World Malaria Report 2020 | UPSC

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.

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.

MALARIA DEATHS

• 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.

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).

• 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.