WHO advisory body(SAGme) releases malaria eradication report
After a 3-year study of trends and future projections, the WHO Strategic Advisory Group on Malaria Eradication (SAGme) has released a detailed report of its findings and recommendations. The report builds and expands on an executive summary published in August 2019.
Established in 2016 at the request of the former WHO Director-General, Dr Margaret Chan, SAGme was tasked with analysing future scenarios for malaria, including the feasibility of eradication. Its members commissioned analyses and consulted widely with malaria and global health experts throughout their tenure.
In the new report, SAGme reaffirms the WHO vision of a world free of malaria – a goal enshrined in World Health Assembly resolutions dating back to 1955. There is a consensus that eradicating malaria would result in millions of lives saved and generate a substantial return on investment.
“Ridding the world of a parasite that overwhelmingly affects the poor and vulnerable would be a remarkable step towards global health equity and improved economic conditions in the poorest parts of the world,” says the 13-member group of eminent public health leaders. “The SAGme unequivocally supports this goal.”
However, members of the advisory body recognize that the goal of eradication is still far from reach. “Even with our most optimistic scenarios and projections, we face an unavoidable fact: using current tools, we will still have 11 million cases of malaria in Africa in 2050,” they conclude.
SAGme considered a broad set of factors that underpin malaria: biological, technical, financial, socio-economic, political, and environmental. Its members reviewed trends in poverty and population growth, mobility, agricultural development, climate change, and urbanization.
The group also analyzed likely threats to malaria eradication, including health emergencies, and concluded that while epidemics may cause short-term setbacks, malaria eradication could still be achieved. They examined the impact of global governance mechanisms, health system readiness, community engagement, and other disease eradication efforts.
After reviewing the findings of numerous analyses and debating the conclusions, SAGme identified 6 areas that would shore up a successful malaria eradication effort.
- Reinforcing the global strategy: While the Global technical strategy for malaria 2016–2030 provides a comprehensive and flexible framework to guide countries in their efforts to control and eliminate malaria, it will require some refinement and updating to lay a strong foundation for the eventual launch of a time-limited eradication campaign.
- Research & development for new tools: Although existing tools have achieved remarkable impact, the world currently lacks the transformative tools needed to achieve malaria elimination in the highest burden areas. One of the highest priorities for achieving a world free of malaria is a renewed research and development agenda that improves the knowledge base and products necessary for achieving eradication.
- Access to affordable, high quality, people-centered health care and services: To eliminate malaria and contribute towards global eradication, a country requires strong political commitment and investment in universal health care, with a well-functioning primary health care system at its base. Health system quality is strongly correlated with malaria progress across the spectrum of malaria endemicity.
- Adequate and sustained financing: Since 2010, global funding for malaria control and elimination has remained relatively stagnant at around US$ 3 billion per year, despite an estimated need of US$ 6.4 billion per year to meet the 2020 targets of the global strategy. Financing must be adequate and sustained to support countries to reduce the burden of malaria and achieve elimination.
- Strengthened surveillance and response: Surveillance and response systems must be nimble, reliable, rapid and accurate to react to changing social and physical environments and provide data to drive better decision-making.
- Engaging communities: Communities play an essential role in the push towards a malaria-free world. Affected communities must be effectively engaged in co-planning, co-implementing and co-evaluating malaria programme services and interventions.
Laying a foundation
SAGme members recognize that the world is currently off track to meet critical 2025 targets of the global malaria strategy – reductions of at least 75% in malaria morbidity and mortality compared to 2015 levels. They note that achieving the targets of the global strategy must be the first step in a “pragmatic, strategic and humanitarian approach” toward the longer-term goal of eradication.
National ownership of malaria elimination efforts, they say, is essential. “Countries must move under their own direction while being supported and encouraged by WHO and partners to progress as quickly as possible towards elimination and, eventually, eradication.”
The full report of the SAGme can be found at: https://www.who.int/
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