Country significantly reduced its malaria incidence since 2015; Africa worst-hit
Photo: iStock India accounted for 66 per cent of the 5.2 million malaria cases recorded in 2022 – the highest for any country in the South East Asia region of the World Health Organization (WHO), the United Nations health agency noted November 30, 2023.
This is even as cases reduced by at least 55 per cent in India since 2015, where the disease is endemic, according to World Malaria Report 2023.
In the early monsoon months of 2023, however, cities like Mumbai and Delhi saw a surge in malaria cases compared to last year, the latter due to unseasonal rainfall in the months of April and May, according to news reports.
The report also highlighted the direct and indirect impacts climate change may have on malaria transmission and overall burden. Climate change can directly interact with the sensitivity of the malaria pathogen and the vector (female Anopheles mosquito) to temperature, rainfall and humidity, and make it easier for the contagion to spread and infect, it added.
“The changing climate poses a substantial risk to progress against malaria, particularly in vulnerable regions. Sustainable and resilient malaria responses are needed now more than ever, coupled with urgent actions to slow the pace of global warming and reduce its effects,” said Tedros Adhanom Ghebreyesus, WHO Director-General.
The global picture was grim: A total of 249 million cases were recorded in 2022, the findings showed. This was five million more than the previous year and significantly more than 2019, which is considered a benchmark year.
Pakistan recorded the largest rise in cases in 2022 compared to 2021, with 2.1 million additional malaria infections. It was followed by Ethiopia, Nigeria, Uganda and Papua New Guinea.
India, along with Indonesia, also accounted for 94 per cent of all the deaths that occurred due to malaria in 2022, the data showed.
The South East Asian region, overall, accounted for only 2 per cent of the global malaria burden and managed to contain the disease in the last two decades, the authors of the report observed. Since 2000, total malaria cases as well as deaths in the region dropped by 77 per cent from 22.8 million and 35,000 respectively, they added.
Apart from India, Bangladesh, Bhutan, the Democratic People’s Republic of Korea, Nepal, Thailand and Timor-Leste also managed to reduce their malaria incidence by 55 per cent or more since 2015, the report stated. Of them, Bhutan (for the first time), Timor-Leste (for the second time) and Sri Lanka reported zero malaria cases in 2022. Nepal, for the first time, didn’t record a single indigenous malaria death.
The trend was reversed in Myanmar, however, where cases increased seven times from 2019-2022, from 78,000 to 584,000 “fueled by political and social instability”, according to WHO.
Africa was the worst-hit, with 94 per cent of all malaria cases (233 million cases) and 95 per cent global malaria deaths (580,000 deaths) in 2022, the authors of the report noted. “About 78 per cent of all malaria deaths in the Region were among children under the age of five.”
The impact of climate change on human health has become increasingly prominent, with the interaction being a major theme at the ongoing 28th Conference of Parties to the United Nations Framework Convention on Climate Change. It poses a direct health hazard and also acts as a 'threat multiplier' by impairing healthcase systems and creating financial strains.
In the case of malaria specifically, meteorological anomalies wrought by climate change can aid disease transmisssion and exacerbate the global crisis both in the short-term and the long. “For instance, the ideal mosquito breeding and survival occurs at temperatures ranging from 20-27 degrees Celsius, with mortality increasing above 28°C. Conversely, a slight warming in cooler, malaria-free zones could lead to new malaria cases.”
Floods, cyclones and other extreme weather events that have been made more intense and frequent by the planetary crisis also lead to outbreak of infectious diseases such as malaria, the authors of the report stressed. They attributed the sharp surge in malaria cases in Pakistan in 2022 to the deluge that occured that year. south. "Post-flood standing water became ideal breeding grounds for mosquitoes, and malaria cases increased five-fold compared to 2021 (just above 500 000 cases reported in 2021 and 2.6 million cases reported in 2022)."
Climate change can worsen a health crisis like malaria in multiple other, less noticeable ways too, the authors highlighted. Natural disasters destroy health infrastructure and can cause a breakdown of the supply chain of critical medication, vaccines as well as mosquito nets.
They also displace people in large numbers. This not only gives rise to socio-economic challenges but also can expose new population groups to the infection by forcing them to move into endemic areas from places where malaria wasn't prevalent.
In the path to malaria eradication, WHO had identified graded targets of reducing case incidence and mortality rates by 75 per cent in 2025 and 90 per cent in 2030.
The world is 55 per cent off track to reach its 2025 target of reducing malaria case incidence and 53 per cent off track to achieving the 2025 target of reducing malaria fatality rate, the analysis showed.
Without drastic measures, these gaps will widen for the ultimate 2030 goals. Despite this, the funding gap for malaria control grew from $2.3 billion in 2018 to $3.7 billion in 2022, the authors of the report pointed out.
Funding for research and development saw its steepest fall ever, to $603 million. This is the lowest in 15 years, the report showed.
The global health organisation salled for sustainable and resilient malaria responses that align with efforts to reduce the effects of climate change.
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