Disruptions due to the COVID-19 pandemic resulted in considerable increases in malaria cases and deaths between 2019 and 2020 in Uganda, according to the annual World Malaria Report released by the World Health Organization (WHO).
The report shows that moderate disruptions in the delivery of malaria services contributed to 14 million malaria cases and 69,000 deaths. Forty-seven thousand of the additional malaria deaths were due to disruptions in the provision of malaria prevention, diagnosis and treatment during the pandemic, when countries enforced lockdowns restricting the movement of people.
However, a doomsday scenario projected by the WHO has not materialized. Early in the pandemic, the WHO had projected a doubling of malaria deaths in sub-Saharan Africa as a worst-case scenario. Current analysis found there was an estimated 12% increase in deaths in the region between 2019 and 2020.
The report disclosed that globally, 1.7 billion cases and 10.6 million deaths were averted between 2000 and 2020. Most of the malaria cases (82%) and deaths (95 %) averted over the last 20 years were in the WHO African Region. The report noted that the WHO African Region carried about 95% of global malaria cases in 2020, and 96% of global malaria deaths in 2020.
A new, country-driven approach to malaria control in high-burden countries was beginning to gain momentum when COVID-19 struck and, according to the analysis in 2020, global malaria case incidence was off track by 40% and the global mortality rate for 2020 was off track by 42%.
The director of the WHO Global Malaria Programme, Dr. Pedro Alonso, said that thanks to urgent and strenuous efforts, the world has succeeded in averting the worst-case scenario of malaria deaths. However, he added that even before the emergence of COVID-19, global gains against malaria were leveling off.
Dr Alonso said they are not on a flight to success, but are increasingly moving away from reaching the 2020 milestones of WHO’s global malaria strategy.
The report found that just 58% of countries completed their planned campaigns to distribute insecticide-treated mosquito nets in 2020, with most experiencing important delays. Globally, 72% of all insecticide-treated mosquito nets planned for distribution had been distributed by the end of 2020.
In 2020, of the 65 countries who responded, 37 reported partial disruptions (5% to 50%) to malaria diagnosis and treatment services, and by 2021 15 countries reported partial disruptions and six countries reported severe disruptions.
This year’s World Malaria Report used a new methodology to estimate malaria deaths worldwide. This resulted in a larger share of deaths (7.8%) among children under five years old than previously recognized (4.8%).
On a global scale, progress against malaria remains uneven. The report found that many countries with a low burden of the disease are moving steadily towards the goal of malaria elimination.
Global progress against malaria over the past two decades was achieved, in large part, through the massive scale-up and use of WHO-recommended malaria tools that prevent, detect and treat the disease. However, the most recent data also demonstrate significant and sometimes widening gaps in access to life-saving tools for people at risk of malaria.
The report warns that the situation remains precarious, especially in sub-Saharan Africa. A convergence of threats in the region poses an added challenge to disease control efforts.
The strategy’s goals include a 90% reduction in global malaria incidence and mortality rates by 2030. The report reiterated that this will require new approaches, and intensified efforts aided by new tools and better implementation of existing ones. This includes a stronger emphasis on equitable and resilient health systems and data-driven strategies.
The report also recommended the expanded use of the RTS,S malaria vaccine recommended by the WHO in October. Dr Alonso said, “the vaccine is feasible to deliver, is safe, has a public health impact and is cost-effective.”
The report found that a total of USD 3.3 billion was invested globally in malaria control and elimination in 2020. This was against a goal of USD 6.8 billion to reach global malaria targets. Annual investments will need to more than triple by 2030, to USD 10.3 billion per year, the report noted.