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1 1 (March 25, 2019)

handle is hein.crs/govyzb0001 and id is 1 raw text is: Congressional Research Service Informing the legislative debate since 1914 S March 25, 2019 Global Trends: Malaria The United States has supported global malaria control efforts since the 1950s, including through the President's Malaria Initiative (PMI) since 2005. Global Trends According to the World Health Organization (WHO), roughly half of the world population (3.2 billion people) is at risk of contracting malaria, a life-threatening disease caused by parasites transmitted through bites of infected mosquitoes. Malaria is preventable and curable, though in some regions malaria parasites are developing resistance to drug treatments and pesticides. From 2000 to 2016, WHO recorded significant progress in combatting malaria in endemic areas. However, data from the 2018 WHO World Malaria Report showed that progress in reducing global malaria cases has stalled in recent years. Malaria: Disease Burden and Global Trends In 2017: * Malaria cases numbered 219 million, up from 217 million in 2016. * 435,000 people died from malaria, of which 61% were children younger than five years old. * Africa had 92% of global malaria cases (201 million cases). * Southeast Asia accounted for 5% of global cases (about II million cases), 80% of which occurred in India (8.8 million cases). * Increased transmission rates in Brazil, Nicaragua, and Venezuela heightened the number of new malaria cases in South and Central America. * 80% of children with malaria also tested positive for anemia, which is a risk factor for malaria. From 2010 to 2017: * The absolute number of malaria deaths worldwide decreased by 172,000. * The incidence rate of malaria cases in the WHO Southeast Asia region decreased by 59%. Source: WHO World Malaria Report, 2018, https://www.who.int/malaria/publications/world-malaria-report- 2018/en/. Malaria is concentrated in the poorest regions of the world, where individuals in malaria-prone rural areas often live in informal dwellings that have few barriers against mosquitoes. Some experts contend that, because malaria has severe effects on a person's body-such as fatigue, diarrhea, vomiting, and nausea-serious socioeconomic impacts can follow, contributing to slowed economic growth and development, thereby perpetuating poverty cycles. Malaria Prevention and Treatment The four strategies commonly thought to be most effective to combat malaria are listed below. 1. Treatment with antimalarial drugs may include chloroquine, primaquine, and artesmisinin-based combination therapy (ACT). ACT is preferred for treating particularly deadly forms of malaria, or in areas with resistance to earlier generations of antimalarial drugs. 2. Intermittent Preventive Treatment in Pregnancy (IPTp) involves routinely administering antimalarial treatments to pregnant women to prevent transmission of the disease to their infants. Coverage and treatment adherence are a problem; currently, 22% of pregnant women in 33 Sub-Saharan countries receive all three necessary antimalarial doses. 3. Insecticide-treated bed nets, if used in high volume in a community, can reduce malaria transmission. Mass bed net distribution is the most commonly used preventive intervention globally, with 220 million nets distributed in 2017, up from 144 million in 2010. 4. Indoor residual spraying covers household walls with an insecticide to kill mosquitos that come into contact with them. Maximum efficacy is achieved when at least 80% of walls within a dwelling are sprayed. The WHO estimates that resistance to the four commonly used insecticides is widespread in all malaria endemic countries, and it identifies insecticide resistance management strategies as a necessary component of country-level malaria control programs. Recent Developments The WHO estimates that global malaria control efforts have helped reduce malaria deaths by more than 60%, saving almost 7 million lives and preventing more than 1 billion malaria cases between 2000 and 2015. Factors likely to affect future malaria developments are discussed below. Research & Development (R&D) Scientists are researching the development of an effective malaria vaccine. The most promising vaccine is being developed through a partnership between GlaxoSmithKline (GSK) and the Malaria Vaccine Initiative (MVI); late stage clinical trials are underway in Ghana, Kenya, and Malawi. The trials are being implemented in 2019 by the WHO, in partnership with relevant ministries of health, and GSK. During the trial, the vaccine halved the number of malaria cases among children. Widespread use of the vaccine is limited, however, by its short-term effectiveness and the need to administer several injections. https:I/crsreports.conc -- -q

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