Global gains against malaria are slowing down, as challenges rise

CHAI recently co-authored a review in Science Translational Medicine reflecting on the diminishing gains in the global fight against malaria in the face of growing challenges.

Since the year 2000, historic reductions in malaria incidence and mortality have been driven by the widespread distribution of bed nets, drugs, and insecticides for the prevention and treatment of malaria. Scale-up of these tools has been enabled by an increase in malaria financing compounded by price reductions, yet these trends are unlikely to continue at the same rate given the need to switch to more expensive next-generation tools to avert the threat of mosquito and drug resistance.

At the same time, the world’s highest endemic countries also feature the fastest population growth in the world. This growth will mean that many more people will need to be protected and treated over the coming decade, even as the tools needed to do so will grow more expensive.

Donor funding is not growing fast enough to keep up with these trends. Unless that changes, we will be unable to afford to keep up current coverage levels with effective malaria tools like bed nets. If coverage levels go down, malaria transmission will increase.

The review suggests a set of solutions to address this looming challenge. These include further increasing available financing for malaria, increasing the cost-effectiveness of existing tools through surveillance-driven targeting, strengthening health systems to improve case management, better engaging the private sector as a means for providing malaria services, and investing in more sustainable, non-commodity-dependent approaches to fight malaria.

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