This year’s report specifically tracks progress towards the 2020 malaria milestones set out in the Global Technical Strategy for Malaria 2016-2030 (GTS). These milestones include: reducing malaria case incidence by at least 40 percent by 2020 (compared to a 2015 baseline); reducing malaria mortality rates by at least 40 percent(from 2015 baseline); eliminating malaria in at least 10 countries; and preventing a resurgence of malaria in all countries that are malaria free.
The report states that malaria-endemic countries are on track to achieve the 2020 elimination milestone (at least 10 countries between 2015 and 2020). But to meet the case incidence and mortality milestones, interventions must be accelerated. The number of cases of malaria has been falling slowly in the highest burden countries, and only forty-nine countries are on track to achieve the 40 percent mortality reduction target.
Unitaid’s current and future investments in malaria are well aligned to help reach the milestones of the Global Technical Strategy. In particular, Unitaid has been working to reduce malaria deaths, by improving treatment of severe malaria.
Each year an estimated 8 million cases of uncomplicated malaria progress to severe malaria. When left untreated, severe malaria, particularly cerebral malaria, approaches 100 percent mortality. Despite WHO recommending injectable artesunate as the treatment for severe malaria in 2010, access remained low. Beginning in 2013, through the Improving Severe Malaria Outcomes (ISMO) project, Unitaid catalysed the availability of injectable artesunate by introducing it as a better alternative to quinine for the treatment of severe malaria.
Children under 5 years of age account for 70 percent of all malaria deaths. For children less than 6 years of age, living in areas that are more than 6 hours travel time from a health facility, rectal artesunate (RAS) used for pre-referral treatment can “buy time”. Under ISMO, two RAS products were submitted to the WHO’s Prequalification Programme.
This week, after ongoing efforts from the malaria community, and supported by work carried out under ISMO, the first RAS product for severe malaria received Expert Review Panel (ERP) approval. The ERP is a mechanism that enables interim access to quality products making them available to countries to purchase with donor funding.
“ERP approval for a rectal-artesunate product is a first step in further supporting infants with severe malaria. This is good news but we also need to be aware that this is monotherapy, therefore it needs to be used responsibly, only in the event of starting pre-referral management of children severely ill with malaria at the community level,” said Alexandra Cameron of Unitaid’s malaria team.
Unitaid is developing a project to demonstrate how rectal artesunate can be used responsibly and rationally in countries that have a high malaria burden. The organization remains committed to investing in innovative ways to prevent, diagnose and treat malaria.
