World Malaria Report 2020 | UPSC
WHO World Malaria Report 2020: India continues to make Impressive Gains in reduction of Malaria Burden
WHY IN NEWS:
India the only high endemic country which has reported a decline of 17.6% in 2019 over 2018
SYLLABUS COVERED: GS 3: Reports
For PRELIMS note down the trends , new definitions , statistics and facts relevant to India’s perspective.
For MAINS look out for strategy , global outreach of this disease , governance , loopholes and do not forget to read the climax . Let us dive in !
WORLD MALARIA REPORT 2020
- World malaria report takes a historical look at key milestones that helped shape the global response to the disease over the last 2 decades.
- The report features a detailed analysis on progress towards the 2020 milestones of WHO’s global malaria strategy.
- The report has a special section on malaria and the COVID-19 pandemic.
- As in past years, the report provides an up-to-date assessment of the burden of malaria at global, regional and country levels.
- It tracks investments in malaria programmes and research as well as progress across all intervention areas.
- This latest report draws on data from 87 countries and territories with ongoing malaria transmission.
- World Malaria Report 2020 : 20 YEARS OF GLOBAL PROGRESS & CHALLENGES
- World Health Organization
- India has made considerable progress in reducing its malaria burden.
- India is the only high endemic country which has reported a decline of 17.6% in 2019 as compared to 2018.
- India has sustained API less than one since year 2012.
- India has also contributed to the largest drop in cases region-wide, from approximately 20 million to about 6 million.
- The percentage drop in the malaria cases was 71.8% and deaths was 73.9% between 2000 to 2019.
- Thereby, achieving Goal 6 of the Millennium Development Goals (50-75% decrease in case incidence between 2000 and 2019).
Epidemiological trends of Malaria in India (2000-2019) Pv; Plasmodium Vivax & pf; Plasmodium Falciparum
- Globally, there were an estimated 229 million malaria cases in 2019 in 87 malaria endemic countries, declining from 238 million in 2000.
- At the Global technical strategy for malaria 2016–2030 (GTS) baseline of 2015, there were 218 million estimated malaria cases.
Countries with indigenous cases in 2000 and their status by 2019 | SOURCES : WHO
- The proportion of cases due to Plasmodium vivax reduced from about 7% in 2000 to 3% in 2019.
- Malaria case incidence (i.e. cases per 1000 population at risk) reduced from 80 in 2000 to 58 in 2015 and 57 in 2019 globally.
- The World Health Organization (WHO) African Region, with an estimated 215 million cases in 2019, accounted for about 94% of cases.
- The South-East Asia Region accounted for about 3% of the burden of malaria cases globally.
- Malaria cases reduced by 73%, from 23 million in 2000 to about 6.3 million in 2019.
- Sri Lanka was certified malaria free in 2015, and Timor-Leste reported zero malaria cases in 2018 and 2019.
DISTRIBUTION OF MALARIA CASES | SOURCES : WHO
- Malaria cases in the WHO Eastern Mediterranean Region reduced by 26%.
- About a quarter of the cases in 2019 were due to P. vivax, mainly in Afghanistan and Pakistan.
- Sudan is the leading contributor to malaria in this region, accounting for about 46% of cases.
- The Islamic Republic of Iran had no indigenous malaria cases in 2018 and 2019.
- China has had no indigenous malaria cases since 2017. Malaysia had no cases of human malaria in 2018 and 2019.
- Brazil, Colombia and Venezuela (Bolivarian Republic of) account for over 86% of all cases in this region.
- Since 2015, the European Region has been free of malaria.
- Globally, malaria deaths have reduced steadily over the period 2000–2019, from 736 000 in 2000 to 409 000 in 2019.
- The global estimate of deaths in 2015, the GTS baseline, was about 453 000.
DEATHS BY COUNTRY | SOURCES : WHO
- Globally, the malaria mortality rate (i.e. deaths per 100 000 population at risk) reduced from about 25 in 2000 to 12 in 2015 and 10 in 2019.
- About 95% of malaria deaths globally were in 31 countries.
- Malaria deaths in the African Region reduced by 44%, from 680 000 in 2000 to 384 000 in 2019.
- The malaria mortality rate reduced by 67% over the same period, from 121 to 40 deaths per 100 000 population at risk.
- In the WHO South-East Asia Region, malaria deaths reduced by 74%, from about 35 000 in 2000 to 9 000 in 2019.
- In the Eastern Mediterranean Region, malaria deaths reduced by 16%, from about 12 000 in 2000 to 10 100 in 2019.
