World Malaria Report 2020 | UPSC

World Malaria Report 2020 | UPSC

      HEADLINES:

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

MINISTRY? :- Ministry of Health and Family Welfare
SYLLABUS COVERED: GS 3: Reports

      LEARNING: 

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 !

      ISSUE: 

India has sustained Annual Parasitic Incidence (API) of less than one since 2012

WORLD MALARIA REPORT 2020

OVERVIEW

  • 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.

The report gives the estimated cases for malaria across the world, based on mathematical projections. 

  • 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.

REPORT TITLE

  • World Malaria Report 2020 : 20 YEARS OF GLOBAL PROGRESS & CHALLENGES

PUBLISHED BY

  • World Health Organization

HIGHLIGHTS

  • 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.

The Annual Parasitic Incidence (API) reduced by 27.6% in 2018 compared to 2017 and by 18.4% 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.

India achieved a reduction of 83.34% in malaria morbidity and 92% in malaria mortality between the year 2000 and 2019.

  • Thereby, achieving Goal 6 of the Millennium Development Goals (50-75% decrease in case incidence between 2000 and 2019).

World Malaria Report

Epidemiological trends of Malaria in India (2000-2019) Pv; Plasmodium Vivax & pf; Plasmodium Falciparum

REPORT ANALYSIS

MALARIA CASES

  • 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.

World Malaria Report 2020 | UPSC

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.

Twenty-nine countries accounted for 95% of malaria cases globally.

COUNTRIES
Nigeria (27%), Congo (12%), Uganda (5%), Mozambique (4%) and Niger (3%) accounted for about 51% of all cases 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.

India contributed to the largest absolute reductions in the WHO South-East Asia Region, from about 20 million cases in 2000 to about 5.6 million in 2019. 
 

  • Sri Lanka was certified malaria free in 2015, and Timor-Leste reported zero malaria cases in 2018 and 2019.

 2020 malaria report incidences

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.

The Western Pacific Region had an estimated 1.7 million cases in 2019, a decrease of 43% from the 3 million cases in 2000. 

  • 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.

MALARIA DEATHS

  • Globally, malaria deaths have reduced steadily over the period 2000–2019, from 736 000 in 2000 to 409 000 in 2019.

The percentage of total malaria deaths among children aged under 5 years was 84% in 2000 and 67% in 2019.
 

  • The global estimate of deaths in 2015, the GTS baseline, was about 453 000.

Mortality World Malaria Report

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.

India accounted for about 86% of all malaria deaths in the WHO South-East Asia Region.

  • 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%).

It is estimated that malaria infection during pregnancy in these 33 countries resulted in 822 000 children with low birthweight. 

  • 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.

China and El Salvador had no indigenous malaria cases for a third consecutive year and have made a formal request for certification.

  • 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.

malaria 2020 report elimination

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.

Despite the considerable progress made since 2000, the GTS 2020 milestones for morbidity and mortality will not be achieved globally.

  • 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.

Malaria Report 2020 UPSC

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).

Total funding for malaria control and elimination in 2019 was estimated at US$ 3.0 billion.

  • 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 percentage of the population at risk protected by indoor residual spraying (IRS) in malaria endemic countries declined from 5% in 2010 to 2% in 2019.  

  • The 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.

More than 3.1 billion treatment courses of artemisinin-based combination therapy (ACT) were sold globally by manufacturers in 2010–2019. 

  • The rate of diagnosis among children aged under 5 years for whom care was sought increased considerably.

BIOLOGICAL THREATS

  • Deletions in the pfhrp2 and pfhrp3 (pfhrp2/3) genes of the parasite renders parasites undetectable by RDTs based on histidine-rich protein 2 (HRP2).

There are currently no WHO-prequalified non-HRP2 combination tests that can detect and distinguish between P. falciparum and P. vivax.

  • 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.

Globally, resistance to pyrethroids – the only insecticide class currently used in ITNs – continues to be widespread.

  • Resistance to organochlorines was reported in 63.4% of the sites.

      IASbhai WINDUP: 

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 COVID-19 pandemic and restrictions related to the response have caused disruptions in essential malaria services

EFFORTS

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.

World Malaria Report 2020 governance

CLOSING REMARKS

  • 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.

Country ownership and leadership, with involvement and participation of communities, are essential to accelerating progress through a multisectoral approach

  • Improved surveillance, monitoring and evaluation, as well as stratification by malaria disease burden, are required to optimize the implementation of malaria interventions
SUGGESTED READING : DOWNLOAD THE REPORT HERE 
     SOURCES:   PIB   | World Malaria Report 2020 | UPSC

 

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