BACKGROUND
Malaria is caused by parasites of the Plasmodium family and transmitted by female Anopheles mosquitoes. There are four different human malaria species (P. falciparum, P. vivax, P. malariae and P. ovale), of which P. falciparum and P. vivax are the most prevalent and P. falciparum the most dangerous. P. knowlesi is a zoonotic plasmodium that is also known to infect humans.
Despite being preventable and treatable, malaria continues to have a devastating impact on people’s health and livelihoods around the world. According to the latest available data, about 3.2 billion people were at risk of the disease in 97 countries, territories and areas in 2013, and an estimated 198 million cases occurred (range: 124 million–283 million). In the same year, the disease killed about 584 000 people (range: 367 000–755 000), mostly children aged under 5 years in sub-Saharan Africa. In most countries where malaria is endemic, the disease disproportionately affects poor and disadvantaged people, who have limited access to health facilities and can barely afford the recommended treatment.
Between 2001 and 2013, a substantial expansion of malaria interventions contributed to a 47% decline in malaria mortality rates globally, averting an estimated 4.3 million deaths. In the WHO African Region, the malaria mortality rate in children under 5 years of age was reduced by 58%. During the same period, the global incidence of malaria was reduced by 30%. Target 6.C of Millennium Development Goal 6, namely “Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases”, has already been reached, and 55 of the 106 countries that had malaria transmission in 2000 are on track to achieve the goal of reducing malaria incidence by 75% by 2015, as set by the Health Assembly in 2005 in resolution WHA58.2 on malaria control.
Despite this progress, the disease remains endemic in all six WHO regions and the burden is heaviest in the African Region, where an estimated 90% of all malaria deaths occur. Two countries – the Democratic Republic of the Congo and Nigeria – account for about 40% of estimated mortality due to malaria worldwide. Around the world, millions of people remain without access to malaria prevention and treatment, and most cases and deaths go unregistered and unreported. Given the projected growth in the size of the world’s population by 2030, more people will be living in countries where malaria is a risk, putting further strains on health systems and national malaria programme budgets.