World health officials had hoped to reduce the number of deaths due to malaria by 50% between 2000 and 2010. They got halfway there, according to the latest estimates of the world burden of malaria, released today by the World Health Organization. The World Malaria Report 2011 calculates that malaria mortality fell by 25% in the last decade. In 2010, an estimated 655,000 people died of malaria. That is 5% fewer than the estimates for 2009. 86% of the victims were children younger than 5, and 91% were in Africa.
The report attributes the decrease to the major boost in funding that malaria prevention programs have enjoyed, but it predicts that 2011 may be a high-water mark. The world spent roughly $2 billion on malaria control this year. "That is likely to decrease the next two years," says Robert Newman, director of the WHO Global Malaria Programme. To fully fund control efforts, including insecticide-treated bed nets, indoor insecticide spraying, disease surveillance and treatment programs would require more than $5 billion, he says.
The report also documents a worrying increase in resistance—both of mosquitoes to insecticides and of the malaria parasite to artemisinin, the most powerful drug available to treat it. Mosquitoes resistant to pyrethroids, the only insecticide used on treated bed nets, have been reported in 39 countries. Scientists are working to understand how that might affect their control efforts, and have developed guidelines to try to manage resistant mosquito populations.
Resistance to artemisinins was found in the border region of Cambodia and Thailand in 2009; it is now suspected to have spread to Myanmar and Vietnam. The good news is that artemisinin combination therapies—which use artemisinin in combination with other drugs—are still very effective.
The report also lays out the next major control targets: By 2015, reduce malaria deaths to "near zero" and reduce malaria cases by 75% compared with 2000. Whether the world comes close to reaching those goals depends on sustained, and increased, funding, Newman says. The disease is both preventable and treatable, he says. "No one should die from malaria for lack of a $2 bed net, a 50 cent diagnostic test, and a $1 treatment."