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WOrld Malaria Report 2017

By Pierre Bush, PhD Moderator | 08 Dec, 2017

Dear Colleagues,
Attached is the 2017 World Malaria Report that was recently released by the WHO. The most striking point is that malaria cases went up in 2016 (216 million) compared to the previous year (211 million), up 5 million. The malaria control programs in several countries have stalled! The WHO African region accounted for 90 % of the all cases. Fifteen countries accounted for 80% of malaria burden. Fourteen of them are in the Sub-Saharan Africa. Let us go back and see what is not working!

Highest Regards

Global disease burden and trends

In 2016, 91 countries reported a total of 216 million cases of malaria, an increase of 5 million cases
over the previous year. The global tally of malaria deaths reached 445 000 deaths, about the same
number reported in 2015.
Although malaria case incidence has fallen globally since 2010, the rate of decline has stalled and
even reversed in some regions since 2014. Mortality rates have followed a similar pattern.
The WHO African Region continues to account for about 90% of malaria cases and deaths
worldwide. Fifteen countries – all but one in sub-Saharan Africa – carry 80% of the global malaria
burden. Clearly, if we are to get the global malaria response back on track, supporting the most
heavily affected countries in this region must be our primary focus.

Attached resource:

Replies

 

Frederick Dun-Dery Replied at 6:58 PM, 9 Dec 2017

Thank you very Dr. Bush, for this useful resource. I have just began working a related issue and I am sure this information will be of great help to me

Emmanuel Bwana Replied at 4:45 AM, 10 Dec 2017

Thanks, very useful report. I am also looking at it

Manuel Lluberas Replied at 7:31 AM, 11 Dec 2017

The report is troubling a very telling at the same time. The reasons for the rise in malaria cases are many and complicated, but they prove at least three points. First, that it is very difficult to control a vector-borne disease without properly addressing the vector. Second, that control with a one-size-fits-all approach is not the right one. Third, that relying on one method alone (LLINs for the most part; IRS is deployed in limited scope) is also not the right approach. To be effective, vector control needs to be deployed as an integrated system that attacks the vector from many flanks. Unfortunately, though LSM proved effective in the 1900s, it is considered effective "only when sources are few, fixed and findable". Those who eradicated malaria from over 100 countries prior to the mid 1900s (Soper, Kligler, Gorgas, etc.) would probably not approve of today's approach. For those who continue to say that their approach is not valid or effective today, please remember that they were told several times they would fail, yet pressed on with the technology and materials they had available; which did not include even a slide rule. Today, we can pick up and categorize mosquito sources from a satellite and a smart phone has more computing capacity than John Glenn had in the Gemini Capsule. The World took on malaria vector control about a dozen years ago and have spent around a billion US Dollars annually implementing the same approach each year with minimal changes yet expecting better results each year. This fits into Albert Einstein's definition of insanity: "doing the same thing over and over again expecting different results each time".

Joel Breman Moderator Emeritus Replied at 10:57 AM, 11 Dec 2017

Surveillance is the key to control and eradication. As reporting improves the numbers are expected to increase. Have ascertainment methods changed? More information is needed on the origin of these numbers before the global strategy is indicted.

Joel Breman

Sunday Chinenye Replied at 2:48 PM, 11 Dec 2017

Dear Pierre,
This is an interesting Report especially for those of us working in
sub-saharan Africa . Thank you .

Maimunat Alex-Adeomi Moderator Replied at 2:49 PM, 11 Dec 2017

Thank you for this report Pierre and everyone’s feedback so far.

Like it was mentioned while it is general not a good picture, better reporting might actually account for the “increased” number of cases.

On the flip side, the general state of instability both political and economic in a host of countries could also account for “failed interventions” and measures

Pierre Bush, PhD Moderator Replied at 7:22 PM, 11 Dec 2017

Hello Maimunat,
I speak to people in Rwanda, Zambia, Uganda and Tanzania. Malaria is back. They are crying, especially in rural Rwanda. I think Lluberas stated it rightly: attack the vector. That's how we will get rid of malaria. But apparently those who are manufacturing LLINS want to keep on making billions of dollars out of the poor people of Africa. LLINS alone will not eliminate malaria. In many communities they don't even know IRS (In house Residual Spraying). No money! No one to provide it!

Jean Paul Mukundiyukuri Replied at 3:49 AM, 12 Dec 2017

Thank you very much Dr Bush for sharing this useful report. When reading the report and finding that despite of a lot of efforts and interventions being made in fight against Malaria, it keeps being a health threat. Regarding the inefficacy/failures of ACTs and other treatments in some cases, I am wondering whether it is only because of vector resistance. I am suggesting that more studies can be carried out on the quality of those medicines currently marketed. Do they have required strength for therapeutic effects? Aren't they underdosed? Are they the right product? I think the counterfeiters may benefit from possible gaps in adequate quality control systems!

Dinesh Koirala Replied at 11:00 AM, 13 Dec 2017

This is a dreadful..we must work together against this situation.

