New study doubles previous estimates of global malaria mortality

Lancet2012;379:413-31OpenUrlCrossRefMedline

In 2010, 1.24 million people worldwide died of malaria, according to the latest estimates (95% uncertainty interval 0.93 to 1.69 million). The new figure for global malaria mortality is twice as high as the World Health Organization’s last estimate for the same year, and it includes more than half a million older children and adults⇑.

The number of deaths after the age of 5 years is particularly striking, say the study’s authors. In Africa, the new figure for this age group is more than eight times higher than the old one. In other regions, such as Asia and the Americas, teenagers and adults now account for most deaths from malaria. Control efforts should be stepped up and refocused, says a linked editorial (p 385). Older children and adults are not as immune as we previously thought and need more protection, including basic measures such as insecticide treated bed nets.

Although absolute numbers of deaths everywhere look high, they are on the way down from a peak in 2004, particularly in sub-Saharan Africa, where malaria deaths have fallen by 32% in the past six years. Malaria programmes that distribute bed nets and modern drug combinations have been very successful, says the editorial, but they now face a funding crisis, partly because of the economic downturn. The global fund paying for malaria control needs immediate binding commitments from international donors.

Even if the money is forthcoming, current targets—to reduce deaths to zero by 2015—look out of reach. If current trends continue (a big if), the study’s authors estimate it will take until at least 2020 to reduce malaria deaths to below 100 000 a year.

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N Engl J Med2012;366:409-20OpenUrlCrossRefMedline

N Engl J Med2012;366:421 … OpenUrlCrossRefMedline