The COVID-19 pandemic has led to a marked rise in malaria cases and deaths – but the worst-case scenario was averted, according to new findings by the World Health Organization.
WHO’s latest World Malaria Report says there were about 241 million malaria cases and 627,000 malaria deaths in 2020 – about 14 million more cases and 69,000 more deaths than in 2019.
It says about 47,000 – or two thirds – of these additional deaths were linked to disruptions in the provision of malaria prevention, diagnosis and treatment because of the pandemic.
However, it adds that because many countries took urgent action to boost their malaria programmes early on in the pandemic, the projected worse-case scenario of deaths potentially doubling in sub-Saharan Africa was averted.
Sub-Saharan Africa accounted for about 95% of all malaria cases and 96% of all deaths in 2020. Of these, about 80% of deaths were among children under the age of five years.
Dr Tedros Adhanom Ghebreyesus, WHO director-general, said: “Even before the COVID-19 pandemic struck, global gains against malaria had levelled off.
“Thanks to the hard work of public health agencies in malaria-affected countries, the worst projections of COVID’s impact have not come to pass. Now, we need to harness that same energy and commitment to reverse the setbacks caused by the pandemic and step up the pace of progress against this disease.”
Since 2015, 24 countries have registered increases in malaria deaths and in the 11 that record the biggest numbers, cases increased from 150 million in 2015 to 163 million cases in 2020, while deaths from the disease increased from 390,000 to 444,600 over the same period.
WHO says innovation in new tools is critical if progress is to be accelerated, with one important new prevention tool being RTS,S/AS01 (RTS,S), the first vaccine to be recommended by WHO against a human parasite.
In October 2021, WHO recommended RTS,S for children living in sub-Saharan Africa and in other regions with moderate to high P. falciparum malaria transmission.
Despite the additional difficulties with COVID-19, 72% of insecticide-treated mosquito nets had been distributed in malaria-endemic countries, as planned, by the end of 2020, while 13 countries in Africa’s Sahel sub region reached 11.8 million more children with preventive antimalarial medicines during the high-transmission rainy season in 2020 compared to 2019.
WHO certified China and El Salvador as malaria-free in 2021, and the Islamic Republic of Iran recorded three consecutive years of zero indigenous cases in 2020.
In the six countries of the Greater Mekong subregion, there were approximately 82,000 cases of malaria in 2020, down from a peak of 650,000 cases in 2012 and about 100,000 cases in 2019.
However, the WHO African Region recorded a 12% increase in malaria deaths in 2020 compared to the previous year.
Dr Matshidiso Moeti, WHO regional director for Africa, said: “While African countries rallied to the challenge and averted the worst predictions of fallout from COVID-19, the pandemic’s knock-on effect still translates to thousands of lives lost to malaria.
“African governments and their partners need to intensify their efforts so that we do not lose even more ground to this preventable disease.”
According to the report, 15 countries with a high burden of malaria reported reductions in malaria testing of more than 20% from April-June 2020 compared to the same period in 2019.
It also reports that national malaria programmes distributed about 48 million fewer courses of treatment in 2020 compared to the previous year. Out of the world’s 11 highest burden countries, only India registered progress against malaria, with the remaining 10, in Africa, reporting a rise in cases and deaths.
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