13.10 Malaria

Document A64/19 is a report by the Secretariat on the prevention and control of malaria.  

See also Resolution EB128.R13 was adopted by the EB in Jan 201

Document EB128/2011/REC/1 (?posted). See provisional record of EB128 discussions. 

Note from WHA64 Watch, May 2011

WHA Agenda item 13.10 Malaria

This report (A64/19) reviews the prevention and control of malaria with regard to sustaining the gains made so far, as well as reducing transmission. The report also charts a course for sustaining and expanding these gains from 2011–2015 while taking into account potential threats to success and new opportunities for action. The document includes a resolution (EB128.R13) for consideration.

Whilst the resolution calls for the use of the expansion of interventions for malaria prevention and control as an entry point for strengthening health systems, it does not include actions around rational use of medicines and strengthening national drug regulatory services. Especially as the report indicates that only 34% of malaria-endemic countries are complying with WHO recommendations to routinely monitor the efficacy of first- and second-line anti-malarial medicines.

Whilst the report mentions the low usage of LLITNs in many malarious countries, it does not acknowledge that people still have to pay a part of the cost of bed nets and this reduces their utilization. Recent studies have found no evidence that cost-sharing reduces wastage. Studies show that women who received free ITNs are not less likely to use them than those who pay part of the cost. There is no evidence that cost-sharing helps in selection of women who need the net more. On the contrary, cost-sharing dampens the use of bed-nets.

Whilst there’s progress is some areas, there is the need to emphasise on improved surveillance and better estimates of malaria deaths. For instance, a recent Lancet study (Dhingra, Jha et al. 2010), show there are 13 times more malaria deaths in India than the World Health Organisation (WHO) estimates. The authors conclude that malaria kills more than 200,000 deaths each year in India.

Global efforts and recommendations against Malaria should develop a more holistic approach  by promoting better living conditions, sanitation, housing conditions, nutrition, access to healthcare and medication among others.

Whilst there’s increase spending on malaria over the past decade, there is need for sustainable commitment to reduce cost of ACTs and improve access. Also, whilst the Affordable Medicine Facility – malaria (AMFm ) may be contributing to increasing access in selected countries, it doesn’t address technology transfer and building of long-term access to drugs.