Gonzo Manyasi Replied at 5:01 AM, 14 Dec 2017

I concur with Lluberas, Maimunat and Bush in your observations, particularly on the vector approach, improved reporting and the commercial interests over the affected communities' interests respectively. What I find most troubling is the WHO DG's observation about the reduced/inadequate funding of the programmes (political will) vis-a-vis the commercial interests of some manufacturers making billions out of the already impoverished African countries as pointed out by Dr Bush (Economic interests). However, having said that and to tangentially touch on Maimunat's point on economic and political instability in some of the countries, there is the perennial 'wastage' or pilferage of the already inadequate funds, mostly through corruption which mostly occurs during procurement. which equally needs eradication like the malaria scourge!

dr.hanifa mbithe Replied at 11:04 PM, 14 Dec 2017

This report is very alarming,and I ask myself how are we going to stop this disease,I just my patient with severe malaria yesterday and it's so sad,what can we to do to combat this disease and many infectious diseases affecting our communities,we need to build up our research capacities and try and help our ppl

Micheal Mazzi Replied at 3:01 AM, 15 Dec 2017

Thank you all for the comments. Where as better reporting May be a reason for the increase, we need to look at the worst scenarios so that we take care of them. If the better reporting is showing that trend, we therefore need to double our efforts in the prevention and control. May be because of the previous under reporting we got complacent yet the malaria was continuing to bite. I also think we need to examine the use of Community health health workers especially for early diagnosis and treatment through ICCM. Research has shown that if well trained and equipped, they can reduce malaria specific mortality by 60 % . Which of those countries With the highest contribution to the numbers of malaria cases and deaths have a functional CHW program?  Just a personal opinion

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Ramesh Rana Replied at 2:35 PM, 16 Dec 2017

Thank you very much

dr.hanifa mbithe Replied at 5:30 AM, 5 Feb 2018

This is Avery good report but scary,we need to research what is happening have we relaxed our campaign against malaria

Johnbull Sonny Ogboi Replied at 6:12 AM, 5 Feb 2018

Dr Hanifa
Thanks once again for the concern which I have always raised even though it is not in this forum. In 2016, 91 countries reported a total of 216 million cases of malaria, an increase of 5 million cases over the previous year. What went wrong? Did we abandon what we were supposed to do? How the it happen that instead of progressing upward, we are progressing downward? This is the time we are to get back on track again if we need to get meaningful results because the ''cost of prevention outweighs the cost of ignoring prevention'' especially with the African Region accounting for about 90% of malaria cases and deaths worldwide.
Clearly, supporting the most heavily affected countries in this region must be our primary focus, but we need to come out with new strategies since old strategies can never give a new result.
We might even be surprised that if critical data are collected very well in hard-to- reach rural areas of African countries, the cases of malaria will increase.
We need to design a new approach of research and train new set of mid level and senior professionals to get us back on track.

Kwan Ching CHAN Replied at 8:59 PM, 5 Feb 2018

Dear Johnbull Sonny Ogboi and all, nice to meet you here! Though we don't have much malaria cases in Hong Kong, the information provided here is also important as we need to take preventive measures. Thanks so much!

genoveva bata Replied at 3:59 AM, 6 Feb 2018

Nice to meet You All,through we have much Malaria case in Mozambique, that
we are in the sub -saharan África, and we Take preventive measures. we are
in proverty country. How Take preventive measures come truth to comunity
People?


Em 06/02/2018 2:04 AM, "Kwan Ching CHAN via GHDonline" <
> escreveu:

Nock Shagata Replied at 10:32 AM, 9 Feb 2018

This report make up for the malaria programs which are in Sub Saharan Africa to be reviewed and see what is missing . Thanks for sharing

dr.hanifa mbithe Replied at 5:28 AM, 13 Feb 2018

Thank you for sharing,my study is on malaria and this will be helpful

Manuel Lluberas Replied at 6:29 AM, 14 Feb 2018

Thanks for your comments and support. The funny thing about the 2017 World Malaria Report is that it does not mention integrated vector management as a valid tool or even as a "supplementary" component of global malaria control programs. Moreover, the WHO continues to place LSM (larval source management) as a supplementary tool useful only when mosquito sources are "few, fixed and findable". As we all know, malaria was eliminated from over 100 countries before 1980 with LSM. Unfortunetely, WHO continues to insist that there is no evidence that LSM works even though many of us know that it was engineers and entomologists, not physicians, who eradicated malaria from the vast majority of these >100 countries.

Part of the discussion during the 13th Vector Control Working Group meeting in Geneva last week was to eliminate the "FFF" from WHO documents on LSM and vector control and modify vector control approaches from strictly malaria to mosquito control, but this seems to be a steep hill to climb. WHO "advisors" continue to attempt randomized control trials and Cochrane Reviews on the subject searching for evidence that LSM works. Fred Soper, Israel Kligler and the others who liberated about a billion people from malaria before 1980 would be incensed. Moreover, this is especially troubling in light of Dr. Margaret Chang's (former Director General of WHO) comment during the 2016 WHA when she pointed out that the global Zika situation was the result of "experts" dropping the ball on vector control. Meanwhile, vector control is not mentioned in the Global Malaria Business Plan and IVM was left out of the 2017 World Malaria Report.

