Malaria Elimination Progress

Highlights from World Malaria Report 2020

The WHO World Malaria Report tracks global progress towards the goals set out in the Global Technical Strategy (GTS) for Malaria 2015 – 2030. The latest report, released in November 2020, documents progress and challenges from 2000 through 2019* as we close in on the first set of GTS milestones for 2020. Despite tremendous global headway in reducing malaria cases and deaths since 2000, the stagnation in progress first observed in 2016 has persisted. The 2020 World Malaria Report projects that we will miss the two GTS 2020 milestones for case and death reduction by 37% and 22%, respectively.

Malaria trends over the past few years have not been consistent, however. While progress has slowed and even reversed in higher burden countries, low burden countries continue to move closer to elimination. The 2020 elimination milestone set by GTS, to eliminate malaria in at least 10 countries that were endemic in 2015, has already been met. The 4th GTS milestone, prevent re-establishment of transmission in all malaria-free countries, had also been met through 2019.

* The 2020 World Malaria Report only presented data through 2019, thus the trends and projections do not take into account the COVID-19 pandemic that caused widespread disruption of societies, economies, and health systems throughout 2020.

Progress towards elimination

  • In 2019, 46 countries reported fewer than 10,000 indigenous malaria cases, up from 26 countries in 2000.
  • 27 countries reported fewer than 100 indigenous malaria cases in 2019 compared to just six countries in 2000.
  • Four additional countries reported fewer than 10 indigenous malaria cases in 2019 vs 2015, increasing from 20 to 24.
  • Since 2000, 21 countries have achieved elimination – 3 consecutive years of zero indigenous cases – and 10 of these were certified malaria-free by WHO.
  • Algeria was the most recent country to be certified malaria-free; it is the first country in the African region to be certified since Mauritius in 1973.
  • China and El Salvador most recently achieved elimination, reporting their final indigenous cases in 2016. Both have made a formal request for WHO certification but this process was delayed due to the COVID-19 pandemic.
  • Three countries reported two consecutive years of zero indigenous cases in 2019 – Iran, Malaysia, and Timor-Leste. Belize and Cabo Verde reported zero indigenous cases for the first time in 2019.
  • Progress in the Greater Mekong Subregion continues to be particularly robust. The 6 countries (Cambodia, Yunnan Province in China, Lao PDR, Myanmar, Thailand, and Vietnam) reported 239,000 combined malaria cases in 2019, a decrease of 90% compared to 2000. Plasmodium falciparum cases fell by 97% during the same period.

Other key points from the 2020 WHO World Malaria Report

  • In 2019, 229 million cases were reported from 87 malaria endemic countries. In 2000, there were 108 malaria endemic countries.
  • Between 2000 and 2015, case incidence declined from 80 cases per 1000 population at risk to 58; the rate of decline slowed dramatically from 2016 onward, with incidence falling to 57 in 2019.
  • Deaths due to malaria decreased from 736,000 to 409,000 between 2000 and 2019, with the greatest rate of decline observed from 2000 to 2015.
  • Of the 11 countries (Burkina Faso, Cameroon, Democratic Republic of the Congo, Ghana, India, Mali, Mozambique, Niger, Nigeria, Tanzania, and Uganda) accounting for an estimated 70% of global cases and 71% of global deaths, 10 had officially launched the High Burden to High Impact (HBHI) response led by WHO and RBM Partnership. Mali’s launch was delayed due to the COVID-19 pandemic.
  • The Global Fund’s malaria allocation for 2020-2022 was US$ 4.8 billion, an increase of US$ 1 billion compared to the previous allocation for 2017-2019. Nearly half of the funds were allocated to the 11 HBHI countries.
  • PMI increased its allocation by US$ 15 million, from US$ 755 million in 2018 to US$ 770 million in 2019. Most of the US$ 770 million went to HBHI countries.