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WHO global report on malaria indicates progress on prevention

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VOL: 101, ISSUE: 20, PAGE NO: 42

Malaria kills one million people every year, mostly in Africa, according to the 2005 World Malaria Report (World He...

Malaria kills one million people every year, mostly in Africa, according to the 2005 World Malaria Report (World Health Organization and the United Nations Children's Fund, 2005). The report found that in 2003, 350 to 500 million people worldwide became ill with malaria. This is a slight revision of the estimate of 300 to 500 million annual cases that WHO has used since 2000.

The reasons for this difference are advances in data collection methods and increases in the world's population. Current methods do not allow for a more precise estimate because of the difficulties in diagnosing malaria and the lack of reliable data from the communities where it occurs.

Progress in prevention and treatment
Progress has been made in preventing and treating malaria since 2000 and a number of countries are now engaged in intense antimalarial campaigns.

Use of insecticide-treated nets
More people are now protected with insecticide-treated nets, which is a highly effective method of malaria prevention. After a campaign in 2003 to distribute treated nets in five districts of Zambia, at least 80 per cent of children under five were sleeping under them.

A similar campaign across Togo in December 2004 succeeded in raising the overall percentage of households owning at least one treated net from eight per cent to 62 per cent.

Drug therapy
Countries where the former mainstays of malaria treatment, such as chloroquine, are no longer effective, are using new therapies. Since 2001, 42 countries where malaria is endemic (23 of them in Africa), have adopted artemisinin-based combination therapies that have been recommended by WHO. These are the latest generation of antimalarial medicines and the most effective treatment against falciparum malaria. An additional 14 countries are in the process of changing their malaria treatment policy, and 22 have embarked on home-care programmes, which enable families and other care-givers to manage malaria.

The report notes that it is too soon to measure the impact of the recent expansion of malaria control strategies on illness and death. This is because of the difficulties involved in gathering reliable information about malaria in the most affected countries and because those countries have intensified their efforts to control malaria only in the past few years. A measurable effect should become apparent about three years after widespread implementation of control measures.

Barriers to improvement
The recent shortage of artemisinin-based combination therapies has hindered efforts to reduce the impact of malaria. However, owing to the combined efforts of UN agencies, other multilateral agencies, non-profit groups and corporations working together under the umbrella of the Roll Back Malaria Partnership, sufficient supplies to meet demand are expected to be available by the end of 2005.

The Roll Back Malaria Partnership aims to provide a coordinated international approach to fighting malaria. It was launched in 1998 by WHO, the United Nations Children's Fund, the United Nations Development Programme, and the World Bank.

Halting and reversing the incidence of malaria by 2015 is a target of the United Nations Millennium Development Goals. The more immediate goal of Roll Back Malaria is to halve the burden of malaria worldwide by 2010.

A major obstacle to achieving that goal, the report explains, is a lack of funds. The report estimates that US$3.2 billion per year is needed if malaria is to be combated effectively in the 82 countries with the highest disease burden.

This year, US$600 million was made available for global malaria control, and the World Bank has recently announced plans to commit up to US$1 billion over the next five years. These contributions will help more people obtain access to essential malaria prevention and treatment.

Further reading
Attaran, A. (2004) WHO, the global fund, and medical malpractice in malaria treatment. Lancet; 363: 237-240.

Useful website
World Health Organization: www.who.int/

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