World malaria report 2021

World malaria report 2021

Each year, WHO’s World malaria report offers in-depth information on the latest trends in malaria control and elimination at global, regional and country levels. The report highlights progress towards global targets and describes opportunities and challenges for curbing and eliminating the disease. This year’s report includes a special analysis on the impact of disruptions to malaria prevention, diagnosis, and treatment during the COVID-19 pandemic.

The World malaria report 2020 provided a detailed review of the key events since 1990 that have contributed to the fight against malaria. One key analysis from that report was progress towards global targets for reducing the burden of malaria cases and deaths. The analysis was based on projected trends from the estimates for the period 2000–2019, to measure progress in malaria case incidence and mortality rate for the 2020 milestone year, as well as 2025 and 2030. This year’s world malaria report, however, includes actual estimates of the malaria burden for the target year 2020, with the 2000-2020 estimates used to re-analyze progress towards global targets. The estimates of cases and deaths reported for 2020 also include the impact of service disruptions during the coronavirus disease (COVID-19) pandemic on malaria. Further, WHO has changed its method for quantifying the “cause of death” fraction in children aged under 5 years (Annex 1, Section 3), which has increased the estimated number of malaria deaths across the period 2000–2020, independent of the impact of malaria service disruptions during the coronavirus disease (COVID-19) pandemic.

A summary of the highlights in 2020 and 2021 tracking some of the key events that are relevant to the global state of malaria, including the response to malaria during the COVID-19 pandemic, is provided in Section 2. Section 3 presents the global trends in malaria morbidity and mortality, and estimates of the burden of malaria during pregnancy. The analysis of malaria during pregnancy is expanded to include the potential burden of low birthweights averted if coverage of intermittent preventive treatment in pregnancy (IPTp) was matched to coverage of at least one antenatal care (ANC) visit or scaled up to 90% effective coverage. Section 3 includes a new subsection on severe malaria in children, looking at variation in clinical features by endemicity and changing age patterns as a result of changing malaria transmission. Progress towards elimination, including the launch of the “eliminating countries for 2025” (E-2025) initiative and the malaria free certification of China and El Salvador, is presented in Section 4. Section 5 presents an update on the trends and response in the 11 highest burden countries, and Section 6 focuses on the total funding for malaria control and elimination, and for malaria research and development. The supply of key commodities to endemic countries and the populationlevel coverage achieved through these investments are presented in Section 7. Section 8 summarizes global progress, by region and country, towards the GTS milestones for 2020 and the trajectory towards 2025 and 2030. Section 9 describes the threats posed by Plasmodium falciparum parasites that no longer express histidine-rich protein 2 (HRP2), which is the target antigen for the most widely used malaria rapid diagnostic test (RDT), and the threats posed by drug and insecticide resistance. Section 10 summarizes the findings of the report and presents concluding remarks.

The main text is followed by annexes that contain data sources and methods, regional profiles, and data tables. Country profiles are presented online.