estimate the following main indicators: ■ ITN use (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 |
percentage of a given population group that slept under an ITN the night before the survey); ■ ITN ownership (i.e.
percentage of households that owned at least one ITN); ■ percentage of households with at least one ITN for every two people; and ■ percentage of the population with access to an ITN within their household (i.e.
percentage of the population that could be protected by an ITN, if each ITN in a household could be used by two people).FIG. | 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 |
7.1.Number of ITNs delivered by manufacturers and distributeda by NMPs, 2010–2019 Sources: Milliner Global Associates and NMP reports.WHO recommends several interventions for the prevention, diagnosis and treatment of malaria (106).
The prevention interventions tracked in this report are ITNs, indoor residual spraying (IRS), SMC and IPTp, discussed here in Sections 7.1–7.4. | 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 |
To measure progress in access to prompt case management, Section 7.5 presents the latest results on distribution of RDTs and ACTs, and population-level coverage of malaria diagnosis and treatment.
s s s7.1 DISTRIBUTION AND COVERAGE OF ITNsManufacturers delivered about 253 million ITNs to malaria endemic countries in 2019, an increase of 56 million ITNs compared with 2018 (Fig.
7.1).
About 84% of these ITNs were delivered to countries 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 |
About 46% of the ITNs delivered by manufacturers were received in Nigeria (33.4 million), the Democratic Republic of the Congo (28.0 million), Ethiopia (15.1 million), Mali (10.4 million), Mozambique (10.2 million), Sudan (10.1 million) and Benin (9.7 million). | 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 |
Data from 2010–2019 are presented here; however, manufacturers’ delivery data for 2004–2019 show that nearly 2.2 billion ITNs were supplied globally in that period, of which 1.9 billion (86%) were supplied to sub-Saharan Africa.In 2019, 154 million ITNs were distributed globally by NMPs 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 |
Of these ITNs, 140 million were distributed in sub-Saharan Africa, with a combined total of about 103 million ITNs being distributed in seven countries: Nigeria (31 million), the Democratic Republic of the Congo (21 million), Ethiopia (11 million), Guinea (9 million), Senegal (9 million), Burundi (8 million) and Cameroon (8 million). | 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 |
Outside of sub-Saharan Africa, the largest distribution was in Myanmar (11 million).Indicators of population-level coverage of ITNs were estimated for sub-Saharan African countries in which ITNs are the main method of vector control. | 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 |
Household 58)noillim(sNTIforebmuN300250200150100500Manufacturerdeliveries:■ Sub-Saharan Africa■ Outside sub-Saharan AfricaNMPdistributions:■ Sub-Saharan Africa■ Outside sub-Saharan Africa2010 20112011 20122012 201320132014201420152015201620162017201720182018 20192019ITN: insecticide-treated mosquito net; NMP: national malaria programme.a A lag between manufacturer deliveries to countries and NMP distributions of about 6–12 months is expected; thus, deliveries by manufacturers in a given year are often not reflected in distributions by NMPs in that year. | 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, distributions of ITNs reported by NMPs do not always reflect all the nets that have been distributed to communities, depending on completeness of reporting.
These issues should be considered when interpreting the relationship between manufacturer deliveries, NMP distributions and likely population coverage.
Additional considerations include nets that are in storage in country but have not yet been distributed by NMPs, and those sold through the private sector that are not reported by programmes. | 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 |
59WORLD MALARIA REPORT 2020WORLD MALARIA REPORT 2020 7Distribution and coverage of malaria prevention, diagnosis and treatmentBy 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.
In the same period, the percentage of the population with access to an ITN within their household increased 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 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%).
These indicators represent impressive progress since 2000, although coverage peaked in 2017 (Fig.
7.2).Using concentration indices, socioeconomic equity of ITN use by the children aged under 5 years at the subnational level was analysed. | 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 DHS and MIS from 24 countries1 for 2015–2019 were used (Fig.
7.3).
In most West African countries, ITN use was generally pro-poor (i.e.
concentration index <0) (Fig.
7.3).
The concentration index varies from -1 to +1, with a value of zero indicating perfect equality.
In this analysis, negative and positive values suggest that ITN use is concentrated in the poorest and richest households.
