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Aggressive malaria control in Africa is putting some countries on track not only to meet malaria targets but also to slash child deaths to Millennium Development Goal levels, says the WHO.

Ten countries, where most people use insecticide-treated bednets and receive the correct treatment, have cut illness and deaths by half, the WHO's 'World Malaria Report 2009', published today (15 December), found.

In three places — the island state of San Tome and Principe, the island of Zanzibar, and Zambia on the African mainland — deaths of children under five from all causes declined by 53 per cent, 57 per cent and 35 per cent, respectively.

If confirmed in more mainland countries, the trends "suggest that intensive malaria control could help many African countries to reach, by 2015, a two-thirds reduction in child mortality," said the report.

"…The tremendous increase in funding for malaria control is resulting in the rapid scale-up of today's control tools. This in turn is having a profound effect on health — especially the health of children in Sub-Saharan Africa," said Margaret Chan, WHO director-general.

The report, which assesses the progress of 108 malarial countries towards targets set by the World Health Assembly for 2010 and 2015, also gave promising accounts of progress towards eradication.

Ten countries have elimination programmes and a further eight are in the pre-elimination phase — where less than five per cent of suspected malaria cases are actually confirmed to be so. A further nine have managed to interrupt malaria transmission, the step before pre-elimination.

The use of rapid diagnostic tests is also on the rise.

But the report also highlighted major concerns about the disease. Countries with the lowest malaria rates are making the greatest strides, leaving populous countries such as the Democratic Republic of Congo and Nigeria far behind — with fewer than one in ten households owning a bednet.

There also remains an enormous funding gap. Funding commitments for malaria programmes increased from US$730 million in 2006 to US$1.7 billion in 2009, but are still far from the estimated US$5 billion needed per year to ensure that existing malaria interventions have maximum impact.

A third threat is resistance to antimalarial drugs, in particular the potent anti-malarial artemisinin. Evidence of artemisinin resistance came to light in 2009 (see New study confirms growing antimalarial resistance).

The countries that have cut malaria illness and deaths by half are: Botswana, Cape Verde, Eritrea, Namibia, Rwanda, Sao Tome and Principe, South Africa, Swaziland, Zambia and Zanzibar (United Republic of Tanzania).