WHO reports more pregnant women/children protected from malaria; calls for global response
The World Health Organisation’s (WHO) 2019 malaria report shows the effective use vector controls, such as insecticide-treated nets or indoor residual spraying, and preventive antimalarial medicines have benefited a significant number of pregnant women and children in sub-Saharan Africa. Malaria afflicted 228 million people, mostly in sub-Saharan Africa, last year and later killed an estimated 405,000. Pregnant women and children are most at risk – pregnancy reduces a woman’s immunity to malaria, resulting in prolonged illness, severe anaemia and death; and also increases the risk of premature delivery, low birth weight and eventual death of the baby.
Despite this, there was no improvement in the global rate of malaria infections during 2014-2018. Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, said the suffering and death due to malaria is “largely preventable” but inadequate funding has been a major burden for malaria control and elimination. In 2018, some 11 million pregnant sub-Saharan African women were infected with malaria in areas of moderate/high disease transmission. Unfortunately, the funding target for global efforts fell short of the US$5 billion required.
However, WHO initiated a “targeted response” programme in countries hardest hit by malaria – the “High burden to high impact” (HBHI) approach has reported two substantial reductions in malaria cases by November 2019, over the previous year: India (2.6 million fewer cases) and Uganda (1.5 million fewer cases).
Under the HBHI programme, anestimated 61% of pregnant women and children in sub-Saharan Africa slept under WHO-sanctioned insecticide-treated nets in 2018 compared to 26% in 2010; while pregnant women in the region who were recommended 3 or more doses of intermittent preventive treatment in pregnancy (IPTp), delivered at antenatal care facilities (ANC), increased from an estimated 22% in 2017 to 31% in 2018. Still, many women do not receive the recommended number of IPTp doses and are unable to access antenatal care services.
According to the Global Technical Strategy (GTS) for malaria 2016-2030, prompt diagnostic testing and treatment is key to malaria eradication. Recent country surveys pegged 36% of children with fever in sub-Saharan Africa do not receive any medical attention –aside from robust health services for mothers, WHO recommends seasonal malaria chemoprevention (SMC) during the high-transmission rainy season as nearly 62% of children who had access to the preventive medicine have benefited from it.
Another recommended strategy calls for the delivery of antimalarial medicines to very young children through a country’s immunisation platform. The treatment is currently being pioneered in Sierra Leone – Dr. Pedro Alonso, Director of WHO’s Global Malaria Programme, said the intermittent preventive treatment in infants (IPTi) offers “a tremendous opportunity to keep small children alive and healthy.”
Although the malaria-eliminating efforts in many high-burden countries have stalled, a total of 38 countries/territories have been certified malaria-free by WHO. WHO grants the certification when a country proves that the indigenous transmission of malaria has been interrupted for at least 3 consecutive years. In 2018, 27 countries reported less than 100 cases of malaria, with at least 10 countries as part of WHO’s “E-2020 elimination initiative.”
Nevertheless, WHO advocates accelerated efforts to realise the goal of zero infection/death from malaria.
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