Despite global progress in combating malaria, the disease continues to cause significant illness and death, especially in malaria-endemic areas. Malaria statistics have improved significantly; between 2010 and 2015, malaria incidence reduced by 21% and the number of deaths fell by 29% globally (and by 31% in the African region).
Despite this improvement, the disease continues to wreak havoc. The World Malaria Report 2016 reported high numbers of infection and death in 2016: globally 212 million new cases were reported in 2015, 90% of which were in Africa, while 92% of the estimated 429,000 malaria deaths occurred in Africa.
The numbers highlight the global inequities in health, with Africa carrying the largest burden of the disease. Children bear the brunt of the infection; it is estimated that in 2015, 303,000 children under five years of age died of malaria globally, 292,000 occurring in the African region.
The Global Technical Strategy for Malaria 2016-2030 that was adopted at the 2015 World Health Assembly calls for a 40% reduction in malaria case incidence by the year 2020, but progress is particularly slow in countries with a high malaria burden, most of these being in Africa.
Interventions to control transmission of malaria include vector control mainly through use of insecticide-treated mosquito nets (ITNs) and indoor residual spraying (IRS). Efforts to scale up the coverage of these interventions have borne fruit. It is estimated that 53% of the population at risk in the sub-Saharan Africa slept under a treated net by 2015 compared with 30% in 2010, and that 29 million people in Africa were protected by IRS.
Anti-malarial treatment is a life-saving intervention. The World Health Organization recommends diagnostic testing for confirmation of infection before treatment in all cases of fever in malaria-endemic and non-endemic areas, including for children less than five years of age. This is important because clinical diagnosis – made on patient-reported symptoms or medical signs, rather than laboratory tests – has low levels of accuracy. The result is over diagnosis of malaria, poor management of non-malarial illnesses and wastage of anti-malarial drugs.
Amref Health Africa is committed to empowering health systems and communities to fight malaria, and to do this we partner with ministries of health across Africa, donors, communities and other stakeholders. In collaboration with the WHO, we have developed several training packages to strengthen the capacity of healthcare workers for improved malaria case management, including better quality of malaria diagnostic procedures and use of malaria rapid diagnostic tests. We have also driven implementation of the East African Regional Quality Assessment Scheme (EA-REQAS), whose overall goal is improving the quality of essential diagnostic services in peripheral health facilities.
In Kenya, with support from the Global Fund against HIV, TB and Malaria, Amref Health Africa is working at the community level to bring services closer to the people in the Western part of Kenya, where malaria is endemic. Over 7,000 Community Health Workers (CHWs) have been trained and are offering services including diagnosis and treatment. Community units have been established or strengthened in the region, and community health extension officers trained to support the CHWs. To date over 300,000 people have successfully been diagnosed and treated, and use of treated mosquito nets has increased. Schools have not been left behind, with students and teachers alike being trained to join the fight against malaria.
As a partner to the ministry of health, Amref Health Africa supports malaria programming at national level by participating in technical working groups, supporting quality audits and providing support supervision.
On this World Malaria Day, Amref Health Africa renews its commitment to working with other stakeholders to:
- Continually empower communities to improve malaria prevention and management;
- Support governments and hold them accountable to delivering on their promises to combating malaria and holding them accountable;
- Support governments to adopt and scale up high-impact, evidence-based interventions such as ITNs and diagnostics to strengthen the fight against malaria.
It is the responsibility of governments to protect and deliver the right to health for their citizenry; Amref Health Africa urges governments and development partners to;
- Support the Global Technical Strategy for Malaria 2016-2030;
- Invest in the fight against malaria to ensure scale-up of evidence-based interventions to move the continent towards universal coverage;
- Invest in surveillance for drug-resistance and enforce regulations to combat it;
- Support research for the development of safer insecticides.