Shrinking the Malaria Map

UCSF Global Health Group’s Malaria Elimination Initiative (MEI)

Malaria elimination trends in the 2018 World Malaria Report

18 December 2018

The WHO World Malaria Report tracks global progress towards the goals set out in the Global Technical Strategy (GTS) for Malaria 2015 – 2030. This year’s report highlights both progress and challenges as malaria endemic countries work towards achieving 2020 GTS targets. Though malaria cases in higher burden countries are on the rise for a second year, the pace of progress is accelerating in a number of low burden countries. Globally, more countries than ever are moving towards elimination of the disease. In 2017, 46 countries reported less than 10,000 indigenous cases of malaria – an important benchmark on the way to zero. At the current rate of progress, the world is on track to achieve the elimination goal set by the GTS: to eliminate malaria in at least 10 countries that were endemic in 2015.

Progress towards elimination

  • In 2017, 46 countries reported fewer than 10 000 such cases, up from 37 countries in 2010. 
  • Since 2000, 21 countries have reported zero indigenous cases, meaning elimination is within reach for these countries. 
  • In the past year, Paraguay and Uzbekistan were certified malaria-free, while Algeria and Argentina made formal requests to WHO for certification. In addition, China and El Salvador reported zero indigenous cases for the first time. 
  • In addition, several higher burden countries including Ethiopia, India, Pakistan and Rwanda recorded substantial declines in cases in 2017.
  • Progress in Southeast Asia continues to be particularly robust. The WHO South-East Asia Region has seen a 59% decrease in its malaria incidence rate since 2010 – from 17 cases per 1000 population at risk in 2010 to 7 in 2017.
  • One of the key GTS milestones for 2020 is elimination of malaria in at least 10 countries that were malaria endemic in 2015. At the current rate of progress, 11 countries are on track to eliminate in the next 2 years. 
  • In 2017, an estimated US$ 3.1 billion was invested in malaria control and elimination efforts globally by governments of malaria endemic countries and international partners – an amount slighter higher than the figure reported for 2016.

Other key points from the 2018 WHO World Malaria Report

  • Malaria deaths continue to decrease. In 2017, there was an estimated 435, 000 deaths from the disease compared to 451,000 deaths in 2016. 
  • Malaria cases have increased for a second year in a row – from 217 million cases in 2016 to 219 million cases in 2017. Many of these increases have occurred in the highest burden countries. (There were 239 million malaria cases globally in 2010.) 
  • In 2017, 11 countries accounted for approximately 70% of estimated malaria cases and deaths globally: 10 in sub-Saharan Africa and India. Among these countries, only India reported progress in reducing its malaria cases in 2017 compared to 2016.
  • While delivery of malaria commodities is fairly robust, there remains significant gaps in coverage. The number of households with at least one insecticide-treated bednet (ITN) increased only slightly over the past three years, with half the people in Africa sleeping under an ITN in 2017. 
  • In the WHO Africa Region, coverage with indoor residual spraying is declining as countries change or rotate insecticides (changing to more expensive chemicals), and as operational strategies change (e.g. decreasing at-risk populations in malaria elimination countries).