“Accelerating the fight against malaria for a more equitable world”
World Malaria Day 2024 will be marked under the theme “Accelerating the fight against malaria for a more equitable world.” In recent years, progress in reducing malaria has ground to a standstill. Not only does malaria continue to endanger health and cost lives, but it also perpetuates a vicious cycle of inequity. People living in the most vulnerable situations continue to be disproportionately impacted.
The Western Pacific faces challenges on the road to malaria elimination. In particular, the epidemiology of malaria exhibits enormous diversity, with the disease often concentrated in remote areas and/or among highly mobile or hard-to-reach populations, including forest goers, migrants, indigenous people, military and refugees. More than 70% of malaria deaths in the Region are attributable to Plasmodium falciparum, often because of delayed treatment.
Other key challenges in the Region include reaching remote populations in Papua New Guinea and Solomon Islands, preventing relapse of vivax malaria through compliant full-course treatment, and halting transmission of knowlesi zoonotic malaria in Malaysia.
Reaching these populations with malaria prevention, diagnosis and treatment is a critical strategy for achieving global malaria targets and delivering on the promise of “zero malaria.” WHO is working with countries and areas in the Region to develop and implement intensification strategies, such as targeted drug administration, fever screening and treatment, and rapid response to all malaria cases.
Malaria vaccines are a breakthrough for child health and malaria control. WHO recommends two safe and effective vaccines, RTS,S and R21. With these two vaccines available, sufficient supply will meet the demand and scale up as needed in the Region.
Malaria success in the Western Pacific
While much work still needs to be done to reach “zero malaria”, the Region has had great success at controlling the disease. In the past 20 years, malaria deaths have decreased by 88%. Between 2021 and 2022, however, there was a 29% increase in estimated deaths to 3600, mainly due to increases in Papua New Guinea.
An increase in estimated malaria cases was also seen between 2021 and 2022, up by 23% or 1.9 million cases.
Although antimalarial drug resistance remains a concern, the Western Pacific countries of the Greater Mekong subregion, including Cambodia, Lao People’s Democratic Republic, and Viet Nam have seen promising results to accelerate Plasmodium falciparum elimination. Between 2000 and 2022, these countries reported a 55.5% decrease in all indigenous malaria cases and an 89% decline in indigenous P. falciparum malaria cases. All countries are on target to meet the 2024 elimination target for Plasmodium falciparum malaria and all forms of human malaria by 2030.
In 2021, China was certified malaria-free by WHO. Malaysia achieved zero cases of human malaria for the fifth year in a row in 2022 but is challenged by thousands of zoonotic knowlesi malaria cases.
Six countries in the Region reported fewer than 10 000 malaria cases in 2022: Cambodia, Lao People’s Democratic Republic, Malaysia, the Republic of Korea, Vanuatu and Viet Nam.
There have been zero reported malaria deaths in the Republic of Korea and Vanuatu since 2012, Cambodia since 2018 and Viet Nam since 2019.
Invest in efforts to defeat malaria through strengthening primary health care to reach the unreached. Funding should be prioritized for the most marginalized and hard-to-reach populations who are less able to access services and are hardest hit when they become ill. End discrimination and stigma against these populations and include malaria control interventions in universal health coverage.
Step up innovation. Add your voice to those calling for innovations that bring new vector control approaches, diagnostics and medicines to accelerate progress against malaria.
Implement the strategies we have now. There is an urgent need to make more effective use of available tools and strategies to prevent, diagnose and treat malaria, particularly among unreached populations. Communities must be further engaged in planning and implementing these strategies and in health decision-making through people-centred primary health care.