In contrast, ITN use was higher in wealthier households (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 |
concentration index >0) in many parts of the Democratic Republic of the Congo, Kenya, Mozambique, Uganda and the United Republic of Tanzania.1 Angola (DHS 2018), Benin (DHS 2017–2018), Burkina Faso (MIS 2017–2018), Burundi (DHS 2016–2017), Cameroon (DHS 2018), Ethiopia (DHS 2016), Ghana (MIS 2019), Guinea (DHS 2018), Kenya (MIS 2015), Liberia (MIS 2016), Madagascar (MIS 2016), Malawi (MIS 2017), Mali (DHS 2018), Mozambique (MIS 2018), Nigeria (DHS 2018), Rwanda (MIS 2017), Senegal (DHS 2018), Sierra Leone (MIS 2016), Togo (MIS 2017), Uganda (MIS 2018–2019), United Republic of Tanzania (MIS 2017), Zambia (DHS 2018) and Zimbabwe (DHS 2015).FIG. | 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 |
7.2.FIG. | 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 |
7.3.Indicators of population-level coverage of ITNs, sub-Saharan Africa, 2000–2019: a) percentage of households with at least one ITN, b) percentage of households with one ITN for every two people, c) percentage of population with access to an ITN, d) percentage of population using an ITN, e) percentage of children aged under 5 years using an ITN and f) percentage of pregnant women sleeping under an ITN Sources: ITN coverage model from MAP (131).Concentration index of ITN use by children aged under 5 years, sub-Saharan Africa at administrative level 1 Source: Most recent household surveys from the period 2015–2019. | 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 |
Kenya Medical Research Institute – Wellcome Trust Research Programme.NTIenotsaeltahtilwsdohesuohfoegatnecrePNTInaotsseccahtilwnoitaupopfoegatnecrePnerdlihcfoegatnecrePNTInagnisusraey5rednudega(a)10095% CIMean0002(c)0002(e)806040200100806040200100806040200500201025102910295% CIMean500201025102910295% CIMean95% CIMean500201025102910295% CIMean500201025102910295% CIMean(b)100lsdohesuohfoegatnecrePlepoepowtyreverofNTIenohtiw806040200NTIlnagnisunoitaupopfoegatnecrePnemowtnangerpfoegatnecrePNTInarednugnpeelsi1008060402001008060402000002(d)0002(f)Concentration index:children <5 years who used an ITN on the night before the survey■ <-0.10■ -0.09–0■ 0.01–0.10■ >0.10–0.20■ >0.20■ Not applicable600002500201025102910200025002010251029102CI: confidence interval; ITN: insecticide-treated mosquito net; MAP: Malaria Atlas Project.ITN: insecticide-treated mosquito net.61WORLD MALARIA REPORT 2020 7Distribution and coverage of malaria prevention, diagnosis and treatment7.2 POPULATION PROTECTED WITH IRS7.3 SCALE‑UP OF SMCGlobally, the percentage of the populations at risk protected by IRS in malaria endemic countries declined from 5% in 2010 to 2% 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 the population protected by IRS decreased in all WHO regions (Fig.
7.4).
The number of people protected globally fell from 180 million in 2010 to 115 million in 2015, but declined to 97 million in 2019.
By country, Burundi, Ethiopia, India and Somalia each had the number of people protected with IRS reducing by a million or more when 2019 was compared with 2018.In Benin, SMC was scaled up for the first time, taking the number of countries in the Sahel that implement SMC to 13. | 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 SMC steadily increased, from about 0.2 million in 2012 to about 21.5 million in 2019 (Table 7.1).
Subnational areas in each country where SMC was targeted in 2019 are shown in Fig.
7.5.
In the 13 countries, a total of about 21.7 million children were targeted in 2019.
