Malaria Factsheet

PDF Version of Factsheet (184 kb) | Frequently asked questions on malaria

Millennium Development Goal 6: To combat HIV/AIDS, malaria and other diseases

• Target 8: By 2015 to have halted and begun to reverse the incidence of malaria and other major diseases.

Key messages

• Malaria kills between 1.1 and 2.7 million people worldwide each year.
• The historic Abuja Declaration commits governments to an intensive effort to halve the burden of malaria in Africa by 2010.
• Malaria is a disease of poverty. Poor people are at increased risk of becoming infected with malaria, and malaria is a major contributing cause of poverty in endemic areas – it makes poor people poorer. The MDGs link achievement of health outcomes - with malaria control as an indicator for progress - to the elimination of poverty. Control programmes should prioritise the poor, and monitor whether they are utilising services.

Facts and figures

• About 100 countries in the world have malaria, almost half of which are in sub-Saharan Africa. More than 2.4 billion people are at risk.
• There are an estimated 200 to 500 million malaria cases each year, with about 90 per cent of these occurring in sub-Saharan Africa.
• Malaria was the fifth most common cause of death due to communicable diseases in 1999 after respiratory infections, HIV and AIDS, diarrhoea and tuberculosis. It kills between 1.1 and 2.7 million people each year, of whom about 1 million are children under 5 years in sub-Saharan Africa.
• Every 30 seconds a child dies of malaria. In Africa, it is the leading cause of death for children under five years, causing at least 20 per cent of all deaths. Children recovering from malaria infections may be left with significant mental and physical disability.
• In Africa, at least 24 million pregnancies are threatened by malaria each year. Pregnant women are more susceptible to malaria infection than non-pregnant women. Malaria causes low birth weight - mortality in these infants is four times higher than in normal birth weight infants.
• Malaria causes an immense burden on health systems, being responsible for about 30 per cent of all outpatient visits and 20 to 50 per cent of all hospital admissions in countries with malaria in Africa.
• Economic losses due to malaria in Africa are estimated to be about US$12 billion per year. It’s estimated that malaria is responsible for reductions in gross domestic product from 0.6 per cent to 6 per cent in African countries.
• The needs for malaria control have been estimated to be about US$3 billion.
• Deaths following acute fever (mostly malaria) were 39 per cent higher among the poorest socio-economic group than the richest in an area of Tanzania.
• The cost of malaria care is 1 per cent of the income of the rich in northern Ghana but 34 per cent of the poor households’ income.
• In Cameroon, malaria was found to account for 31 per cent of annual family illness expenditures and costs.
• A high proportion of the malaria deaths in Africa occur in populations affected by conflict. Over 30 million people in Africa are displaced each year.

Are we on track to meet the MDG?

The MDG indicators are the prevalence and death rates associated with malaria, and the proportion of the population in malaria risk areas using effective malaria prevention and treatment measures.

The potential to better track improvements in malaria-related illness and death through improving health measurement systems has been given recent attention, for example by the Health Metrics Network (a collaborative network to build better health information systems, made up of UN, bilateral, public, private and institutional partners).

Considerable progress has been made on the second indicator since Abuja. There has been a policy shift to combination therapies containing artemisinin (ACT) (a new herb-based drug) as first line treatment of malaria, where there is significant resistance to current drugs. 30 countries have now adopted ACT (16 in sub-Saharan Africa) as first line treatment. This is seen as the most significant shift in malaria control for past 50 years.

And almost 20 African countries have reduced or eliminated taxes and tariffs on insecticide-treated nets (ITNs) to make them more affordable. While overall use of ITNs remains relatively low, a number of low-income countries affected by malaria, such as Tanzania and Malawi, have demonstrated progress towards the target.

