Malaria deaths could vanish in ten years, claims report

Global malaria deaths could be reduced to near-zero, and cases of infection cut by 75 per cent, within the next decade, a report claims.

‘A Decade of Partnerships and Results’, published by the Roll Back Malaria (RBM) Partnership last week (12 September), says these goals can be met if the progress made fighting the disease over the last ten years is sustained.

The target has been adopted by the RBM’s partners — more than 500 of them — including malaria endemic countries, the private sector, non-governmental organisations and academic institutions.

A ten-fold increase in funding to fight malaria over the last ten years has resulted in halving malaria cases and deaths in 43 countries. Eleven of these are in Sub-Saharan Africa, where an estimated 1.1 million infant malaria-related deaths have been avoided.

"We are light years ahead from where we were ten years ago," said Awa Marie Coll-Seck, executive director of the RBM Partnership. The report attributes this success to global collaboration — with African nations playing a major part — and availability of new tools to fight the disease.

It highlights artemisinin combination therapies (ACTs); better diagnostic techniques; and an increased use of insecticides for nets and indoor spraying. The prevalence of insecticide-treated nets, which are often given out for free, has jumped from around only two per cent of households to up to 80 per cent in some regions.

But the report comes amidst growing concern that the malarial parasite is growing resistant to artemisinin, and mosquitoes to insecticides.

A recent study linked a rise in cases of the disease in one locality to the decreased efficacy of insecticide-treated mosquito nets, while another found resistance to ACTs in South-East Asia. Meanwhile, the WHO has become so concerned about resistance to artemisinin, the cornerstone therapy, that it has issued a blueprint for urgent action to fight it.

Pierre Druilhe, from the Malaria Vaccine Development Laboratory, at the Pasteur Institute, France, said the report’s claims may be unrealistic.

"Claiming that elimination will occur in ten years makes no sense with resistance on the rise," he told SciDev.Net.

"Altogether RBM is doing a good job, but making claims like this is dangerous in the long term."

The report acknowledges the spread of resistance, and says that the search for new drugs and insecticides is vital if the goals are to be met in time.

"It is a fight against time, but with enough resources I am confident that we will stay one step ahead, and the claims of the report are a real possibility," said Thomas Eisele, an associate professor at Tulane University’s School of Public Health and Tropical Medicine, United States, and a contributor to the report.

Resistance to artemisinin has so far been contained within a small region in Cambodia and Thailand, and rigorous measures are in place to prevent it spreading, he said.

And insecticide resistance, although more worrying, is still very localised, he said.

The report was supported by the Bill & Melinda Gates Foundation, which has also been responsible for funding the Malaria Eradication Research Agenda (malERA).