On average, 21.5 million children received treatment each month (Table 7.2), but household surveys are needed to establish coverage gaps.FIG. | 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 |
7.4.Percentage of the population at risk protected by IRS, by WHO region, 2010–2019 Source: IVCC data and NMP reports.■ AFR ■ AMR ■ EMR ■ SEAR ■ WPR ■ WorldTABLE 7.1.Average number of children treated with at least one dose of SMC by year in countries implementing SMC, 2012–2019 Sources: NMPs, LSHTM and MMV.ksirltanoitaupopfoegatnecreP12108642010.1%5.8%5.3%3.9%3.9%2.9%5.7%2.4%1.9%1.6%1.0%0.3%2010201120122013201420152016201720182019AFR: WHO African Region; AMR: WHO Region of the Americas; EMR: WHO Eastern Mediterranean Region; IRS: indoor residual spraying; IVCC: Innovative Vector Control Consortium; NMP: national malaria programme; SEAR: WHO South-East Asia Region; WHO: World Health Organization; WPR: Western Pacific Region.FIG. | 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 |
7.5.Subnational areas where SMC was delivered in implementing countries in sub-Saharan Africa, 2019 Source: LSHTM.■ Areas with SMC in 2019■ Not applicable2012201320142015201620172018201900000000000114 165307 770860 0582 648 0832 949 9013 298 3973 298 397001 070 8651 581 1831 636 6581 681 73710 000263 97227 307322 493824 806899 3201 184 7061 491 9050000000048 95376 45073 71076 726101 511110 870000115 309151 510327 446329 953964 956201 283442 177575 927840 120750 9031 999 98736 681166 16290 99882 918160 000537 294699 880646 1733 849 6723 990 0964 278 4013 767 2050000225 970518 110787 3991 994 3452 545 8853 810 8844 151 103209 451370 280471 8031 579 2292 284 9153 460 7334 110 15255 709446 8090477 614485 7170671 132119 222127 6245 480 954308 858382 319325 621296 332170 0001 411 6182 546 733 10 961 909 13 457 550 16 265 597 19 357 982 21 491 775Country BeninBurkina Faso CameroonChadGambiaGhanaGuinea Guinea-BissauMaliNigerNigeria Senegal Togo TotalTABLE 7.2.Average number of children targeted and treated, and total treatment doses targeted and delivered, in countries implementing SMC, 2019 Sources: NMPs, LSHTM and MMV.Country BeninBurkina FasoCameroonChadGambiaGhanaGuineaGuinea-BissauMaliNigerNigeriaSenegalTogoTotalAverage number of children targetedAverage number of children treatedTotal treatments targetedTotal treatments delivered117 4703 588 2711 687 8801 424 920142 6951 074 214726 40293 3643 548 9684 188 3043 989 073821 473346 259114 1653 298 3971 681 7371 491 905110 870964 956750 90382 9183 767 2054 151 1034 110 152671 132296 33221 749 29321 491 774469 88114 353 0856 751 5205 699 681570 7804 296 8562 905 606373 45614 195 87216 753 21715 956 2903 285 8931 385 03586 997 172456 66013 193 5886 726 9485 967 620443 4803 859 8243 003 612331 67215 068 82016 604 41216 440 6082 684 5281 185 32885 967 09662LSHTM: London School of Hygiene & Tropical Medicine; SMC: seasonal malaria chemoprevention.LSHTM: London School of Hygiene & Tropical Medicine; MMV: Medicines for Malaria Venture; NMP: national malaria programme; SMC: seasonal malaria chemoprevention. | 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 |
63WORLD MALARIA REPORT 2020 7Distribution and coverage of malaria prevention, diagnosis and treatment7.4 COVERAGE OF IPTp USE BY DOSE7.5 MALARIA DIAGNOSIS AND TREATMENTTo date, 33 African countries have adopted IPTp to reduce the burden of malaria during pregnancy.
These countries reported routine data from health facilities in the public sector on the number of women visiting ANC clinics, and the number receiving the first, second, third and fourth doses of IPTp (i.e.
IPTp1, IPTp2, IPTp3 and IPTp4). | 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 |
IPTp1, IPTp2, IPTp3 and IPTp4).
Using annual expected pregnancies as the denominator (adjusted for fetal loss and stillbirths), the percentage of IPTp use by dose was computed.
Despite a slight increase in IPTp3 coverage from 31% in 2018 to 34% in 2019, coverage remains well below the target of at least 80% and underscores the substantial number of missed opportunities, given that 62% of women receive IPTp1 (Fig. | 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 |
7.6).This section presents information on manufacturer sales and deliveries and national distribution of RDTs and ACTs, treatment seeking for fever in children aged under 5 years, and population-level coverage of malaria diagnosis and treatment with ACTs.
RDT data shown in this section reflect sales by manufacturers eligible for procurement (i.e.
under the Malaria RDT Product Testing Programme) from 2010 to 2017, and since 2018 for WHO Prequalification, and NMP distributions of RDTs. | 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 types of ACTs tracked are those recommended by WHO for use in the treatment of clinical malaria.Globally, 2.7 billion RDTs for malaria were sold by manufacturers in 2010–2019, with nearly 80% of these sales being to sub-Saharan African countries.
