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The annual mortality from malaria is higher today than before the start of the WHO's Roll Back Malaria (RBM) programme in 1998, an indication of a failing campaign, according to an article in the American Journal of Tropical Medicine and Hygiene.

Ephantus J. Muturi, Peter Burgess and Robert J. Novak argue that although insecticide-treated bednets have helped control the disease among young children and pregnant women, they might not be the best method for achieving the RBM goal of halving deaths by 2010 and again by 2015.

Reduced death and illness in children could shift malaria to unprotected older children and adults, who will be absent from work and be unable to care for young children and pregnant women.

Despite the strategy's "moral value ... In the end, we are likely to witness a significant reduction in child mortality but an increase or no change in economic burden caused by disease."

The current policy needs to be evaluated and changed "before it is too late". But civil unrest, tribal wars and lack of political goodwill need to be addressed, as effective malaria control requires a stable civil setting.

Link to full article in the American Journal of Tropical Medicine and Hygiene