World Malaria Day 2019
Message from Dr Poonam Khetrapal Singh, Regional Director, WHO South-East Asia Region on the occasion of World Malaria Day, 25 April 2019
The world stands at a crossroads in eliminating malaria. Stunning successes in recent decades to prevent, control and treat malaria have once again put the disease’s elimination on the map, bringing the world closer to a historic victory for public health and well-being. But global progress in the past three years has been less than optimal. In some places it has even stalled or gone backward. In 2015, for example, malaria’s estimated global caseload was 214 million. In 2017 it was 219 million, with estimated mortality almost unchanged from the previous year. Urgent action is needed to get the global response back on track.
The WHO South-East Asia Region is standing tall. As the 2018 World Malaria Report outlines, between 2010 and 2017 the Region reduced its estimated caseload by a remarkable 56%. It slashed estimated malaria mortality by 50% and a reported 88%. Notably, between 2015 and 2017 the total reported number of cases presumed and confirmed decreased by 25%, while reported mortality was more than halved. Maldives and Sri Lanka remain malaria-free, while seven of the Region’s nine malaria-endemic Member States are set to have reduced case incidence by 40%. Bhutan and Timor-Leste are now working to overcome last-mile challenges, while several other Member States have made significant progress.
Importantly, all countries have committed to the Ministerial Declaration on Accelerating and Sustaining Malaria Elimination in the South-East Asia Region, pledging to rid the Region of the disease by or before 2030. Though ambitious, doing so is entirely achievable should resolve remain strong, as it is in India, which is part of the WHO-supported ‘high burden to high impact’ initiative, and which in a single year (2016-2017) reduced its caseload by a stunning 22% due to concentrated efforts.
That point is crucial. As the theme of this year’s World Malaria Day – ‘zero malaria starts with me’ – underscores, to sustain our gains, accelerate progress and make full use of emerging innovations, we must ensure malaria remains a core political issue. Doing so is particularly important to overcome present funding gaps and mobilize additional resources to drive life-changing progress.
Region-wide, advocacy aimed at fully operationalizing the Ministerial Declaration must be fortified. Wherever possible, the Declaration’s time-bound targets should serve as rallying points for action and – where needed – accountability. While this is especially important in the Region’s medium and high-burden countries, it is equally important in countries where subnational elimination remains troublesome and where malaria has, like many diseases before it, become a symbol of exclusion, neglect and marginalization. Insofar as malaria persists in certain areas and among specific communities, all people in the Region are at risk.
That is exactly why increased cross-border collaboration is so crucial. A cross-border response will allow authorities to respond to outbreaks more efficiently (especially via complementary initiatives) and better protect vulnerable populations in border areas, which are often malaria-prone. Importantly, it will also enhance country-to-country capacity building, including in research, and promote buy-in to combating the problem. A Region-wide mechanism, with a specific focus on drug- and insecticide resistance, is needed to integrate malaria surveillance to help achieve these outcomes.
As the global community mobilizes, all initiatives must remain country-led and country-owned. That means ensuring malaria prevention, control and treatment – including integrated vector control measures – are prioritized at the highest levels as part of the wider push towards sustainable development. It also means ensuring communities at the grassroots are empowered to act and have access to long-lasting insecticidal mosquito nets, indoor residual spraying and quality-assured diagnosis and treatment as per national strategies. Special efforts must be made to protect pregnant women and children under five years of age.
WHO is committed to providing Member States its technical and operational support to ensure malaria’s sometimes deadly, always life-sapping burden is lifted Region-wide. Achieving that outcome is possible, but only with the full strength, commitment and resolve of Member States, partners, donors and the public alike. As we mark World Malaria Day, we must be aware of and embrace our ability to shape history and do so for the better. We must be bold, dare to act, and affirm that achieving ‘zero malaria starts with me’.
Dr Poonam Khetrapal Singh