25th April 2017 is World Malaria Day

Each year the World Health Organisation (WHO) highlights World Malaria Day as a way of getting a key message out about malaria. This year the key message focuses on ‘Closing the Gap’ –

Malaria Prevention Works – let’s close the gap.

Recent successes in the fight against malaria have shown that malaria prevention works. This year WHO show that there is much to celebrate including:

• Many countries have reduced disease burden significantly
• Globally the rate of new malaria cases fell by 21% between 2010 and 2015
• During that same period malaria deaths fell by 29%
• In sun-Saharan Africa - where malaria burden is heavily concentrated - access to testing for children and prevention for pregnant women has increased.

However, these successes must be taken in context:

• In 2015 there were 212 million new cases of malaria and 429 000 deaths (mostly in African children)
• One child dies every 2 minutes from malaria.
• Many people in endemic countries do not have access to tools for the prevention, diagnosis and treatment of malaria.

The WHO Global Malaria Programme Global Strategy milestones for 2020 include:

• Reducing incidence by at least 40%
• Reducing mortality by at least 40%
• Eliminating malaria in at least 10 countries
• Preventing re-establishing malaria in all countries that are malaria free.

In 2017, the WHO Global Malaria Programme campaign on ‘Closing the Gap’ focuses on two core areas:

1. Focus on vector controls through:

a) Insecticide treated mosquito nets (ITNs) – use of ITNs is the mainstay of prevention in sub-Sharan Africa, yet in 2015 an estimated 47% of the population were not sleeping under nets

b) Indoor residual spraying of insecticides (IRS) - to confer significant community protection at least 80% of homes need to be treated with IRS.

Insecticide resistance is a key threat in vector controls and supplementary vector control management methods such as larval source management and personal protection measures continue to be important.

2. Prevention for vulnerable groups (pregnant women, infants and children under 5 years) – this focus being in sub-Saharan Africa:

a) Intermittent prevention treatment in pregnancy (IPTp) – prevents maternal and infant anaemia and other adverse effects of malaria in pregnancy

b) Intermittent preventive treatment in infancy (IPTi) – administration of a full course of antimalarial medicine three times a year during the fist year of life when infants are most at risk of P.falciparum malaria

c) Seasonal chemoprophylaxis for children under 5 years of age (SMC) – a targeted intervention for children living in the Sahel region of Africa where malaria occurs mostly during the rainy season. The use of effective prevention treatment for 3 to 4 months has been shown to reduce malaria by about 75% in this way.

Critical to the success of these interventions are:

Community engagement

Good public health planning

Behavioural change.

See the full WHO report at: http://www.who.int/malaria/en/