The just released World Malaria Report 2020 indicates that African countries have made big strides in reducing malaria mortalities over a stretch of two decades from 2000 to 2019 with the death toll reducing from 680000 to 384000 respectively.
The report reflects on key milestones that have shaped the global response to the disease over the last 2 decades, according to the director general of WHO, Dr Tedros Adhanom Ghebreyesus.
According to the report, globally, there were an estimated 229 million malaria cases in 2019 in 87 malaria endemic countries, declining from 238 million in 2000. The Global Technical Strategy for malaria 2016–2030 (GTS) baseline of 2015 indicates that there were 218 million estimated malaria cases.
The proportion of cases due to Plasmodium vivax has also reduced from about 7% in 2000 to 3% in 2019.
Between 2000 and 2015, the global malaria case incidence declined by 27%, and between 2015 and 2019 it declined by less than 2%, indicating a slow decline rate since 2015.
Twenty nine countries accounted for 95% of malaria cases globally. 5 African countries accounted for 51% of all cases globally with Nigeria taking the highest percentage (27%), the Democratic Republic of the Congo (12%), Uganda (5%), Mozambique (4%) and Niger (3%).
Furthermore, global malaria mortality fell by 60% over the period 2000 to 2019 with the African Region achieving impressive reductions in its annual malaria death toll from 680,000 in 2000 to 384,000 in 2019.
Although there were fewer malaria cases in 2000 (204 million) than in 2019, as per the World Health Organisation (WHO) African Region, the malaria case incidence reduced from 363 to 225 cases per 1000 population at risk in this period, reflecting the complexity of interpreting changing disease transmission in a rapidly increasing population.
The report notes that the high burden to high impact (HBHI) approach has been launched in 10 countries including Uganda to reduce the malaria incidence and prevalence.
The report emphasizes that in each high burden to high impact country initiation, there has been high-level political engagement and support.
“The Mass Action Against Malaria initiative in Uganda is presented as an example of a country-led process of political engagement at all levels, and multisectoral and community mobilization,” the report notes.
Mass Action Against Malaria (MAAM)
The Mass Action Against Malaria (MAAM) initiative was launched in April 2018 by President Museveni in order to address the high malaria burden in the country and its impact on individual and community development.
The initiative was targeted at utilising the influence of high-level state leadership, parliamentarians, government civil servants, religious and cultural leaders, media personnel, private sector, district health teams, health facilities, schoolteachers, community leaders, and households and the public at large in preventing malaria.
A handbook to guide the MAAM initiative also has been developed, detailing the roles and responsibilities of all the key stakeholders.
MAAM has, since its inception, made a number of achievements. Among those, it has managed to incorporate the malaria agenda into the 2021–2025 National Development Plan III, Health Sector Development Plan III.
There has been an establishment of Uganda Parliamentary Forum for Malaria (UPFM), supported by the government. There has also been an establishment of district task forces, and support for malaria operational interventions and local information dissemination through music, dance and drama.
MAAM has had an increase in domestic malaria financing, through institutions such as the Ministry of Finance, Planning and Economic Development, with a budget call circular to all sectors to prioritize the malaria agenda.
On top this, MAAM has also engaged the private sector in Uganda through the establishment of Malaria Free Uganda Initiative, a private mechanism to drive the malaria agenda as well as the establishment of Rotary Malaria Partnership.
The report, however, notes that most of the challenges in the fight against malaria are to do with funding and this has delayed some projects.