In the same period, NMPs distributed 1.9 billion RDTs – 84% in sub-Saharan Africa (Fig.
7.7).
In 2019, 348 million RDTs were sold by manufacturers and 267 million distributed by NMPs. | 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 |
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.FIG.
7.6.FIG. | 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 |
7.6.FIG.
7.7.Percentage of pregnant women attending an ANC clinic at least once and receiving IPTp, by dose, sub-Saharan Africa, 2010–2019 Source: NMP reports, US CDC and Prevention estimates and WHO estimates.Number of RDTs sold by manufacturers and distributed by NMPs for use in testing suspected malaria cases, 2010–2019a Sources: NMP reports and sales data from manufacturers eligible for the WHO Malaria RDT Product Testing Programme. | 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 |
nemowtnangerpfoegatnecreP100806040200■ Attending ANC at least once ■ IPTp1 ■ IPTp2 ■ IPTp3 78%80%62%60%49%49%34%31%69%42%28%2%201020112012201320142015201620172018201964ANC: antenatal care; CDC: Centers for Disease Control and Prevention; IPTp: intermittent preventive treatment in pregnancy; IPTp1: first dose of IPTp; IPTp2: second dose of IPTp; IPTp3: third dose of IPTp; NMP: national malaria programme; US: United States; WHO: World Health Organization.NMP distributions■ Sub-Saharan Africa■ Outside sub-Saharan AfricaManufacturer salesSub-Saharan Africa:■ P. falciparum only tests■ Combination testsOutside sub-Saharan Africa:■ P. falciparum only tests■ Combination tests)noillim(sTDRforebmuN4504003503002502001501005002010201120122013201420152016201720182019NMP: national malaria programme; P. falciparum: Plasmodium falciparum; RDT: rapid diagnostic test; WHO: World Health Organization.a NMP distributions do not reflect those RDTs still in storage that have yet to be delivered to health facilities and community health workers.65WORLD MALARIA REPORT 2020 7Distribution and coverage of malaria prevention, diagnosis and treatmentMore than 3.1 billion treatment courses of ACT were sold globally by manufacturers in 2010–2019 (Fig. | 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 |
7.8).
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.
National data reported by NMPs show that, in the same period, 1.9 billion ACTs were delivered to health service providers to treat malaria patients in the public health 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 |
In 2019, some 190 million ACTs were sold by manufacturers to the public health sector; in that same year, 183 million ACTs were distributed to this sector by NMPs, of which 90% were in sub-Saharan Africa.Aggregated data from household surveys conducted in sub-Saharan Africa between 2005 and 2019 in 21 countries1 with at least two surveys (baseline – 2005–2011 and most recent – 2015–2019) in this period 1 Angola (MIS 2011; DHS 2018), Benin (DHS 2006; DHS 2017–2018), Burkina Faso (DHS 2010; MIS 2017–2018), Burundi (DHS 2010; DHS 2016–2017), Cameroon (DHS 2011, DHS 2018), Ghana (DHS 2008; MIS 2019), Guinea (DHS 2005; DHS 2018), Kenya (DHS 2008–2009; MIS 2015), Liberia (MIS 2011; MIS 2016), Madagascar (MIS 2011; MIS 2016), Malawi (DHS 2010; MIS 2017), Mali (DHS 2006; DHS 2018), Mozambique (DHS 2011; MIS 2018), Nigeria (MIS 2010; DHS 2018), Rwanda (DHS 2010; MIS 2017), Senegal (DHS 2010-2011; DHS 2018), Sierra Leone (DHS 2008; MIS 2016), Uganda (DHS 2011; MIS 2018–2019), United Republic of Tanzania (DHS 2010; MIS 2017), Zambia (DHS 2007; DHS 2018) and Zimbabwe (DHS 2010–2011; DHS 2015).FIG. | 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 |
7.8.Number of ACT treatment courses delivered by manufacturers and distributed by NMPs to patients, 2010–2019a,b Sources: Companies eligible for procurement by WHO/UNICEF and NMP reports. | 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 |
)noillim(sesruoctnemtaertTCA5004003002001000Manufacturer sales ■ Public sector ■ Public sector – AMFm/GF co-payment mechanisms ■ Outside sub-Saharan Africa■ Private sector – AMFm/GF co-payment mechanisms■ Private sector – outside AMFm/GF co-payment mechanismsNMP deliveries■ Sub-Saharan Africa2010201120122013201420152016201720182019were used to analyse coverage of treatment seeking, diagnosis and use of ACTs by children aged under 5 years (Table 7.3). | 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 |
Comparing baseline and latest surveys, there was little change in prevalence of fever within the 2 weeks preceding surveys (median 24% versus 21%) and treatment seeking for fever (median 64% versus 69%).
