Malaria control beyond 2010

Major efforts are being made to achieve the goals for malaria control set by the World Health Assembly1 and the Roll Back Malaria partnership,2 including halving the malaria burden by the end of 2010 compared with 2000. Particularly encouraging is the progress in availability of long lasting insecticide treated mosquito nets. In Africa alone, 140 million nets were distributed between 2006 and 2008.3

These efforts, coupled with targeted application of indoor residual spraying and modest increases in access to artemisinin based combination therapy, have begun to produce results. In countries where these malaria control interventions have been scaled up, such as Eritrea, São Tomé and Principe, Rwanda, Zambia, and Zanzibar (Tanzania), rates of malaria cases, hospital admissions, and deaths have dropped by more than 50%.3 In São Tomé and Principe and Zanzibar, these gains have been mirrored by a greater than 50% fall in all-cause hospital admissions and deaths among children under 5 years old, suggesting that malaria control may be a critical factor in achieving the millennium development goal for child mortality in endemic countries.3

These early results are encouraging, and we need to push forward with achieving and then maintaining universal coverage with vector control interventions. However, other facets of malaria control require equally urgent attention in order to ensure long term success:

• Universal access to diagnostic tests for malaria and artemisinin based combination therapy together with routine surveillance systems

• Mitigating threats to success, including drug resistance, insecticide resistance, poor quality or counterfeit medicines and diagnostics, and unstable financing; and

• Fostering community ownership over malaria control and building district capacity to manage programmes.