Sunday , April 18 2021

the tragedy of malaria in ten lessons



Anglogold Ashanti Malaria officials spread insecticide in the village of Odumase, Ghana, on May 2, 2018.
Anglogold Ashanti Malaria workers spread insecticide in the village of Odumase, Ghana, on May 2, 2018. CRISTINA ALDEHUELA / AFP

Danger of warning! If it was necessary to summarize the World Health Organization (WHO) report on malaria in 2018, this warning would better synthesize the analysis released by the UN agency on Monday, November 19. While this scourge is regressing on a global scale, in Africa the number of cases and deaths has increased between 2016 and 2017.

For Dr. Tedros Adhanom Ghebreyesus, Director-General of WHO, "We are not on track to achieve two key intermediate objectives of the Malaria Technical Strategy for 2016-2030, which is to reduce the incidence of malaria and associated mortality by 40% from 2015 levels."

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By 2017, the disease affected 219 million people worldwide, compared with 239 million in 2010. This killed more than 435,000 people, mostly in Africa, where the ten hardest hit countries recorded 3.5 million more of malaria cases compared to 2016. In fact, the report is concerned that 200 of these 219 million cases of infection (or 92%) have been reported in Africa. The continent is the first victim and far ahead of Southeast Asia (5%) and the Eastern Mediterranean (2%).

1. Of the five countries most affected, four are from Africa

Globally, five countries share almost half of the contamination, but only one is outside of Africa. For example, Nigeria alone accounts for a quarter of the world's population, followed by the Democratic Republic of Congo (DRC) with 11%, followed by Mozambique (5%) and Uganda (4%). The only "intruder" on this list is India, ex aequo with Uganda.

2. More and more cases in the most vulnerable countries

The ten countries with the highest numbers of malaria cases in Africa recorded an increase in the number of cases in 2017 compared to 2016. Among them, Nigeria, Madagascar and the Democratic Republic of Congo have the highest increases, all estimated at more than half – millions of cases In contrast, India recorded 3 million fewer cases in the same period, 24% less than in 2016.

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3. Rwanda and Ethiopia, good students

Some good news is still emerging, especially in two countries. In 2017, fewer than 430,000 malaria cases were reported in Rwanda compared to the previous year, and Ethiopia reported a decline of more than 240,000 in the same period.

4. Malaria more fatal in Africa than elsewhere

Only Africa accounted for 93% of malaria-related global deaths in 2017. Although 88% of the 172,000 deaths have been recorded on this continent compared to 2010, the geographic area remains the hardest hit.

5. Sixteen African countries concentrate 80% of global deaths

Almost 80 percent of global malaria deaths in 2017 are concentrated in 16 African countries and India. Seven of these countries account for more than half of the deaths (53%). Nigeria is at the top of this sad list, with 19% of the dead alone. It is followed by the DRC (11%), Burkina Faso (6%), Tanzania (5%), Sierra Leone (4%) and Niger (4%). India, with its billions of inhabitants, comes to the end of this list, with also 4% of the deaths.

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6. Declining mortality in Africa compared to 2010

Taking a step back and comparing 2017 data with 2010 data, malaria-related mortality has declined in all regions of the world except the Americas. The largest decreases were observed in Southeast Asia (54%), Africa (40%) and Eastern Mediterranean (10%). However, this optimism should be weighed down by the reversal of the curve in 2015. At that time, malaria-related mortality began to slow.

7. Mozambique, land of innovation

To put malaria control back, a new approach, called "Reducing Malaria where it matters most," will be launched on November 19 in Mozambique along with the publication of the World Malaria Report. 2018. Initiated by WHO and the Roll Back Malaria partnership, this approach is based on four pillars. Will be "Galvanize the national and international political will to reduce malaria-related mortality; through the strategic use of information; implement the most effective and appropriate international strategies, policies and guidelines for countries with endemic malaria; coordinated national response. "

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8. Money, the nerve of war

Twenty-four of the 41 countries where malaria is prevalent rely heavily on external funding to control the disease. However, the average level of available funding per person at risk has decreased over the period 2015-2017 compared to 2012-2014. The decline was 95% in Congo-Brazzaville and 1% in Uganda.

9. The WHO message

In view of these disturbing data, Dr. Tedros Adhanom Ghebreyesus presents a clear message. He believes that "The actions undertaken over the next two years will be decisive in relation to the achievement (or not) of the intermediate objectives set for 2025 by the WHO global technical strategy for malaria control." In his eyes, "These actions will also determine our collective contribution to achieving the Sustainable Development Goals."

10. The arsenal of fighting is global

Overcoming malaria requires a comprehensive strategy that includes vector control measures, expanded population diagnosis, and rapid treatment, especially at the village level. By 2018, a significant portion of the population at risk is not protected, including pregnant women and children in Africa. The road is still long.

Maryline Baumard

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