Comparisons of the source of treatment between baseline and more recent surveys shows that a median 63% versus 71% received care from public health facilities, and a median 39% versus 30% from the private 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 |
Use of community health workers was low in both periods, at a median of less than 2%.The rate of diagnosis among children aged under 5 years for whom care was sought increased considerably, from a median of 15% at baseline to 38% in the latest household surveys.
Use of ACTs also increased more than twofold, from 39% at baseline to 81% in the latest surveys when all children with fever for whom care was sought were considered. | 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 |
Among those who received a finger or heel prick, use of ACTs was 42% in the most recent survey, suggesting that many children received ACTs without parasitological diagnosis.TABLE 7.3.Summary of coverage of treatment seeking for fever, diagnosis and use of ACTs for children aged under 5 years from household surveys in sub-Saharan Africa, at baseline (2005–2011) and most recent (2015–2019) Source: household surveys.Children aged under 5 yearsBaseline (2005-2011)Most recent survey (2015-2019)IndicatorPrevalence of feverWith fever in past 2 weeksTreatment seeking for feverWith fever in past 2 weeks for whom treatment was soughtMedian estimateLower boundUpper boundMedian estimateLower boundUpper bound24.1%18.3%34.3%20.6%16.1%30.9%63.5%57.7%71.6%69.1%56.3%73.8%Source of treatment for fever among those who were treatedPublic sector (health facility)Public sector (community health worker)Private sector (formal and informal)62.9%2.0%39.1%52.8%0.2%21.6%80.3%3.4%50.3%71.0%1.3%30.2%49.0%0.4%16.3%85.0%4.9%51.9%Diagnosis among those with fever and for whom care was sought Received a finger or heel prick 15.4%6.5%26.9%37.7%17.8%49.1%Use of ACTs among those for whom care was sought Received treatment with ACTs 38.9%23.6%68.2%80.5%30.6%93.4%Use of ACTs among those for whom care was sought and received a finger or heel prickReceived ACTs18.9%14.3%37.7%42.4%17.1%58.7%ACT: artemisinin-based combination therapy.ACT: artemisinin-based combination therapy; AMFm: Affordable Medicines Facility–malaria; GF: Global Fund to Fight AIDS, Tuberculosis and Malaria; NMP: national malaria programme; UNICEF: United Nations Children’s Fund; WHO: World Health Organization.a NMP deliveries to patients reflect consumption reported in the public health sector.b AMFm/GF indicates that the AMFm operated from 2010 to 2013, with the GF co-payment mechanism operating from 2014.6667WORLD MALARIA REPORT 2020 7Distribution and coverage of malaria prevention, diagnosis and treatmentAnalysis of equity of fever prevalence and treatment seeking at subnational level was conducted using the most recent household survey data for 2015–2019, from 23 countries1 (Fig. | 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 |
7.9). | 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 |
In most countries, children in 1 Angola (DHS 2018), Benin (DHS 2017–2018), Burkina Faso (MIS 2017–2018), Burundi (DHS 2016–2017), Cameroon (DHS 2018), Ethiopia (DHS 2016), Ghana (MIS 2019), Guinea (DHS 2018), Kenya (MIS 2015), Liberia (MIS 2016), Madagascar (MIS 2016), Malawi (MIS 2017), Mali (DHS 2018), Mozambique (MIS 2018), Nigeria (DHS 2018), Rwanda (MIS 2017), Senegal (DHS 2018), Sierra Leone (MIS 2016), Togo (MIS 2017), Uganda (MIS 2018–2019), United Republic of Tanzania (MIS 2017), Zambia (DHS 2018) and Zimbabwe (DHS 2015).poorer households had a higher prevalence of having a fever in the 2 weeks preceding the household surveys (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 |
concentration index <0).
