On Tuesday, April 25, the global community celebrated the World Malaria Day 2023. It had as its theme “Time to deliver zero malaria: invest, innovate, implement”. At the World Health Organization, there is a focus on the need to raise awareness on the need to “implement” the tools and strategies that are available today in the fight against malaria to reach those who continue to be unreached across the Western Pacific. The region faces challenges on the road to malaria elimination. In particular, the epidemiology of malaria exhibits enormous diversity, with the disease often concentrated in remote areas and, or among highly mobile or hard-to-reach populations, including forest goers, migrants, indigenous people, military and refugees. More than 70% of malaria deaths in the region are attributable to Plasmodium falciparum, often because of delayed treatment.
Other key challenges include reaching remote populations in Papua New Guinea and Solomon Islands, preventing relapse of vivax malaria through compliant full-course treatment, and halting transmission of knowlesi zoonotic malaria in Malaysia.
Reaching these populations with malaria prevention, diagnosis and treatment is a critical strategy for achieving global malaria targets and delivering on the promise of “zero malaria.” WHO is working with countries and areas in the region to develop and implement intensification strategies, such as targeted drug administration, fever screening and treatment, and rapid response to all malaria cases.
While much work still needs to be done to reach “zero malaria”, there is a recorded success against malaria in the region. In the past twenty years, malaria deaths have decreased by 88%, and despite a 15% increase in malaria cases during the first year of the COVID-19 pandemic, malaria cases fell the following year by 14% from 1.7 million cases in 2020 to 1.4 million cases in 2021.
Although anti-malarial drug resistance remains a concern, the Western Pacific countries of the Greater Mekong sub-region, including Cambodia, Lao People’s Democratic Republic, and Vietnam have seen promising results to accelerate Plasmodium falciparum elimination. Between 2000 and 2021, these three countries reported a nearly a 73% decrease in all indigenous malaria cases and a 92% decline in indigenous Plasmodium falciparum malaria cases. All countries are on target to meet the 2023 elimination target for Plasmodium falciparum malaria and all forms of human malaria by 2030.
In 2021, China was certified malaria-free by WHO and Malaysia achieved zero cases of human malaria for the fourth year in a row. Four countries in the Region reported fewer than 10, 000 malaria cases in 2021: Lao People’s Democratic Republic, the Republic of Korea, Vanuatu and Viet Nam. There have been zero reported malaria deaths in the Republic of Korea and Vanuatu since 2012, Cambodia since 2018 and Vietnam since 2019.
These elimination and drastic reduction of malaria cases in these countries provide opportunities for lessons for African countries such as Nigeria.
To achieve such similar success therefore in Nigeria, there is need for increase and prioritizing funding for the most marginalized and hard-to-reach populations who are less able to access health services and are always hardest hit when they become ill. Everyone can add their voice to the call for innovations that bring new vector control approaches, diagnostics and medicines to accelerate progress against malaria and as such there is an urgent need to make more effective use of available tools and strategies to prevent, diagnose and treat malaria, particularly among the unreached population.
Written by PROF. PETER KATCHY
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