While deaths came down to 619,000 in 2021 from 625,000 in the first year of the pandemic, it remained higher than the pre-pandemic level of 568,000 deaths in 2019
Insecticide-treated bednets are the key vector control tool used by endemic countries. Photo: iStock. High-burden malaria countries maintained a strong front against the disease in 2021 despite the COVID-19 pandemic, with cases and deaths stabilising.
While deaths came down to 619,000 in 2021 from 625,000 in the first year of the pandemic, it remained higher than the pre-pandemic level of 568,000 deaths in 2019.
As for cases, the upward trend continued but at a slower rate — 247 million cases in 2021, compared to 245 million cases in 2020 and 232 million in 2019 — data from the World Malaria Report 2022 released by the World Health Organization (WHO) December 8, 2022 showed.
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In 2020, the first year of the COVID-19 pandemic, there were concerns about decades of progress on the malaria front being undone.
However, these figures offer a ray of hope and evidence of the continued efficacy of national malaria programmes (NMPs) across the world.
There were region-wise discrepancies in rallying from the setback, with some countries trying to recover lost ground and others attempting to reduce the impact of the pandemic.
WHO Director-General Dr Tedros Adhanom Ghebreyesus said:
Following a marked increase in malaria cases and deaths in the first year of the COVID-19 pandemic, malaria-affected countries redoubled their efforts and were able to mitigate the worst impacts of Covid-related disruptions to malaria services.
There are many challenges, but there are many reasons for hope. By strengthening the response, understanding and mitigating the risks, building resilience and accelerating research, there is every reason to dream of a malaria-free future, Ghebreyesus added.
Among the 11 high-burden countries, five — the Democratic Republic of the Congo, Ghana, India, Niger and the United Republic of Tanzania — recorded a decline in deaths. But these countries continued to contribute heavily to the global disease burden.
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Insecticide-treated bednets (ITNs) are the key vector control tool used by endemic countries. In 2021, of the 171 million ITNs planned for distribution, 128 million were distributed. These figures are similar to pre-pandemic levels.
In Africa, seasonal malaria chemoprevention (SMC) is a recommended tool to protect children. In 2021, 45 million children per SMC cycle in 15 African countries received the treatment; an improvement from 33.4 million in 2020 and 22.1 million in 2019.
Intermittent preventive treatment in pregnancy (IPTP) remained consistent. In 2021, some 35 per cent of pregnant women in 35 African countries received a full three-dose regimen of IPTP, a marginal improvement from 32 per cent in 2020.
While improvement has been made in efforts to mitigate malaria, Africa — home to 95 per cent of cases and 96 per cent of deaths globally in 2021 — continues to suffer.
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“Despite progress, the African region continues to be hardest hit by this deadly disease,” said Dr Matshidiso Moeti, WHO regional director for Africa.
New tools — and the funding to deploy these — are urgently needed to help us defeat malaria, Moeti added.
Other hurdles impeding the progress include mutating parasites which can evade rapid diagnostic tests, increasing drug resistance and the invasion of an urban-adapted mosquito in Africa, which is resistant to most insecticides used in this geography.
The pandemic derailed progress in the efforts to end malaria.
The aim is to reduce malaria case incidence and mortality rates by at least 40 per cent by 2020, at least 75 per cent by 2025 and at least 90 per cent by 2030 against a 2015 baseline, according to the WHO Global technical strategy for malaria 2016–2030.
In 2021, the case incidence was 48 per cent off track — at 59 cases per 1,000 population at risk, compared to a target of 31. Death incidence is also 48 per cent off track — 14.8 in 2021 against a target of 7.8. If these trends continue, the world will be 88 per cent off target in its fight against malaria.
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