Malaria can and should be eradicated within a generation, declare global health experts

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Monday, 9 September 2019

A future free of malaria, one of the world’s oldest and deadliest diseases, can be achieved as early as 2050, according to a new report published today by The Lancet Commission on malaria eradication.

Authored by 41 of the world’s leading malariologists, biomedical scientists, economists, and health policy experts, the report looks at existing evidence with new epidemiological and financial analyses to demonstrate that – with the right tools, strategies, and sufficient funding – eradication of the disease is possible within a generation. 

“For too long, malaria eradication has been a distant dream, but now we have evidence that malaria can and should be eradicated by 2050,” said Sir Richard Feachem, Co-chair of The Lancet Commission on malaria eradication.

“This report shows that eradication is possible within a generation. But to achieve this common vision, we simply cannot continue with a business as usual approach. The world is at a tipping point, and we must instead challenge ourselves with ambitious targets and commit to the bold action needed to meet them.”

Global malaria trends

Recent decades have seen unprecedented progress made against malaria, prompting discussions about the feasibility of eradicating the disease altogether. Since 2000, global malaria incidence and death rates declined by 36 and 60%, respectively, due to strong leadership, country-driven ambition, innovative new tools and strategies, and increased investments peaking at US$4.3 billion in 2016. Today, more than half of the world’s countries are malaria-free.

However, this progress hangs in the balance. Despite global efforts, there are over 200 million cases of malaria reported around the world each year, claiming the lives of nearly half a million individuals. The achievements of the past two decades are threatened by recent plateaus in global funding, together with a rise of malaria cases in 55 countries across Africa, Asia and Latin America and increasing concern about parasite and vector resistance to currently available drugs and insecticides.

“Despite unprecedented progress, malaria continues to strip communities around the world of promise and economic potential. This is particularly true in Africa, where just five countries account for nearly half of the global burden,” said Dr Winnie Mpanju-Shumbusho, Co-chair of The Lancet Commission on malaria eradication. 

Modelling a world free from malaria

In the report, the authors used new modelling to estimate plausible scenarios for the distribution and intensity of malaria in 2030 and 2050. Analyses indicate that socioeconomic and environmental trends, together with improved coverage of current malaria interventions, will create a world in 2050 with malaria persisting in pockets of low-level transmission across equatorial Africa.

Rather than continue efforts to gradually reduce malaria in most countries, hold the constant threat of resurgence at bay, and fight an ongoing and increasingly difficult struggle against drug and insecticide resistance, the report notes the malaria community can instead choose to commit to a time-bound eradication goal that will bring purpose, urgency, and dedication. The objective of these efforts is to convert the modelled future of persisting malaria into an engineered future of a world free of malaria in 2050.

Bending the malaria curve

To achieve eradication by 2050, the Commission urges that specific and deliberate actions at country, regional and global levels must be taken. This report identifies three ways to accelerate the decline in malaria cases worldwide:

  • First, the world must improve the management and implementation of current malaria control programmes and make better use of existing tools 
  • Second, we need to develop and roll out innovative new tools to overcome the biological challenges to eradication 
  • Lastly, malaria endemic countries and donors must provide the financial investment needed to ultimately rid the world of this disease

While the cost of malaria eradication is unknown, as it was for smallpox, polio, and Guinea worm when their respective eradication campaigns were launched, an annual increase of approximately US$2 billion will greatly accelerate progress.

When combined with the increasing commitment and ambition by endemic countries and regions and strengthened leadership and accountability, these actions will propel us towards a world without malaria by 2050 or sooner.

Dr Tedros Adhanom Ghebreyesus, Director-General of the WHO, says: “I would be thrilled to see this global scourge eradicated even earlier. But we will not achieve eradication within this time frame with the currently available tools and approaches...The good news is that we, the global malaria community, know what we need to do.”

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