World Malaria Report: Beyond the numbers, new approaches needed to reaccelerate progress

Today, the World Health Organization (WHO) published its World Malaria Report for 2023, assessing global and regional malaria trends in 2022 and providing an opportunity to reflect on progress towards global targets.

The report estimates that globally, between 2000-2022, 2.1 billion malaria cases were averted and 11.7 million deaths were prevented. But since 2017, progress has plateaued and, following a decrease in the number of deaths averted annually to 886,000 in 2020 as a result of the impacts of the COVID-19 pandemic, there has been only a marginal rise in the following two years with the 2022 figure of 991,000 deaths averted just above pre-pandemic levels.

“We must remember that the numbers in this report represent real people. When we see the headline figures, it means more people have got sick or died as a result of a preventable and treatable disease. We must ask ourselves, how can we reaccelerate the progress that is needed? The development of new tools, like next generation nets and vaccines, give us reason to be hopeful that we can counter the evolving malaria parasite, but unless we can ensure these tools are affordable and available at scale in the long term and are accessible to and accepted by the communities where they are needed, we cannot hope to see those numbers reduce to zero.”

commented Dr James Tibenderana , Malaria Consortium’s Chief Executive.

Approximately five million additional malaria cases were recorded compared with figures from the 2021 report. This increase was largely seen in five countries including Pakistan, which faced excessive rainfall and flooding due to extreme weather. For the first time, the report explores the short and long-term impacts of climate change on malaria transmission. Climate change is one of the biggest threats to human health, undermining many of the social determinants of health, including access to quality services. Malaria is one of the most sensitive vector-borne diseases to climatic changes and robust surveillance is critical in ensuring national malaria programmes can predict and respond to the impact of changing weather patterns on potential malaria upsurges.

Katherine Theiss-Nyland , Malaria Consortium’s Technical Director, commented,

“We need to be smarter in how we fight malaria. Urgent investment and commitment to creating or adapting malaria surveillance systems that work alongside meteorological systems is crucial. This will enable timely and systematic collection, analysis and interpretation of disease-related data, show how climate change is impacting incidence, transmission and distribution of infectious diseases and how effective responses to climate-related risk can be incorporated into programmes.”

Strong surveillance, monitoring and evaluation is also key to better understanding the prevalence of drug and insecticide resistance and the spread of the urban malaria vector, Anopheles stephensi, in Africa , additional threats to malaria elimination outlined in the report. Countries that have eliminated malaria, or have nearly done so, have documented significant improvements in their surveillance systems that made it possible to deploy a range of interventions and adapt them to needs over time. This ability to develop adaptive, responsive surveillance and information systems needs to be a key component of elimination programmes alongside strengthening community involvement and ownership.

Our current strategy prioritises data-informed decision-making, part of which is also tied to the expansion of digital approaches in community engagement. Working closely with national malaria programmes to develop capacity at all levels of the health system to interpret data has been a vital step in supporting policy recommendations as well as enabling decision makers to determine which interventions can be prioritised and targeted more efficiently and effectively, adapting and responding accordingly.

It cannot go unnoticed that progress towards eliminating malaria has stalled and the global funding gap has continued to increase – currently approaching 30 percent of the target of US $7.8 billion. To buck the trend, global partners need to consider novel ways of plugging this gap. The role of philanthropy in funding our seasonal malaria chemoprevention (SMC) programme has been a contributing factor in the organisation’s ability to rapidly scale up its SMC programme, now reaching 25 million children, half of the 50 million reached by all implementing partners. Developing capacity within national and sub-national levels of governments to identify opportunities and facilitate public-private-philanthropic partnerships through collective financing should be encouraged as a means to increase the coverage and quality of malaria services.