World Malaria Day 2018
Message from Dr Poonam Khetrapal Singh, Regional Director, WHO South-East Asia Region on the occasion of World Malaria Day 2018
The theme of this year’s World Malaria Day is the need for each of us to be ‘Ready to Beat Malaria’ – a theme that reflects our drive towards the South-East Asia Region’s 2030 elimination target, and is also aligned with the recently signed Ministerial Declaration on Accelerating and Sustaining Malaria Elimination in the South-East Asia Region.
In recent years our Region has made remarkable progress. As detailed in the 2017 World Malaria Report, since 2010 the Region’s reported malaria incidence has been slashed by half. Associated mortality has declined by 60%. Two countries in the Region – Maldives and Sri Lanka – have already beaten indigenous malaria transmission and been certified malaria-free.
A number of the Region’s Member countries are ready to do the same. In 2016 four Member countries recorded fewer than 10 000 cases. Bhutan and Timor-Leste have reported zero malaria deaths since 2013 and 2015 respectively. Eight of the Region’s nine malaria endemic countries are on course to reduce malaria cases by at least 40% by 2020. Three countries – Bhutan, Nepal and Timor-Leste – are identified as having the potential to interrupt local malaria transmission by the same date. Importantly, all countries have taken steps to align national malaria control programmes with the WHO Global Technical Strategy for Malaria 2016–2030. Despite these advances, however, the South-East Asia Region remains the second most malaria-affected Region in the world, with around 1.35 billion men, women and children at risk of the disease. The Region accounts for 58% of the global burden of cases of Plasmodium vivax malaria, while in 2016 63% of the Region’s malaria cases were from Plasmodium falciparum – the most deadly malaria parasite.
As outlined in the ‘Regional Action Plan 2017–2030 Towards 0. Malaria Free South-East Asia Region’, to beat malaria by 2030, a series of key – and locally tailored – interventions is needed, both in areas and communities that remain high-burden, as well as those where the problem is almost eliminated.
First among them is expanding national malaria programmes’ activities to difficult-to-reach, disadvantaged or neglected communities at high risk of malaria, including tribal, migrant or mobile populations. That means providing them access to the full package of malaria interventions, including long-lasting insecticidal nets or indoor residual spraying, diagnostic testing and effective treatment. It also means intensifying community engagement so as to better understand local needs and calibrate elimination interventions accordingly. Among these groups, pregnant women and children under-5 need special attention, including increased access to antenatal services.
Strengthening surveillance and harnessing the full power of available tools and treatments is likewise essential. Though surveillance should be strengthened Region-wide (including via cross-border initiatives), where feasible it should be transformed so as to facilitate elimination, particularly in countries that are striving to eliminate the disease by 2020, as well as those in the Greater Mekong Subregion that aim to eliminate the P. falciparum parasite by 2025. This should be part of a larger push to effectively utilize evidence-based tools and treatments. A more practical approach to case management of vivax malaria, for example, is needed with respect to the safe and effective use of primaqine, particularly given the South-East Asia Region has the majority of the world’s vivax malaria cases.
Ensuring national malaria programmes are provided sustainable funding is similarly paramount. Unless domestic financing is increased Region-wide, the prospect of malaria’s deadly resurgence is a distinct – and alarming – possibility. As more of the Region’s Member countries move in to the middle-income bracket and transition away from dependence on international funding, high-level leaders must recognize the benefits beating malaria will bring, not only to their citizens’ health and wellbeing, but to sustainable development as a whole.
To that end, I commend the Region’s Member countries for their resolve to achieve our common goal, whether by reducing malaria in high-burden areas and communities or overcoming last-mile challenges. As each one of them expressed in a Ministerial Declaration on Accelerating and Sustaining Malaria Elimination in the South-East Asia Region in November, a unique opportunity exists to eliminate malaria from our Region by 2030 at the latest, especially given recent progress. Their commitment is both necessary and highly encouraging.
On World Malaria Day, I reiterate that WHO South-East Asia is Ready to Beat Malaria, and will continue to support Member countries across the Region achieve that goal. As reflected in our activities to date, and as highlighted in the theme of this year’s World Malaria Day, we will do so by providing practical and strategic guidance where needed, as well as by keeping our joint malaria elimination target front-of-mind and emphasizing the winning mentality required to achieve it. With sustained, high-level commitment we can eliminate malaria by 2030 at the latest. We can free millions of people across our Region from a disease whose burden has weighed so heavily for so long, but whose burden we are now ready to beat for good.
Dr Poonam Khetrapal Singh