New York (ABC Live): Malaria is caused by Plasmodium parasites and is transmitted by female Anopheles mosquitoes. It is a life-threatening disease which, according to the “World Malaria Report 2016”, killed an estimated 429 000 people (range: 235 000–639 000) in 2015.
WHO “World Malaria Report 2016” Almost half of the world’s population is at risk of the disease. Over 90% of cases and deaths occur in sub-Saharan Africa and are due to P. falciparum.
Nevertheless, in 2015 around 8.5 million (range: 6.6 – 10.8 million) malaria episodes were due to P. vivax infection, the predominant cause of malaria in the Americas and Western Pacific Regions. Malaria is a disease of poverty, affecting the most vulnerable. Severe and fatal falciparum disease is concentrated in children under 5 years old and pregnant women, and disproportionately affects migrant and mobile workers. Malaria is also a frequent cause of catastrophic household health expenditure
Despite these figures, global trends show: a 48% decrease in global malaria mortality between 2000 and 2015 .
That the Millennium Development Goal (MDG) target – “to have halted and begun to reverse the incidence of malaria” – was achieved.
This reduction in malaria was largely due to the deployment of core interventions to prevent, diagnose and treat malaria:
Long lasting insecticide treated nets (LLINs)
Indoor residual spraying (IRS)
Rapid diagnostic tests (RDTs)
Artemisinin combination therapies (ACTs).
WHO Global Technical Strategy for Malaria 2016–2030
History has shown that, where malaria is well controlled, relaxing the intensity of control efforts leads rapidly to disease resurgence. The alternative to continued high-level control is elimination, and ultimately eradication.
The WHO GTS covers the period 2016–2030 and includes targets and a timetable of milestones, reaching a 90% reduction in the global malaria disease burden, and the elimination of malaria from at least 35 countries, by 2030 .
The goals encompass both P. falciparum and P.vivax malaria and will require efforts to: • prevent and treat malaria (including the relapsing form of P. vivax) interrupt transmission of Plasmodia between mosquitoes and humans.
MESA Track database
Key information about which research questions are being addressed, how and by whom is therefore available on an ongoing basis.
Some new tools for malaria are in the late stages of development, including combination LLINs, a drug which treats P. vivax and clears the liver hypnozoites, and highly sensitive RDTs.
Pilot implementation of the world’s first malaria vaccine is expected to begin in 2018. Nevertheless, at the end of 2016, 91 countries and territories had ongoing malaria transmission. New knowledge, new tools and optimizing their effectiveness (informed by operational research) are needed to free the world of malaria.
Investments in malaria research will need to be sustained and appropriately targeted. A process to revise and update the research needs is required every few years to keep the malaria community on course.
