For World Malaria Day 2024, WHO shared a message from the Director of the WHO Global Malaria Programme and emphasised the need to return to malaria progress in line with this year’s theme:
“Accelerating the fight against malaria for a more equitable world.”
WHO suggests that, in recent years, progress in reducing malaria has “ground to a standstill”, affecting health and costing lives. Furthermore, it “perpetuates a vicious cycle of inequity”. In this article we cover the message from WHO Global Malaria Programme Director, explore the key concerns shared for this year’s World Malaria Day, and share UKHSA’s update on malaria cases observed in the UK.
World Malaria Day: in pursuit of an equitable world
The theme, “accelerating the fight against malaria for a more equitable world”, highlights the fact that malaria “disproportionately” affects people who live in the “most vulnerable situations”. WHO states that the African Region “shoulders the heaviest burden” of the disease; in 2022 it accounted for 94% of malaria cases and 95% of malaria deaths. WHO reflects that the “current trajectory” indicates that we will miss critical 2025 milestones for reductions in cases and deaths.
The most likely to be affected are those who live in “situations of poverty and with less access to education”. This year, WHO is joining the RBM Partnership to End Malaria and other partners to highlight barriers to health equity, gender equality, and human rights in malaria responses worldwide, with “concrete measures to overcome them”.
Dr Ngamije’s message
Dr Daniel Ngamije, Director of the WHO Global Malaria Programme, shared a message in April 2024, highlighting the collaboration with the RBM Partnership and others. The statement begins by “acknowledging the tremendous contributions of national malaria programmes and their partners”.
“Our collective work will contribute to a more equitable future.”
However, malaria is still a “serious global health challenge” that takes the “heaviest toll on the most vulnerable”. Dr Ngamije is concerned that “too many people” are missing the services and information needed to prevent, detect, and treat malaria. This is particularly true for those “experiencing disadvantage, discrimination, and exclusion”.
“We need to strengthen and step up our support for these populations – not only is it our moral duty, it is the best way to get back on track to achieve our global malaria targets.”
Since 2017, WHO has been reporting “stalling of progress”, notably in countries that carry a high burden of disease. In 2022, malaria killed around 608,000 people and caused 249 million new cases.
“Without a change in the current trajectory, many people, especially those living in situations of greatest poverty and vulnerability, will continue to die from malaria – a disease that is preventable and treatable.”
High burden countries
Dr Ngamije identifies “health inequities” as “hampering efforts” to reduce malaria in the countries hardest hit by disease. With the “High burden to high impact” (HBHI) approach from 2018, countries have been identifying those who suffer most and responding with a “concerted effort” to provide customised packages of interventions and services.
Low burden countries
“Health inequities are also undermining efforts to complete the last mile in the pathway to eliminate malaria.”
In “many” lower burden countries, cases of malaria are “concentrated among vulnerable, hard-to-reach populations”. These populations include mobile and migrant workers, refugees, and indigenous communities.
“Reaching, engaging, and empowering these populations with targeted, gender-responsive, and culturally sensitive interventions and services is an important strategy for achieving our collective vision of a malaria-free world.”
Yaoundé Declaration
In March 2024, Ministers of Health from HBHI countries demonstrated “further political commitment” as they signed the Yaoundé Declaration in Cameroon. This declaration signified Ministers’ commitment to providing “stronger leadership and increased domestic funding for malaria control programmes”, ensuring investment in data technology, applying the latest technical guidance, and enhancing control efforts at all levels.
The declaration demands that countries “sustainably and equitably” address the challenge of malaria, with Ministers recognising the importance of “tackling the root causes of stagnating progress in malaria control”. Further commitments relate to ensuring all populations at risk of malaria “consistently receive the appropriate tools”.
What are WHO and partners doing?
The global malaria response can be strengthened by increased investment into the research and development of new tools to benefit anyone who is at risk, especially the “poorest and most marginalised populations”. WHO hopes that recommended tools will be scaled up in an “equitable and sustainable way”. For example, recent recommendations, such as dual active ingredient nets and malaria vaccines, could increase health equity for populations at risk of malaria.
WHO also suggests that the fight against malaria can be accelerated through a commitment to UHC (universal health coverage).
“Everyone should have access to the health services they need – when and where they need them, and without facing financial hardship.”
WHO recommends reorienting health systems towards primary care, which is understood to be the “most inclusive, equitable, and cost-effective way to achieve UHC”. A recent operational strategy from the Global Malaria Programme has the “potential to shape the malaria ecosystem and achieve impact at country level”. The strategy emphasises that efforts to fight malaria should be “rooted in the principles of health equity, gender equality, and human rights”.
UKHSA data
In advance of World Malaria Day, UKHSA shared data that reveal an increase in malaria cases across England, Wales, and Northern Ireland. Reported cases exceeded 2,000 for the first time since 2001, with cases confirmed in individuals who had “recently been abroad”. The number of cases is described as a sign of the importance of “taking precautions” while travelling abroad.
In 2023 there were 2,004 cases of malaria confirmed after international travel, which compares with 1,369 in 2022. UKHSA links this rise to a “resurgence of malaria in many countries” and an increase in overseas travel as pandemic restrictions were lifted.
ABCD and commentary
UKHSA shares the ABCD of malaria prevention: “Awareness of risk, Bite prevention, Chemoprophylaxis, and Diagnose promptly and treat without delay”. This method can ensure that travellers are protected as they follow travel advice for their destination. There are currently no licensed malaria vaccines for travellers.
Professor Peter Chiodini is Director of the UKHSA Malaria Reference Laboratory (MRL) and remarked that “all malaria cases are preventable”, with “simple steps” reducing infection risks.
“While malaria can affect anyone, the majority of Plasmodium falciparum malaria cases in the UK occur in those of African background. Even if you have visited or lived in a country before, you will not have the same protection against infections as local people and are still at risk.”
Professor Chiodini is working “in partnership with communities at greater risk” to improve access to and use of “effective” malaria prevention measures. Dr Dipti Patel, Director of the National Travel Health Network and Centre, encouraged travellers to “prioritise” their health and “plan ahead”.
“Check the relevant country information pages on our website, TravelHealthPro, and ideally speak to your GP or travel health clinic 4 to 6 weeks ahead of travelling to ensure you have had all the necessary vaccinations and advice you need to ensure your trip is a happy and healthy one.”
At The World Vaccine Congress malaria continues to be a topic of priority and we look forward to continuing these conversations with the community. Do make sure you have subscribed to our weekly newsletters here for more information and insights.
