Philip Welkhoff
Malaria Program Director, Bill & Melinda Gates Foundation
Insecticide-treated nets, better data and Genetically-modified mosquitoes can help end malaria. But endemic countries must make it a top health priority, and funding must not plateau.
This time last year, leaders from government, industry and philanthropy convened in London to spotlight and advance the global effort to end malaria. The Malaria Summit London was an unqualified success, resulting in financial commitments totaling £2.9 billion and a bold commitment by Commonwealth nations to halve the burden of malaria by 2023. This is aligned with the World Health Organization’s (WHO) global target to significantly reduce the burden of malaria by 2030, including a milestone to reduce burden by at least 75% compared to 2015 levels, by 2025.
The summit captured the nature of malaria – we either move forward or we fall back. Since 2000, deaths from malaria have been reduced by half. This is the result of increased funding and scale-up of drugs, diagnostics and insecticide-treated bed nets and spraying.
Mosquitos are becoming resistant to insecticides
But the total number of malaria cases remains stubbornly high. Overall funding for the malaria response has plateaued, and the malaria parasite and mosquitos that transmit it are growing resistance to our most effective drugs and insecticides.
Continued process is possible, but not inevitable. The situation today requires us to evolve our approach and harness new learnings, technologies and partnerships to overcome the challenges we face.
Steps being taken to drive progress:
Using data to save lives in high-burden countries
More than two-thirds of malaria cases and deaths are concentrated in just 11 countries. And the rate of reduction in deaths per year has slowed. To meet ambitious milestones and more importantly save lives today, we need a more targeted, data-driven approach to fighting the disease.
Encouragingly, that approach is the focus of a range of initiatives. A new initiative led by high-burden countries and supported by the WHO and RBM Partnership to End Malaria aims to strengthen malaria surveillance and case management, while using data to drive decision-making.
The Global Fund and US President’s Malaria Initiative are collaborating for more accurate and timely data. Efforts like Visualize No Malaria are integrating technology, data and country programmes to bring real-time data to the frontlines of the fight against malaria.
Harnessing innovation to deliver impact
A new generation of interventions are in development, which will enable us to stay ahead of resistance and tackle the disease in the most challenging places, including new insecticide-treated nets and insecticide sprays. Scaling innovation is critical to turning the tide on malaria infections and deaths.
Investments in transformative tools are vital. We must advance research into innovative vector control tools – such as attractive targeted sugar baits and genetically-modified mosquitos.
Elevating malaria on health agendas
Making major strides against malaria is biologically and technically feasible today but will only be possible if donors and endemic countries make it a top health priority. This year, the world has an opportunity to signal its commitment by replenishing the Global Fund. Since its establishment in 2002, more than 27 million lives have been saved by health programmes supported by the Global Fund partnership. In 2017 alone, countries where the fund invests saw distribution of 197 million bed nets and treatment of 108 million malaria cases.
The UK government has historically been a leading supporter of the Global Fund, pledging £1.1 billion during the last replenishment cycle. Stepped-up leadership from the UK and other donors will be vital to ensuring that Global Fund programmes continue to save and improve lives around the world.
Some of the most striking recent successes, including elimination of the disease in Sri Lanka, were driven by dedicated health ministries and strong local malaria control programmes. Deepening collaboration with affected countries and supporting their efforts will be essential to translating global commitments into a world free of malaria. Reducing deaths now and eliminating the disease for good go hand in hand.