In contrast, treatment seeking was higher in febrile children from wealthier households in all subnational units, although in some units the difference was small.FIG. | 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 |
7.9.Concentration index of a) prevalence of fever in, and b) care seeking for children aged under 5 years at administrative level 1, sub-Saharan Africa Source: most recent household surveys from the period 2015–2019, Kenya Medical Research Institute – Wellcome Trust Research Programme.a)b)Concentration index:those with fever■ <-0.20■ –0.19 to –0.10■ –0.09 to 0■ 0.01 to 0.20■ >0.20■ Not applicableConcentration index:those who sought treatment■ <-0.05■ 0.06 to 0.15■ 0.16 to 0.25■ 0.26 to 0.35■ >0.35■ Not applicable6869WORLD MALARIA REPORT 2020 8Global progress towards the GTS milestonesThe 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 (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 |
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 as mandated to WHO by the World Health Assembly (4).
The projections presented here 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 (Section 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 |
s s s8.1 GLOBAL PROGRESSDespite the considerable progress made since 2000, the GTS 2020 milestones for morbidity and mortality will not be achieved globally (Fig.
8.1).
Without actions to reverse this trend, the 2030 GTS and SDG targets for malaria morbidity and mortality will also not be met (Fig.
8.1). | 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 |
8.1).
The malaria case incidence of 56 per 1000 population at risk in 2020 instead of the expected 35 cases per 1000 means that, globally, we are off track by 37%; at the current trajectory, we could be off track by 87% in 2030 (Fig.
8.1a).
Although relative progress in the mortality rate is greater than that in case incidence (see Section 3 for potential methodological reasons), globally projected malaria deaths per 100 000 population at risk in 2020 was projected to be 9.8, reducing from 11.9 in 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 |
This implied that globally we were off track by 22% (Fig.
8.1b).
Fig.
8.2 and Fig.
8.3 on the next page present progress in all countries considered to be malaria endemic in 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 |
Countries were ranked into eight categories of reduction of case incidence and mortality rates in 2020 from a 2015 baseline: ■ achieved zero malaria by 2020; ■ reduced by 40% or more; ■ reduced by between 25% and less than 40%; ■ reduced by less than 25%; ■ no change since 2015 (less than 5% increase or decrease in case incidence or mortality rate); 70 ■ increased by less than 25%; ■ increased by between 25% and less than 40%; and ■ increased by 40% or more.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. | 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 |
Another 21 (23%) had made progress in reducing malaria case incidence but were not on track for the GTS milestone.
Thirty-one countries (34%) are estimated to have experienced increased incidence, with 15 countries (16%) estimated to have experienced an increase of 40% or more in malaria case incidence in 2020 compared with 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 |
Malaria case incidence in nine (10%) countries in 2020 was estimated to be at levels similar to those of 2015.Thirty-nine (42%) countries that were malaria endemic in 2015 were on track for the GTS mortality milestone for 2020, with 28 of them reporting zero malaria cases.
An additional 34 countries (37%) were estimated to have achieved reductions in mortality rate but progress was below the 40% target. | 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 mortality rates remained at the same level in 2020 as in 2015 in seven countries (8%), while another 12 countries (13%) had estimated increases, with six of these countries having increases of 40% or more.FIG. | 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 |
8.1.Comparison of global progress in malaria: a) case incidence and b) mortality rate, considering two scenarios: current trajectory maintained (blue) and GTS targets achieved (green) Source: WHO estimates.a)80)ksirltanoitaupop0001rep(ecnedcniiesacairaaMlb)ksirltanoitaupop000001repshtaedairaamlforebmuN70605040302010018161412108642058575756454035■ Current estimates of global case incidence (WMR 2020)■ ■ GTS milestones (baseline of 2015) ■ ■ Forecasted trend if current trajectory is maintained 5214486201020112012201320142015201620172018201920202021202220232024202520262027202820292030■ Current estimates of global mortality rate (WMR 2020)■ ■ GTS milestones (baseline of 2015) ■ ■ Forecasted trend if current trajectory is maintained 11.99.87.28.23.06.91.2201020112012201320142015201620172018201920202021202220232024202520262027202820292030GTS: Global technical strategy for malaria 2016–2030; WHO: World Health Organization; WMR: world malaria report.71WORLD MALARIA REPORT 2020WORLD MALARIA REPORT 2020 FIG. | 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 |
8.2.FIG.
