New research shows that after 10 years of intensified campaigns against malaria 184-million people in Africa still live in moderate to high-risk areas. While the number is high, it’s down from nearly 220-million in 2000 when anti-malaria efforts began to increase.
The findings are based on thousands of community-based surveys in 44 African countries and territories. These are places where malaria has been endemic.
Dr. Abdisalan Noor, co-leader of the team that conducted the research, said, “What we are looking at, first of all, is to try and estimate the level of infection with malaria in African communities. This doesn’t necessarily mean the number of people who die of malaria, but the proportion of people who are likely to carry the most virulent type of the malaria parasite. That’s Plasmodium falciparum.”
Noor and co-leader Professor Robert Snow are with the Kenya Medical Research Institute-Wellcome Trust Research Program. The team also included researchers from Oxford University and the World Health Organization.
The study reflects the effects of the Roll Back Malaria campaign and other programs. The campaign brought together many multi-lateral, private and non-governmental organizations. The goal was to cut in half the number of deaths from malaria by 2010. It had a shaky start and was criticized in its early years for a lack of progress.
Dr. Noor said that the new study finds a mix of good and bad news about efforts to combat malaria.
“The positive news is there has been production in 40 of the 44 African countries for which we were able to estimate change. There has been some reduction in the proportion of people who are likely to be affected with the falciparum parasite. About 218-million people in 2010 lived in areas where transmission – malaria transmission – had dropped by at least one level of endemicity. So that’s good news.”
Endemicity is described as the measure of disease prevalence in a region.
“The other side of it.” said Noor, “is that despite all these gains almost 60 percent of African populations still live in areas where more than 10-percent of the population is likely to carry the malaria parasite. And out of these about 184-million people live in areas where more than 50-percent of the population are likely to carry malaria infections.”
Among the countries where disease transmission remained high or unchanged are DRC, Uganda, Malawi and South Sudan.
Despite the large number of people still likely to be infected, Noor says he does not want to detract from the gains made by the international community – namely, the reduction in risk for 34-million people from 2000 to 2010.
“We haven’t actually looked at the reasons why some places are more resilient to change than others. Epidemiologically, it’s got something to do with the higher the starting transmission, the longer it takes to bring down the disease,” he said.
Another reason, he said, may be weak health care systems in many countries. It can be difficult to get reliable estimates on how many people get sick or die from malaria. Noor says stronger health care systems would play a major role in reducing infection risk.
In the 10-year period studied, funding for malaria programs steadily increased from 100-million-dollars to two-billion dollars a year.
He said, “It’s no news that despite all this investment we need more. I think the estimate for the needs for malaria control in Africa is around five-billion dollars if we look at the last global malaria action plan.”
Noor said that there’s a lot to be proud of in the global community in terms of reducing malaria cases.
He added that despite a recent global recession -- and competing priorities -- resources for malaria campaigns should not only be sustained, but increased. That would help bring malaria to a point where, he said, it would be of “minimal public significance.”
Right now, though, the Roll Back Malaria campaign estimates a child dies every 60 seconds from the disease.