India and 15 other countries in sub-Saharan Africa accounted for almost 80 percent of the malaria cases reported globally last year, according to a WHO report which notes that a whopping 1.25 billion people in India were at the risk of contracting the mosquito-borne disease. The World Health Organization’s (WHO) 2018 World malaria report, however, in an encouraging note said that India was the only country to report progress in reducing its malaria cases in 2017 as compared with 2016.
It said five countries to account for nearly half of all malaria cases worldwide were Nigeria (25 percent), the Democratic Republic of the Congo (11 percent), Mozambique (5 percent), India and Uganda (4 percent) both. In all, 15 countries in sub-Saharan Africa and India carried almost 80 percent of the global malaria burden. In India, 1.25 billion people in the population were at risk of malaria, the report said. It said that targets to reduce global rates of infections and deaths from malaria were not being met.
The study reveals that while new cases fell steadily up until 2016, the number rose from 217 to 219 million in 2017: the targets set by the WHO Global technical strategy for malaria 2016–2030 call for a drop in malaria case incidence and death rates of at least 40 percent by 2020. The 10 highest burden countries in Africa reported increases in cases of malaria in 2017 compared with 2016.
Of these, Nigeria, Madagascar and the Democratic Republic of the Congo had the highest estimated increases, all greater than half a million cases. In contrast, India reported three million fewer cases in the same period, a 24 decrease compared with 2016. However, cases in the African countries rose by 3.5 million compared with the previous year. Nearly 80 percent of global malaria deaths in 2017 were concentrated in 17 countries in the WHO African Region and India, the report said.
Seven of these countries accounted for 53 percent of all global malaria deaths: Nigeria (19 per cent), Democratic Republic of the Congo (11 per cent), Burkina Faso (6 per cent), Tanzania (5 per cent), Sierra Leone (4 per cent), Niger (4 per cent) and India (4 per cent). The report noted that while India “had made impressive gains and was on track” to meet the Global technical strategy for malaria 2016–2030 targets, it still accounted for 4 percent of the global burden of malaria morbidity and 52 percent of deaths outside of the WHO African Region.
India was among the countries that detected high treatment failure rates and responded by changing their treatment policies, it said. The report added that India and Indonesia were on track to achieve a 20–40 percent reduction in case incidence by 2020. The WHO, the main United Nations health agency, and its partners have launched a country-led ‘high burden to high impact’ response plan – to coincide with the release of the report – with the aim of scaling up prevention, treatment and investment to protect vulnerable people, and get reductions in malaria deaths and disease back on track.
The plan builds on the principle that no one should die from a disease that can be easily prevented and diagnosed, and that is entirely curable with available treatments. “The world faces a new reality: as progress stagnates, we are at risk of squandering years of toil, investment and success in reducing the number of people suffering from the disease,” WHO Director-General Tedros Adhanom Ghebreyesus said.
“We recognise we have to do something different – now,” Ghebreyesus said. A positive note was struck in Paraguay, which has this year been certified as malaria free, the first country in the Americas to receive this status in 45 years.
The number of countries nearing elimination has now grown from 37 to 46, and three countries – Algeria, Argentina and Uzbekistan – have requested official malaria-free certification from the WHO.
Domestic financing has been identified as key to the success of the WHO’s malaria strategy. The UN agency says that funding, which has levelled off, needs to reach at least USD 6.6 billion annually by 2020 – more than double the amount available today. Malaria kills an estimated 660,000 people each year.