The fight against malaria has saved 3.3 million lives worldwide since 2000 but the mosquito-borne disease still killed 627,000 people last year, mainly children in Africa, the World Health Organization said Wednesday.
A shortage of funding and basic remedies such as bed nets mean that malaria is still a major threat, particularly in Africa and Southeast Asia, according to the WHO’s Malaria Report 2013.
“The fact that so many people are infected and dying from mosquito bites is one of the greatest tragedies of the 21st century,” said WHO Director-General Margaret Chan.
A surge in global funding over the past decade has led to great strides against malaria, but even levels as high as $2.5 billion in 2012 are still only half what is needed to make sure everyone at risk of the disease has access to interventions, the WHO report said.
“This remarkable progress is no cause for complacency: absolute numbers of malaria cases and deaths are not going down as fast as they could,” Chan said.
In 2012, there were an estimated 207 million cases of malaria, causing some 627,000 deaths, down from the WHO estimate of 660,000 deaths in 2011.
Malaria is caused by a parasite and symptoms include fever, vomiting, diarrhea and jaundice.
The Democratic Republic of Congo, Nigeria and India are the hardest-hit countries.
An estimated 3.4 billion people are at risk of malaria worldwide, with 80 percent of cases occurring in Africa.
Tangible progress has been seen in over half of the 103 countries with ongoing malaria transmission, with decreases in the incidence rate since 2000, said the report.
Death rates worldwide fell by 45 percent between 2000 and 2012 in all age groups, and by 51 percent in children under five.
“That is pretty astonishing, for a disease that was neglected and abandoned,” said Robert Newman, a pediatrician who heads the WHO’s Global Malaria Program.
The main interventions for malaria are indoor spraying, diagnostic testing, artemisinin-based combination drug therapies, and bed nets treated with insecticides.
However, malaria parasites are showing signs of resistance to insecticides in 64 countries.
Another main concern is the emerging resistance to the anti-malarial medicines’ core component artemisinin in Thailand, Vietnam, Myanmar and Cambodia, the WHO report said.
Despite WHO recommendations that pills containing artemisinin only be removed from the market in favor of combination therapies to better protect against emerging resistance, nine countries — six of them in Africa — continue to make these drugs available.
The report also raised concern about “a slowdown in the expansion of interventions to control mosquitoes for the second successive year,” particularly regarding the distribution of bed nets.
Just 92 million of the 150 million needed annually were delivered by manufacturers to malaria-endemic countries in sub-Saharan Africa in 2011, and only 70 million were delivered in 2012.
“In 2013 we have seen a strong upsurge… but that has not made up for the couple of years when we did not get enough bed nets out there,” said Newman.
“We know that these are lifesaving tools,” he said, noting that it costs five dollars for a net that can last three years.
Experts said a restructuring of the Global Fund, a top financer of anti-malaria efforts, was largely to blame for the setback, but those problems have since been fixed.
According to Joy Phumaphi, executive secretary of the African Leaders Malaria Alliance, a new procurement system is modeled against UNICEF’s and has cut the time that it took governments to distribute the nets from as long as two years to as little as six weeks.
“With this approach we are going to see a much more rapid allocation of procurement process and lower cost,” she told reporters in Washington.
Newman said a continued focus on eliminating malaria is needed, or else years of work can be undone in just a couple of transmission seasons.
“The progress is fragile,” he said. “Poverty and malaria are inextricably intertwined. If we want to break that cycle, this is an incredible investment.”