Ronald Ross has been quoted as saying something like "Malaria will continue to affect millions until the vector is not taken seriously."

Margaret Chirgwin Replied at 9:47 AM, 14 Feb 2018

Well said. I have been soooo frustrated by the negativity towards vector control. We need to actively campaign for it. Does someone have the ear of Bill gates?

Margaret chirgwin


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Manuel Lluberas replied to a (http://email.ghdonline.org/c/eJxlT8tqxDAM_Jr4VuNHHHsPPhTK_kbwxkpi8AvHadi_rwLt...) discussion in (http://email.ghdonline.org/c/eJxlUEGOwyAMfE24JcKGBHrgUGnVb1RsoI0lAgjoRv39Eql7...) Malaria Treatment & Prevention: (http://email.ghdonline.org/c/eJxlT8tuxCAM_JpwRMEOEA4cKlX7GxFdIEHiJcI22r8vkdpT...)


Thanks for your comments and support. The funny thing about the 2017 World Malaria Report is that it does not mention integrated vector management as a valid tool or even as a "supplementary" component of global malaria control programs. Moreover, the WHO continues to place LSM (larval source management) as a supplementary tool useful only when mosquito sources are "few, fixed and findable". As we all know, malaria was eliminated from over 100 countries before 1980 with LSM. Unfortunetely, WHO continues to insist that there is no evidence that LSM works even though many of us know that it was engineers and entomologists, not physicians, who eradicated malaria from the vast majority of these >100 countries.
Part of the discussion during the 13th Vector Control Working Group meeting in Geneva last week was to eliminate the "FFF" from WHO documents on LSM and vector control and modify vector control approaches from strictly malaria to mosquito control, but this seems to be a steep hill to climb. WHO "advisors" continue to attempt randomized control trials and Cochrane Reviews on the subject searching for evidence that LSM works. Fred Soper, Israel Kligler and the others who liberated about a billion people from malaria before 1980 would be incensed. Moreover, this is especially troubling in light of Dr. Margaret Chang's (former Director General of WHO) comment during the 2016 WHA when she pointed out that the global Zika situation was the result of "experts" dropping the ball on vector control. Meanwhile, vector control is not mentioned in the Global Malaria Business Plan and IVM was left out of the 2017 World Malaria Report.
Ronald Ross has been quoted as saying something like "Malaria will continue to affect millions until the vector is not taken seriously."

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Manuel Lluberas Replied at 12:39 PM, 14 Feb 2018

Margaret, as far as I can tell, the B&MGF has not engaged itself in active vector control. With all the supporting evidence that mosquito control works and after hearing Dr. Chan's comments during the 2016 World Health I am not sure why that is, but it is very frustrating that they have not ventured into this field. It may have something to do with an aversion to the use of insecticides, but I believe that it might be because the WHO does not suscribe to active mosquito population suppression methods beyond the use of nets and some IRS. This is especially troubling in light that the 2017 World Malaria Report, which points to an increase in malaria rates.

Many are agianst the use of insecticides and fail to see them and use them as what they are: drugs for the environment. No one would consider telling a radiologist or a dentist to stop using radioactive materials in X-Ray machines, but the use of insecticides is frowned upon my many.

Margaret Chirgwin Replied at 1:12 PM, 14 Feb 2018

However bednets and IRS use insecticides!


Sent from my BlackBerry 10 smartphone on the O2 network.


Manuel Lluberas replied to a (http://email.ghdonline.org/c/eJxlT8tqxDAM_Br71mBZSewcfFgo-xvBTZSNwS8cp2H_vg60...) discussion in (http://email.ghdonline.org/c/eJxlUEGOwyAMfE24JcI4CemBw0qrfqNCgTSWCCCgG_X360jd...) Malaria Treatment & Prevention: (http://email.ghdonline.org/c/eJxlT8tuhDAM_BpyjEgMhD3kUGm1v4EiYiBSXgreov37Gqk9...)


Margaret, as far as I can tell, the B&MGF has not engaged itself in active vector control. With all the supporting evidence that mosquito control works and after hearing Dr. Chan's comments during the 2016 World Health I am not sure why that is, but it is very frustrating that they have not ventured into this field. It may have something to do with an aversion to the use of insecticides, but I believe that it might be because the WHO does not suscribe to active mosquito population suppression methods beyond the use of nets and some IRS. This is especially troubling in light that the 2017 World Malaria Report, which points to an increase in malaria rates.
Many are agianst the use of insecticides and fail to see them and use them as what they are: drugs for the environment. No one would consider telling a radiologist or a dentist to stop using radioactive materials in X-Ray machines, but the use of insecticides is frowned upon my many.

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Manuel Lluberas Replied at 4:16 PM, 14 Feb 2018

Insecticides are indeed used in these measures, but there is a LOT more to mosquito control than IRS and LLINs. There are insecto growth regulators, bacteria, hormones, fungi and even radiation in mosquito control. The number of insecticides currently used in vector control is very limited and has resulted in many vectors changing their biting and foraging behavior and some have even developed resistance to them. These two factors make it imperative the implementation of a new approach with additional tools.

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