8.3.Map of malaria endemic countries showing progress towards the GTS 2020 malaria case incidence milestone of at least 40% reduction from a 2015 baseline Source: WHO estimates.Map of malaria endemic countries showing progress towards the GTS 2020 malaria mortality rate milestone of at least 40% reduction from a 2015 baseline Source: WHO estimates. | 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 |
)sesacairaamorez(lkcartnOlebacilppatoNlairaamoN■■■%04<dna%52neewtebybesaerceD)eromro%04ybesaerced(kcartnO%52<ybesaerceD■■■%04<dna%52neewtebybesaercnIeromro%04ybesaercnI5102ecnisesaercedroesaercnioN%52<ybesaercnI■■■■.inoitaznagrOhtlaeHdlroW)shtaedairaamorez(lkcartnOlebacilppatoNlairaamoN■■■%04<dna%52neewtebybesaerceD)eromro%04ybesaerced(kcartnO%52<ybesaerceD■■■%04<dna%52neewtebybesaercnIeromro%04ybesaercnI5102ecnisesaercedroesaercnioN%52<ybesaercnI■■■■.inoitaznagrOhtlaeHdlroW:OHW;0302–6102airaamlrofygetarts:OHW;0302–6102airaamlrofygetartsliacnhcetlaboGlliacnhcetlaboGl72:STG:STG73WORLD MALARIA REPORT 2020 8Global progress towards the GTS milestones8.2 WHO AFRICAN REGIONAnalysis of the trends by region shows that the WHO African Region is off track for both the malaria morbidity and mortality 2020 GTS milestones, by 37% and 25%, respectively (Fig. | 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 |
8.4).
Only Botswana, Cabo Verde, Ethiopia, the Gambia, Ghana and Namibia are on track to achieve the GTS 2020 target of a 40% reduction in malaria case incidence, and Algeria has already been certified 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 |
Although not on track, 17 countries (Equatorial Guinea, Gabon, Guinea, Guinea-Bissau, Kenya, Malawi, Mali, Mauritania, Mozambique, Niger, Senegal, Sierra Leone, South Africa, Togo, United Republic of Tanzania, Zambia and Zimbabwe) were estimated to have achieved reductions in malaria case incidence by 2020 compared with 2015 (Fig.
8.2). | 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 |
8.2).
There was no difference (<5% increase or decrease) in case incidence in 2020 compared with 2015 in Benin, Burkina Faso, Cameroon, Central African Republic, Liberia, Madagascar, Nigeria, South Sudan and Uganda.
Case incidence was higher in 2020 than in 2015 by less than 25% in Angola, Chad, Congo, Côte d’Ivoire, Democratic Republic of the FIG. | 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 |
8.4.Comparison of progress in malaria: a) case incidence and b) mortality rate in the WHO African Region considering two scenarios: current trajectory maintained (blue) and GTS targets achieved (green) Source: WHO estimates.Congo, Rwanda, and Sao Tome and Principe, and increased by 40% or more in Burundi, Comoros, Eritrea and Eswatini.Botswana, Cabo Verde, Eswatini, and Sao Tome and Principe reported zero malaria deaths in 2019 and were projected to maintain this in 2020 (Fig.
8.3). | 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 |
8.3).
