Drug resistance threatens malaria control: WHO

Drug resistance threatens malaria control:  WHO

New Delhi, 23 April 2012:  Drug resistance, financial constraints and inadequate public awareness threaten to reverse the gains achieved in malaria control in the past decade.  On World Malaria Day, 25 April 2012, WHO is urging health and other sectors of society to invest more in malaria control to ensure that recent achievements in controlling this disease are sustained. With an estimated 28 million cases and 38 000 deaths in 2010, malaria remains a significant public health problem in WHO’s South-East Asia Region where around 1.32 billion people are at risk.

“Malaria is also a socioeconomic and developmental issue,” said Dr Samlee Plianbangchang, WHO Regional Director, for South-East Asia. “The high burden of malaria is associated with economic and development activities like mining, forestry, plantation, farming, constructions of roads and dams. This is why, malaria control should be the collective responsibility of various sectors,” he added.

In WHO’s South-East Asia Region, the estimated malaria incidence per 1000 population at risk was reduced by 27% from 30 in 2000 to 22 in 2010. Since 2000, the number of reported confirmed cases of malaria was reduced by more than 50% in five countries of the Region; Bhutan, DPR Korea, Sri Lanka, Nepal and Thailand.  In India, the reduction is 21%.  Even though the burden is still high, significant progress was also noted in Bangladesh, India, Myanmar and Timor-Leste.  Bhutan, DPR Korea, Indonesia, Nepal, Sri Lanka and Thailand aim for elimination of malaria as a long-term goal.  Maldives has been malaria-free since 1984.

                                                                                                                       

The estimated malaria mortality rate per 100 000 population at risk was reduced by 29% from 4.2 in 2000 to 3.0 in 2010 in the Region.  Bangladesh, Bhutan, Myanmar, Sri Lanka and Thailand have shown more than 65% reduction in malaria-related deaths. This is attributed to better access to early diagnostic testing and effective treatment with artemisinin-based combination therapy (ACT). 

The cumulative availability of effective long-lasting insecticidal nets for malaria prevention in the Region increased from 4.3 million in 2005 to 17.05 million in 2010. Better targeting ensured at least 80% coverage in moderate and high risk villages. Treatment courses of ACT increased from 79 000 in 2005 to 3.9 million in 2010. The use of rapid diagnostic tests for malaria increased from 1.4 million in 2005 to 15.2 million in 2010. However, more investment is needed to achieve universal coverage for malaria prevention and treatment.

Artemisinin resistance has emerged at the Thai-Cambodia border, Thai-Myanmar border and probably in Viet Nam and the Myanmar-China border, and could seriously affect malaria control efforts.  Containment of artemisinin resistance is ongoing in Thailand and in Cambodia since 2009 and in Viet Nam and Myanmar since 2011. This is being done with support of international development partners and technical leadership by WHO which has been advocating a multi-sectoral approach in addressing artemisinin resistance.