Malaria – amazing success; huge challenges

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Presentation transcript:

Malaria – amazing success; huge challenges

Life expectancy – whole world Life expectancy is up! Life expectancy – whole world …this is true in every region of the world, rich and poor

Extreme poverty is down!

Population growth rates are in decline …this is because fertility rates decline as parents become confident of their kids survival

Gains in child survival are across the board

Beating infectious disease in children: malaria is hard!

Beating malaria in the tropics is especially hard

Malaria cases by region in 2017 (millions) World malaria report 2018

Huge success: Since 2010… ~1 million lives saved (607,000 to 435,000 deaths/annum) ~100 million cases averted (239 million to 219 million cases/annum) Several countries have eliminated malaria World malaria report 2018

An update on elimination

Malaria in 2018 Zanzibar Comoros Mayotte Seychelles Mauritius Reunion Cape Verde Maldives São Tomé & Príncipe Solomon Islands Vanuatu Malaria-free (≥ 3 years) Malaria-free (< 3 years) Eliminating malaria Controlling malaria El Salvador Timor-Leste UCSF GLOBAL HEALTH GROUP’S MALARIA ELIMINATION INITIATIVE (MEI)

Why the success? – Better testing and treatment

Why the success? Better prevention

But, progress has stalled World malaria report 2018

Resurgence in PNG World Malaria Report 2017 UCSF GLOBAL HEALTH GROUP’S MALARIA ELIMINATION INITIATIVE (MEI)

Why the stalling? Darwinism Hard to know precisely but includes some technical issues… Insecticide resistance Drug resistance Diagnostic test ‘resistance’

Pyrethroid resistance frequency

What else is/will impede further progress… Financing challenges Have we reached the limits of what’s possible in the ‘hardest’ areas? Shifts in climate, populations and vector location Distraction through complacency, conflict, other priorities, etc

Resourcing

Alarming spread of Anopheles stephensi Djibouti City, Djibouti Mannar District, Sri Lanka Jaffna District, Kebri Dahar, Ethiopia Photo: Dr. Hugh Sturrock UCSF GLOBAL HEALTH GROUP’S MALARIA ELIMINATION INITIATIVE (MEI)

What can be done about it High Burden to High Impact strategy; a targeted malaria response Integrate research, data and innovation into all facets of the response; that is, develop and use the latest tools and knowledge; always learn in a robust way

High Burden to High Impact strategy The Global Technical Strategy for Malaria 2016–2030 calls for reducing malaria cases and deaths by at least 40% by 2020, at least 75% by 2025 and at least 90% by 2030. Without a major turnaround, these targets are unlikely to be met – a challenge further compounded by insufficient levels of funding for malaria control. ”High burden to high impact” is a country-led response – catalyzed by WHO and the RBM Partnership – to reignite the pace of progress in the global malaria fight.