Nearly half the world’s population is at risk of falling ill with the life-threatening disease, malaria. Malaria is transmitted to humans by female Anopheles mosquitos, which infect the liver, and subsequently red blood cells, with parasites that fly under the radar of our immune systems. Malaria causes fever, headache, vomiting and chills, and if not treated promptly and adequately, it can lead to severe illness and often death.

Malaria has been eradicated in most developed countries, but it remains one of the most severe public health problems worldwide — in fact, it is a leading cause of death and disease in many developing countries.

Here are five things to know about this deadly disease — and what we can do to prevent it.

1) Malaria is most prevalent in sub-Saharan African countries

In 2017, 92 percent of reported cases of malaria were reported in Africa.

Countries in Africa carry a disproportionately high share of the global burden of malaria. The vast majority (approximately 90 percent) of malaria cases and deaths are concentrated in just 11 countries: 10 on the African continent, and India. Approximately 70 percent of malaria deaths occur in young children — and children under 5 are at particular risk. In 2017, approximately 266,000 children around the world did not see their fifth birthday because of malaria.

Malaria transmission is most common in warmer climates close to the equator where mosquitos thrive in densely populated areas. A longer lifespan allows the malaria parasite inside the mosquito to develop into a form that is dangerous to humans.

Source: World Health Organization, World Malaria Report 2018

2) Malaria is preventable and curable

Global mortality rates have decreased by 29 percent among all age groups since 2010.

Prevention

There are no vaccines to prevent malaria (although a vaccine with promising lifesaving potential for young children is currently being researched and piloted), but transmission of malaria can be reduced and even effectively prevented in other ways.

Most importantly, so-called vector-control interventions include the distribution and use of insecticide-treated mosquito nets and indoor residual spraying once or twice a year. Nets significantly reduce risk because Anopheles mosquitos predominantly feed at night. In 2017, half of the people in at risk areas slept protected by a net, compared to approximately 29 percent in 2010. Orher protection measures include the use of topical insect repellants and insecticide-treated clothing.

The World Health Organization has developed a set of 20 global guidelines to provide evidence-based recommendations for effective malaria vector control so technical experts, policy makers, and researchers can design efficient vector-control strategies.

Treatment 

If treated in a timely and adequate manner, most malaria patients make a complete recovery. Early diagnosis and prompt appropriate treatment are critical. If malaria is suspected, a parasitological test can confirm the diagnosis, and anti-malarial medicines — administered intravenously, intramuscularly, and/or orally, often in combinations of at least two types — can effectively treat the disease. Malaria parasites are growing increasingly drug-resistant, so the use of anti-malarial medicines should be limited to confirmed cases of malaria, and patients should be encouraged to adhere to treatment in full.

What malaria treatment looks like depends on a variety of factors, including the specific type of parasite and severity of the disease. Pregnant women, infants, young children, people living with HIV and people co-infected with tuberculosis are considered special risk patients that may require specialized treatment.

When someone falls ill with malaria, treatment should begin within 24 to 48 hours of the onset of the first symptoms. Unfortunately, half the world’s population does not have access to health care.

3) The risk of malaria significantly increases in times of disaster

Vector-borne diseases, including malaria, are increasingly likely to spread after disasters, whether natural or man-made. Humanitarian emergencies often drive displacement of large numbers of people. These people may move to new environments where diseases are more common, or they may become exposed to new strains of diseases their immune systems are not prepared for. Malaria outbreaks are also more likely to happen because vector control activities are complicated by disasters — people may not have access to adequate shelter, let alone mosquito nets.

The Indonesian earthquake and tsunami of September 2018

Malaria is a particular concern after meteorological disasters such as cyclones and hurricanes that cause flooding. Standing water can create optimal conditions for mosquito breeding sites, since Anopheles mosquitos lay their eggs in water. The mosquito population can increase rapidly and spread disease. Project HOPE responded to the critical medical needs in Palu, Indonesia after a massive earthquake and tsunami destroyed the lives of thousands of women, children, and men. As part of our response, we partnered with UNICEF to launch a program providing malaria preventative services to internally displaced Indonesian families in Central Sulawesi. Through March 2019, we have distributed a total of 101,502 bed nets to tsunami survivors.

4) Project HOPE is currently monitoring the risk of malaria in two humanitarian crises

An upsurge of malaria due to the Venezuelan Crisis

A potential malaria outbreak lurks in Colombia — the country that has taken in the vast majority of Venezuelans who have fled their country. Our team in Colombia has reported seeing an upsurge of malaria cases.

Learn more about our work in Colombia.

The threat of a malaria outbreak in Mozambique after Cyclone Idai

Mozambique is one of the 11 so-called high burden countries that carry approximately 90 percent of the global burden of malaria. In spring 2019, Tropical Cyclone Idai left large parts of the coastal city of Beira flooded and thousands of people displaced. Experts fear a potential major outbreak of malaria in the storm’s aftermath, as confirmed cases of the disease are rising.

Learn more about our response to Cyclone Idai in Mozambique.

5) Progress is being made but we must act now

In 2017, an estimated 435,000 people died from malaria globally — that’s 172,000 fewer deaths than in 2010.

Incidence rates of malaria were steadily declining over the past years — from 72 cases per 1,000 people at risk in 2010, to 59 cases more recently. But for the past three years, progress appears to be stalled, and in some regions malaria is even on the rise. Apart from the fact that malaria-causing mosquitos cannot be contained or easily eradicated, malaria is particularly difficult to combat because interventions depend heavily on political commitment, financial resources and public health infrastructures.

Major goals outlined in the WHO Global Technical Strategy for Malaria 2016-2030 would reduce the 2015 levels of case incidence and death rates by at least 40 percent by 2020. But currently, we are not on track to hit these milestones. In order to get back on track to hit 2025 targets, efforts must be intensified — specifically in the 11 high-burden countries. Accordingly, the WHO is calling for an urgent global response and support for a new aggressive approach through the “High burden to high impact” program, led by countries most significantly affected by the disease.

The time to focus on course correction in the fight against malaria is now.

Source: World Health Organization, World Malaria Report 2018

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