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WHO European region reports no indigenous cases of malaria for first time

BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h6718 (Published 10 December 2015) Cite this as: BMJ 2015;351:h6718
  1. Anne Gulland
  1. 1London

The World Health Organization’s European region has reported no indigenous cases of malaria for the first time, new data have shown.

The World Malaria Report 20151 showed that the region—which to the east includes Azerbaijan, Armenia, Tajikistan, and Uzbekistan—has reported no home grown cases of malaria this year. This milestone is in line with the goal to eliminate malaria from the region by the end of 2015, after a peak of 90 712 cases in 1995.

The number of countries reporting fewer than 1000 cases of indigenous malaria a year has grown from 13 in 2000 to 33 in 2015. In 2014, 16 countries reported no indigenous cases for the first time.

While the number of deaths from malaria has fallen dramatically—from 839 000 in 2000 to 438 000 in 2014—the number of cases has not fallen by such a large margin, down from 262 million cases in 2000 to 214 million in 2014. And progress in eliminating malaria in Africa, where 88% of cases occur, is patchy.

Three of the four countries in Africa aiming to eliminate malaria by 2015 actually saw their total number of cases increase in 2014, compared with the previous year: in Botswana the number rose from 456 to 1346, in Namibia it rose from 4911 to 15 914, and in South Africa it rose from 8645 to 11 705. In Swaziland numbers fell from 962 to 711 in the same period.

In the South East Asia region, where 10% of all malaria cases occur, progress to elimination has been better. The last indigenous malaria case was reported in Sri Lanka in 2012, down from a baseline of 210 039 cases in 2000, and Bhutan saw only 19 cases in 2014. However, North Korea still recorded 10 535 cases in 2014, compared with 14 407 the previous year.

Despite the successes, WHO has warned that progress in malaria elimination is threatened by a number of factors: slower declines in incidence of the disease in high burden countries; gaps in coverage of key interventions such as insecticide treated bed nets; and weak health systems in countries where the disease is still endemic.

Insecticide resistance among mosquitoes is another major concern. Since 2010, of 78 countries keeping track of the problem, 60 reported resistance to at least one insecticide in one vector population, and 49 reported resistance to insecticides in two or more.

Pedro Alonso, director of WHO’s Global Malaria Programme, said, “In many countries, progress is threatened by the rapid development and spread of mosquito resistance to insecticides. Drug resistance could also jeopardise recent gains in malaria control.”

Notes

Cite this as: BMJ 2015;351:h6718

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