Dr Poonam Khetrapal Singh, WHO Regional Director for South-East Asia
To commemorate World Malaria Day 2023, WHO is urging countries affected by malaria in the South-East Asia Region and globally to accelerate the reach of high-impact tools and strategies to prevent, detect and treat malaria, with a focus on reaching the most vulnerable, ensuring that no person or population is left behind.
In the shadow of the COVID-19 crisis, the world is not on track to reach the two critical targets of the WHO Global technical strategy (GTS) for malaria 2016–2030: reducing global case incidence and mortality by 90% or more by 2030, based on 2015 levels. In 2021, an estimated 619 000 people globally died of malaria compared to 625 000 in 2020. There were an estimated 247 million new cases of malaria, compared to 245 million in 2020.
The WHO South-East Asia Region continues to lead globally. By the end of 2020, the South-East Asia Region was the only WHO region to achieve a 40% reduction in malaria case incidence and mortality compared to 2015 – the first GTS milestones. Amid the COVID-19 response, Maldives and Sri Lanka have maintained their malaria-free status, and five countries of the Region – Bhutan, DPR Korea, Nepal, Thailand and Timor-Leste – are among 25 countries and one territory globally identified as having the potential to eliminate malaria by 2025. In September 2023, Timor-Leste is likely to complete three consecutive years of reporting zero local malaria transmission. It would therefore be eligible to be certified malaria free.
In 2022, ministers of health from across the Region unanimously endorsed a Statement on Renewed Commitment for Malaria Elimination, emphasizing the urgent need to scale up proven implementation strategies, while also adopting innovative strategies and tools. The Statement is aligned with the Region’s 2017 Ministerial Declaration for Accelerating and Sustaining Malaria Elimination, as well as the 2018 Ministerial Call for Action to eliminate malaria in the Greater Mekong Subregion.
Today, the Region is at a crossroads. Since 2010, overall funding for malaria prevention and control in the Region has decreased by 36%, mostly on account of flagging global support. Reductions in the efficacy of artemisinin-based combination therapies, especially in the Greater Mekong Subregion, as well as increased vector resistance to pyrethroids, risk increased morbidity, mortality and spread. In several countries, cross-border transmission continues to be a major impediment to achieving the elimination targets. Across the Region, gaps in services persist: In 2021, there were an estimated 385 000 more cases in the Region compared to 2020.
WHO is calling for action in several key areas. First, strengthening capacity at the sub-national level, with a focus on identifying clear and actionable goals, increasing resource allocations, and empowering local decision-makers. Second, shifting power to the peripheries, with a focus on increasing cross-border collaboration, especially in high-burden countries neighbouring countries on the verge of elimination. For this, decision-makers should develop action-oriented roadmaps with strong frameworks for monitoring and evaluation.
Third, ensuring adequate and sustained financing for malaria programmes, recognizing that transitions in funding must be anticipated, planned for and implemented gradually, based on a time-bound strategy. Fourth, transforming surveillance into a core malaria intervention, ensuring that last-mile barriers are identified and overcome. And fifth, accelerating high-impact innovations, not just in diagnostics and treatments, but also in service delivery, in line with the Region’s primary health care approach to achieving universal health coverage – since 2014, one of eight Flagship Priorities in the Region.
Crucially, intensified efforts must be made to reach at-risk and vulnerable populations with currently available strategies and tools. Globally, children in the poorest households are five times more likely to be infected with malaria. Malaria is also more prevalent among young children whose mothers have a lower level of education and live in rural areas. Reaching these populations with available malaria prevention, diagnosis and treatment is critical for achieving the Global technical strategy for malaria 2016–2030 and Sustainable Development Goal targets and delivering on the promise of zero malaria for everyone, everywhere.
On World Malaria Day, WHO reiterates its support to all countries of the Region to accelerate and/or sustain malaria elimination, building on the Region’s world-leading progress, and uniting our partners to leave no person or population behind.