According to new data released by the World Health Organization (WHO), the global malaria case and death count in 2021 remained consistent with previous years. However, given the setbacks to malaria treatment and prevention services during the Covid-19 pandemic and challenges to the efficacy of current control methods, it’s possible that morbidity associated with malaria will continue to rise.

Malaria is mosquito-bourne disease caused by infection with the Plasmodium parasite. The disease causes acute febrile illness, with high mortality rates disproportionately affecting young children in the Africa region. The WHO’s World malaria report 2022, which was published in December 2022, estimated there to be 619,000 global malaria deaths in 2021, showing marginal improvement over the 625,000 deaths observed in 2020. Pre-pandemic mortality figures were substantially lower, with 568,000 deaths recorded in 2019. Similarly, the report found that malaria cases continued to increase in 2020–21, but at a slower rate than in the 2019–20 period.

Over the course of the pandemic, many malaria-endemic countries experienced disruptions to essential treatment and prevention services. Insecticide-treated bed nets (ITNs), which provide a personal protective barrier against infected mosquitoes, are routinely distributed each year. In 2020, 74% of the 272 million ITN annual global distribution target was achieved. Similarly, 75% of the global distribution target was attained in 2021. Moreover, in terms of testing capacity, 10.5 million and 38 million fewer tests were performed in the WHO Africa Region and WHO South-East Asia Region, respectively, in 2020 compared to 2019. Overall, the report found that disruptions to diagnostics and treatment caused by the pandemic had eased significantly by late 2021.

GlobalData epidemiologists forecast that in the six major markets, the Democratic Republic of the Congo, Ghana, Kenya, Nigeria, India, and Indonesia, there were an estimated 107,000,000 new malaria infections and over 190,000 deaths caused by malaria in 2021. With malaria expected to cause approximately 110,000,000 incident cases and 200,000 deaths in 2023, GlobalData epidemiologists expect this trend of increasing morbidity to continue climbing over the coming years.

Several major challenges are hindering malaria control efforts. In some species, the biting behaviour of mosquitoes is changing such that people are bitten in the daytime, reducing the exposure of the mosquito to insecticides which are primarily applied indoors. Furthermore, insecticide resistance poses a threat to vector control methods, reducing the efficacy of methods, including ITNs. There is also the problem of growing parasite resistance to artemisinin-based combination therapies (ACTs), reducing the success of current treatment methods. Despite these setbacks, investment in research and development has played a critical role in the success against malaria in recent years. A concerted effort has been made to develop viable non-ACT treatment options and to find new ways to use existing drugs more effectively. Last year, the WHO recommended the RTS,S/AS01 malaria vaccine for the prevention of Plasmodium falciparum malaria in children living in regions of moderate to high transmission, and there are more candidate vaccines in the development pipeline.

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