- In the Western Pacific Region, malaria deaths reduced by 52%.
MALARIA CASES AND DEATHS AVERTED
- Globally, an estimated 1.5 billion malaria cases and 7.6 million malaria deaths have been averted in the period 2000–2019.
- Most of the cases (82%) and deaths (94%) averted were in the African Region, followed by the WHO South-East Asia Region.
BURDEN OF MALARIA IN PREGNANCY
- There were an estimated 33 million pregnancies, of which 35% (12 million) were exposed to malaria infection during pregnancy.
- Central Africa had the highest prevalence of exposure to malaria during pregnancy (40%).
- If up to 80% of pregnant women who reported using antenatal care (ANC) services once were to receive one dose of intermittent preventive treatment in pregnancy (IPTp).
MALARIA ELIMINATION AND PREVENTION OF RE‑ESTABLISHMENT
- The number of countries that were malaria endemic in 2000 and that reported fewer than 10 000 malaria cases increased from 26 in 2000 to 46 in 2019.
- There were more cases in 2019 than in 2018 in Comoros, Costa Rica, Ecuador and Suriname.
- Iran (Islamic Republic of), Malaysia and Timor-Leste reported zero indigenous malaria cases in 2018 and 2019.
- Between 2000 and 2019, no country that was certified malaria free has been found to have malaria transmission re-established.
SOURCES : ELIMINATION OF MALARIA 2000-2019 | World Malaria Report 2020 | UPSC
PROGRESS TOWARDS THE GTS MILESTONES OF 2020
- The GTS(Global Technical Strategy) 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.
- The 2000–2019 trends in malaria cases and deaths were used to make annual projections from 2020 to 2030.
- Malaria case incidence in nine countries (10%) in 2020 was estimated to be at levels similar to those of 2015.
- All countries in the WHO South-East Asia Region were on track for both the morbidity and mortality 2020 GTS milestones.
INVESTMENTS IN MALARIA PROGRAMMES AND RESEARCH
- The GTS sets out estimates of the funding required to achieve milestones for 2020, 2025 and 2030.
SOURCES : WHO
- 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).
- 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.
- The funding gap between the amount invested and the resources needed has continued to widen dramatically over recent years.
DISTRIBUTION AND COVERAGE OF MALARIA PREVENTION
- Nearly 2.2 billion insecticide-treated mosquito nets (ITNs) were supplied globally in that period, of which 1.9 billion (86%) were supplied to sub-Saharan Africa.
- The number of children reached with at least one dose of seasonal malaria chemoprevention (SMC) steadily increased.
DISTRIBUTION AND COVERAGE OF MALARIA DIAGNOSIS AND TREATMENT
- 2.7 billion rapid diagnostic tests (RDTs) for malaria were sold by manufacturers in 2010–2019.
- The rate of diagnosis among children aged under 5 years for whom care was sought increased considerably.
- Deletions in the pfhrp2 and pfhrp3 (pfhrp2/3) genes of the parasite renders parasites undetectable by RDTs based on histidine-rich protein 2 (HRP2).
- WHO is tracking published reports of pfhrp2/3 deletions using the Malaria Threats Map mapping tool.
VECTOR RESISTANCE TO INSECTICIDES
- 81 countries reported data on standard insecticide resistance monitoring to WHO.
- Resistance to organochlorines was reported in 63.4% of the sites.
MALARIA RESPONSE DURING THE COVID‑19 PANDEMIC
- By April 2020, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), causing COVID-19, had spread to all malaria endemic countries.
- By the end of the second week of November 2020, about 22 million cases and 600 000 deaths had been reported in these countries.
The cross-partner effort led to a strong partnership alignment that resulted in various outcomes:
– Publication of technical guidance on how to safely maintain malaria control services in the context of the COVID-19 pandemic
– Mitigating the pressure to shift diagnostic production away from malaria to the detection of SARS-CoV2;
– Success in resolving major global manufacturing bottlenecks for malaria medicines
– Mitigating the disruptions in the shipment and delivery of malaria commodities
– Resource mobilization for personal protective equipment (PPE)
– Tracking of disruptions in countries to help guide the response.
- Equity in access to health services especially for the most vulnerable and hard-to-reach populations is essential
- Strengthen health workforce and malaria expert base.
- Innovation in tools and implementation approaches will enable countries to accelerate their progression along the path to elimination.
- Improved surveillance, monitoring and evaluation, as well as stratification by malaria disease burden, are required to optimize the implementation of malaria interventions
SOURCES: PIB | World Malaria Report 2020 | UPSC