Ethiopia and Namibia were estimated to have achieved a reduction in mortality rate of more than 40%. | 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 not on track for the GTS 2020 mortality milestones, 30 countries (Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Congo, Côte d’Ivoire, Democratic Republic of the Congo, Equatorial Guinea, Gabon, Gambia, Ghana, Guinea, Kenya, Malawi, Mali, Mauritania, Mozambique, Niger, Nigeria, Senegal, Sierra Leone, South Africa, Togo, Uganda, United Republic of Tanzania, Zambia and Zimbabwe) had achieved mortality rate reductions of less than 40%. | 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 |
Guinea-Bissau, Liberia, Madagascar, Rwanda and South Sudan showed no change in levels of mortality rate (<5% decrease or increase) in 2020 compared with 2015, whereas increases in mortality rate of more than 40% were reported in Comoros, Eritrea and Sudan. | 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 |
■ Current estimates of regional case incidence (WMR 2020)■ ■ GTS milestones (baseline of 2015) ■ ■ Forecasted trend if current trajectory is maintained ■ Current estimates of regional mortality rate (WMR 2020)■ ■ GTS milestones (baseline of 2015) ■ ■ Forecasted trend if current trajectory is maintained a)300)ksirltanoitaupop0001rep(ecnedcniiesacairaaMl2502001501005002332292252221831611402075819423b)100ksirltanoitaupop000001repshtaedairaamlforebmuN908070605040302010049403439293212275201020112012201320142015201620172018201920202021202220232024202520262027202820292030201020112012201320142015201620172018201920202021202220232024202520262027202820292030GTS: Global technical strategy for malaria 2016–2030; WHO: World Health Organization; WMR: world malaria report.GTS: Global technical strategy for malaria 2016–2030; WHO: World Health Organization; WMR: world malaria report.7475WORLD MALARIA REPORT 2020 8Global progress towards the GTS milestones8.3 WHO REGION OF THE AMERICASIn the WHO Region of the Americas, both Belize and El Salvador had zero malaria cases in 2019 and are projected to remain unchanged in 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 |
Belize, French Guiana, Guatemala, Haiti, Honduras and Peru were all on target for the 2020 malaria morbidity GTS milestone of a reduction of at least 40% in case incidence (Fig.
8.5).
Bolivia (Plurinational State of), Brazil, Mexico and Suriname are estimated to have reduced malaria case incidence by less than 25% in 2020 compared with 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 |
Colombia, Costa Rica, Dominican Republic, Ecuador, Guyana, Nicaragua, Panama and Venezuela (Bolivarian Republic of) are estimated to have increases in case incidence of more than 40% in 2020 compared with 2015.
At regional level, most of the worsening of the trend is attributable to the epidemic in Venezuela (Bolivarian Republic of). | 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 analysis in the WHO Region of the Americas shows that the region would be about 43% off the GTS 2020 malaria case incidence milestones with the estimated cases in Venezuela (Bolivarian Republic of) and 15% off without those FIG. | 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 |
8.5.Comparison of progress in malaria: a) case incidence and b) mortality rate in the WHO Region of the Americas considering two scenarios: current trajectory maintained (blue) and GTS targets achieved (green) Source: WHO estimates.■ Current estimates of regional case incidence (WMR 2020)■ ■ GTS milestones (baseline of 2015) ■ ■ Forecasted trend if current trajectory is maintaineda)14■ ■ GTS milestones (baseline of 2015) – without Venezuela (Bolivarian Republic of) ■ ■ Forecasted trend if current trajectory is maintained – without Venezuela (Bolivarian Republic of))ksirltanoitaupop0001rep(ecnedcniiesacairaaMl1210864201021122047337632estimated cases (Fig. | 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 |
8.5).
Urgent control of the epidemic in Venezuela (Bolivarian Republic of) is required to get the region back on track.There are few malaria deaths in the WHO Region of the Americas, and changes in 2020 relative to the 2015 GTS baseline should be interpreted with caution.
For example, although the mortality rate in Bolivia (Plurinational State of), Dominican Republic and Nicaragua has increased by more than 40% (Fig. | 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 |
8.3), it is estimated that the actual number of deaths would be fewer than 15 in all these 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 |
Malaria deaths in Venezuela (Bolivarian Republic of), however, are estimated to have doubled and there have been more than 400 cases in 2020.■ Current estimates of regional mortality rate (WMR 2020)■ ■ GTS milestones (baseline of 2015) ■ ■ Forecasted trend if current trajectory is maintained0.40.40.40.40.30.20.20.10b)1.0ksirltanoitaupop000001repshtaedairaamlforebmuN0.90.80.70.60.50.40.30.20.10201020112012201320142015201620172018201920202021202220232024202520262027202820292030201020112012201320142015201620172018201920202021202220232024202520262027202820292030GTS: Global technical strategy for malaria 2016–2030; WHO: World Health Organization; WMR: world malaria report.GTS: Global technical strategy for malaria 2016–2030; WHO: World Health Organization; WMR: world malaria report.7677WORLD MALARIA REPORT 2020 8Global progress towards the GTS milestones8.4 WHO EASTERN MEDITERRANEAN REGION8.5 WHO SOUTH‑EAST ASIA REGIONOverall, the WHO Eastern Mediterranean Region is off track for both the 2020 GTS milestone for malaria morbidity and mortality, by twice the expected levels (Fig. | 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 |