The Goal of Zero Malaria is Ours to Seize: Statement on the 2019 World Malaria Report

The 2019 World Malaria Report reveals a lucid truth: we can end malaria—and the achievement is ours to seize. However, like all major feats of public health, success will not occur by chance. Great efforts must be undertaken to coordinate and implement ambitious plans. Political will, financial investment, scientific innovation and frontline delivery must all coalesce to maximize the greatest gains.

We have seen these elements coalesce in the fight against malaria before. From 2000-2015, under the United Nations’ Millennium Development Goals (MDGs), an infusion of unprecedented resources resulted in exceptional progress against the burden of malaria on a global scale—saving nearly 7 million lives, mostly children under the age of five.

The recent World Malaria Report (WMR) shows us that the legacy of these investments continues to bear fruit. More countries than ever are within reach of malaria elimination, including China who anticipates malaria-free certification in the coming year. High-burden countries like India and Uganda have also shown substantial reduction in malaria cases in 2018 over the previous year—hard won gains made through increased investments, and collaboration with neighboring countries to improve surveillance and to strengthen primary health care. 

However, the WMR also tells us that our battle with malaria is far from over. Despite many positive returns, progress has been uneven. For three years running, global reduction rates of new malaria infections and deaths has slowed—in no small part due to years of flat funding for prevention and treatment efforts. Consequently, countries with the highest burden of the disease, mostly in sub-Saharan Africa, are now off-track to meet global targets. The range of effective tools – from diagnostics to long-lasting insecticidal nets to anti-malarial drugs and indoor residual spraying – are not completely reaching the most at-risk populations. And though the percentage of eligible women receiving the recommended doses of Intermittent Preventive Treatment in Pregnancy (IPTp) increased from 22% to 31% in just one year, more progress must be made to achieve universal coverage.

Climate change has also begun to reveal its perilous consequences on public health, notably in the fight against malaria. Uncharacteristically heavy rainfalls and increased temperatures have created new breeding ground for the malaria parasite—affecting communities ill-equipped to handle the disease. 

All people at risk of malaria – particularly those most vulnerable, such as pregnant women and children – must have access to the primary health care services they need to prevent, diagnose and treat malaria. However, health systems remain weak in many high-burden regions, underscoring the need for universal health coverage (UHC). Realizing UHC, and obtaining the 18 million frontline health workers necessary to fulfill this goal by 2030, are central to ending malaria worldwide and achieving the health-related Sustainable Development Goals (SDGs).

To tackle these issues head-on, the World Health Organization, under the stewardship of Director-General Dr. Tedros Adhanom Ghebreyesus, and in collaboration with the RBM Partnership to End Malaria, have unveiled a plan known as “high-burden to high-impact” (HBHI)—a country-led approach to help ensure future success of malaria efforts. Implementation in Uganda, Nigeria, and Democratic Republic of Congo have already begun to show positive outcomes.

Innovations in treatment and prevention also hold great promise in curbing the disease. Among these are next generation mosquito nets aimed to combat insecticide resistance, and the launch of the world’s first malaria vaccine—which provides partial protection against malaria in young children, and is currently being piloted in Ghana, Kenya, and Malawi.

However, these efforts must be complimented by increased financial commitments for new tools and strategies that will be critical to accelerate the pace of progress. In 2018, total funding for malaria control and elimination reached an estimated US$ 2.7 billion, falling far short of the US$ 5 billion funding targets for 2016–2030. This may seem like a steep price tag, but we must recognize that the benefits of malaria eradication will greatly exceed the investment needed to reach it. A revitalized, global commitment to fight malaria, the likes of which have not been seen since the turn of the last century, is vital to our success.

The path to zero malaria is possible if we stay the course, double-down efforts, and prioritize health for all. We must not delay in heeding this call—our very lives depend on it.