Challenges / obstacles

• Malaria is spreading faster than control efforts and urgent action is required to mobilize enough resources, public awareness and political commitment to halt it.
• The broad approach adopted by current malaria control efforts does not automatically result in benefits for the poor people most at risk of contracting it.
• One of the greatest challenges facing Africa in the fight against malaria is drug resistance. Because of this, many countries are having to change their treatment policies and use drugs which are more expensive, largely artemisinin-based drugs.
• It costs a lot of money to put interventions in place to protect children from malaria. For example, it would cost US$22.5 million – or the equivalent of 24 per cent of the existing health care budget – to provide all under-fives in a country of 20-30 million people with insecticide treated nets. Very low-income countries simply can’t afford to do this. There is scope for increased private sector involvement, but the most vulnerable and impoverished groups in Africa can only be reached if substantial additional resources from governments and external donors are found.

Progress - what DFID is doing to help

Supporting global partnerships

• The UK Government pledged £60 million in support of malaria activities at the 1998 G8 Summit in Birmingham.
• DFID is a board member of the Roll Back Malaria (RBM) Partnership. Launched in 1998, the 90 or so partners have a goal of halving the burden of malaria by 2010. DFID has provided £48 million to RBM.
• DFID has been a key donor to the Global Fund to Fight AIDS, TB and Malaria, which was created in 2002, pledging US$280 million in May 2004, and a further pledge in July 2004 of £154 million over the next three years, effectively doubling the existing pledge for 2005-2007. The Global Fund has already approved grants totalling US$2.1 billion for direct support to programmes in developing countries. Early results include the distribution of artemisinin-based therapy for drug-resistant malaria in 28 Zambian clinics.
• The UK has also been a strong supporter of the Global Fund through advocacy at the highest political level. This will be of particular importance in 2005 when the UK will assume the presidency of the G8.

Regional support

DFID is providing support and investment to the Integrated Management of Childhood Illness programme being run by the WHO’s African Regional Office and to the East Africa Network for Monitoring Anti-Malarial Treatment.

Strengthening health systems

DFID places a high priority on ensuring that the drugs, commodities and services that are needed to treat malaria are accessible through well functioning health systems. Since 1997, DFID has committed over £1.5 billion to strengthening health systems at country level so that better care and drugs can be delivered.

Providing cheaper drugs

DFID is working with others, including G8 colleagues, to secure greater international commitment to affordable pricing for medicine, particularly those drugs that are needed to treat drug-resistant strains of malaria.

Development of new research evidence

• DFID funds specific malaria knowledge programmes to increase the evidence base. It provides malaria expertise to countries through its health resource centre.
• We give significant research contributions to the Medical Research Council and WHO.
• DFID supports public-private partnerships to develop the new generation of affordable drugs and rapid diagnostic tests required for malaria control.

  From 2003/04-2005/06 we will contribute £1 million annually in support of the Medicines for Malaria Venture (MMV).

  We are working in partnership with GlaxoSmithKline, the WHO and the University of Liverpool to develop an effective, safe and affordable drug (Lapdap) for treating drug resistant malaria. We will provide £213,000 in 2003/04 and £286,000 in 2004/05.

  • DFID maintains an active interest in vaccine research. Malaria vaccines are currently in the early stages of development, with the first vaccines potentially available from 2011.

Case studies

Insecticide-treated mosquito nets (ITNs)

One of the most cost effective ways of preventing malaria is through the use of ITNs, which are known to reduce malaria disease burden and death in households. They are cheap, safe, easy to use and if used properly can last a long time. ITNs have the potential to decrease the infant mortality rate by 20 per cent.

The Abuja target for expanding ITN use in Africa is ambitious – at least 60 per cent coverage of high-risk groups by the year 2005. DFID provides extensive funding to social marketing groups to extend ITN coverage.

In Malawi, 100,000 nets are being sold monthly at US$0.50 each. As a result, coverage of malaria risk groups has rapidly increased between 2000 and 2004, with 43 per cent of households now owing at least one mosquito net, about two thirds of which are treated.

In Nigeria, a Futures Group Europe (FGE)/DFID project is creating ITN awareness and building business confidence in eight target states. It is estimated that as many as 70 per cent of adults in the target states recognise the role and importance of insecticide treatment of nets. FGE has generated strong interest, investment and commitment from the business sector in Nigeria to develop branded ITN products and establish distribution networks. It is envisaged that the next stage for this private sector approach will be a massive national programme that includes creative approaches such as vouchers to lower the cost of ITNs for pregnant women, young children and poor families.