UCSF-led Lancet Commission says malaria can be eradicated within a generation

Malaria, one of the world’s oldest and deadliest diseases, can be eradicated as early as 2050, according to a new report published today by The Lancet Commission on malaria eradication.

Authored by 41 of the world’s leading malariologists, biomedical scientists, economists, and health policy experts, this seminal report synthesizes existing evidence with new epidemiological and financial analyses to demonstrate that – with the right tools, strategies, and sufficient funding – the mosquito-borne disease can be eradicated within a generation.

“For too long, malaria eradication has been a distant dream, but now we have evidence that malaria can and should be eradicated by 2050,” said Sir Richard Feachem, Co-chair of The Lancet Commission on malaria eradication and Director of the Global Health Group at the Institute of Global Health Sciences. “We simply cannot continue with a business-as-usual approach.”

Global malaria trends

Recent decades have seen unprecedented progress made against malaria, making it possible to aim to eradicate the disease altogether. Since 2000, global malaria incidence and death rates have declined by 36 and 60 percent, respectively. Even so, malaria claims the lives of nearly half a million people every year, and more than 200 million cases of malaria are reported.

The achievements of the past two decades are threatened by recent plateaus in global funding, together with the warming climate and increasing concern about parasite and vector resistance to currently available drugs and insecticides. Investment in anti-malaria efforts peaked at US$4.3 billion in 2016.

Twenty-nine countries accounting for the large majority of new cases and 85 percent of global deaths reported in 2017. All but two—Papua New Guinea and the Solomon Islands—are located in Africa, and Nigeria and the Democratic Republic of the Congo alone account for 36 percent of global cases.

Bending the malaria curve

The Lancet Commission on malaria eradication, a joint endeavor between The Lancet and UCSF with funding from the Bill and Melinda Gates Foundation, used new modeling to estimate plausible scenarios for the distribution and intensity of malaria in 2030 and 2050. Models suggest that current trends will lead to a world in 2050 with malaria persisting in pockets of low-level transmission across equatorial Africa.

But, rather than continue efforts to gradually reduce malaria in most countries, hold the constant threat of resurgence at bay, and fight an ongoing and increasingly difficult struggle against drug and insecticide resistance, the commission encourages the global health community instead to commit to eradicating the disease by 2050.

To achieve that goal, the Commission urges that specific and deliberate actions at the country, regional and global levels must be taken. This report identifies three ways to bend the curve.

First, the world must improve the management and implementation of current malaria control programs and make better use of existing tools – what the Commission refers to as the “software of eradication.” Second, Commissioners highlight the need to improve the “hardware of eradication” by developing and rolling out innovative new tools to overcome the biological challenges to eradication. And lastly, malaria endemic countries and donors must provide the financial investment needed to ultimately rid the world of this disease. The Commission estimates an annual increase of approximately US$2 billion is needed.

The Lancet Commission on malaria eradication. Read the TIME September 8 article on the report. 

Photo: USAID/Wendy Stone