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New tools, funds, political will vital if nations must eradicate malaria─WHO

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GOING by the available tools in fighting malaria which include the use of mosquitoes nets and insecticides, the World Health Organisation said the global goal of eradicating malaria by 2030 would be unachievable, except new transformative strategies and tools were developed.

The findings surfaced in a report from WHO’s Strategic Advisory Group on Malaria Eradication (SAGme) where the executive summary was launched and published on Friday.

The report is a three-year-long analysis of the global fight against malaria where the group considered the biological, technical, financial, socio-economic, political and environmental factors that underpin malaria.

“Accelerated research and development in new tools for malaria prevention and treatment is key if the world is to eradicate malaria in the foreseeable future,” the summary read partly.

WHO also said there is an urgent need for countries to develop strong political wills and invest in universal health coverage with a well-functioning primary health care system.

It added that access to affordable and quality people-centred health services are key, if countries want to eliminate malaria and prevent re-establishment of transmission.

The global health agency noted that most of the tools being used to tackle malaria currently were “developed in the last century or even earlier”.

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The tools included insecticide-treated mosquito nets, indoor residual spraying, rapid diagnostic tests and drugs based on artemisinin.

“To achieve a malaria-free world we must reinvigorate the drive to find the transformative strategies and tools that can be tailored to the local situation. Business, as usual, is not only slowing progress, but it is sending us backwards,” said Marcel Tanner, Chair of the SAGme.

The global aim is to have a 90 per cent reduction in the malaria case incidence and mortality rate by 2030.  But the latest WHO report shows that progress is stalling.

Global malaria infection and death rates have remained virtually unchanged since 2015.

According to the World Malaria Report 2018, there were 219 million cases of the disease in 2017, where only eleven countries carry 70 per cent of the burden. The eleven countries include Burkina Faso, Cameroon, Democratic Republic of the Congo, Ghana, Mali, Mozambique, Niger, Nigeria, Uganda, United Republic of Tanzania and India.

Nigeria is the highest carrier of the burden with 25 per cent. Thus, more than 53 million Nigerians had malaria in 2017, the largest in the world. The disease is the fourth leading cause of death in Nigeria.

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WHO said access to health services had remained a major challenge in fighting malaria.

“Only one in five pregnant women living in areas of moderate to high malaria transmission in Africa is able to obtain the drugs she needs to protect herself from malaria.

“Half the people at risk of malaria in Africa sleep under an insecticide-treated net and just 3 per cent are protected by indoor spraying with insecticides,” said WHO.

Need to rethink approaches- WHO

“Our priority now should be to establish the foundation for a successful future eradication effort while guarding against the risk of failure that would lead to the waste of huge sums of money, frustrate all those involved… and cause a lack of confidence in the global health community’s ability to ever rid the world of this disease,” the report said.

Setting unrealistic goals with unknown costs and endpoints can lead to “frustration and backlashes”, said the director of the WHO’s global malaria programme, Pedro Alonso, so the world should focus first on developing new medicines, vaccines and insecticides to get malaria cases and deaths under control.

“With the tools that we have today, it is most unlikely that eradication could be achieved,” Alonso said. “We need to focus on getting back on track.”

Credit: WHO
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WHO Chief Tedros Adhanom Ghebreyesus said eradicating malaria would both save lives and boost economies.

Freeing the world of malaria would be one of the greatest achievements in public health, he said.

“With new tools and approaches we can make this vision a reality,” he said.

The report showed that by scaling up current malaria interventions, an additional two billion malaria cases and four million deaths would be prevented by 2030.

But the achievement would happen provided those interventions reach 90 per cent of the population in the 29 countries that account for 95 per cent of the global burden.

The cost of this scale-up is estimated to be US$ 34 billion. The economic gain would be around US$ 283 billion in the total gross domestic product (GDP) – a benefit to cost ratio in excess of 8:1.

The world’s first malaria vaccine, RTS,S/AS01, has been developed and it is being deployed in Ghana and Malawi, with plans for rollout in Kenya.

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