While achieving malaria elimination in sub-Saharan Africa requires innovation and creative thinking, a crucial step involves optimizing the use of the tools we already have—existing interventions and strategies proven to reduce malaria-related illnesses and deaths.
A major reason why elimination now seems feasible is because scaling up existing tools has proven to be so effective over the past decade. The Scale-Up For Impact (SUFI) approach—which rapidly increases access to and use of interventions to quickly achieve optimal health effects—has been embraced in over 40 countries and has had a dramatic impact on malaria mortality and morbidity.
Worldwide, over 6.2 million malaria deaths have been averted between 2000 and 2015, primarily in sub-Saharan Africa. In that region an estimated 90 percent of malaria deaths occur, with 78 percent of those deaths in children under five years of age. Four hundred and forty-four million cases of malaria were averted in Africa between 2001 and 2013.
This marked decrease in malaria cases and mortality comes even as the number of people living in malaria endemic areas has continued to grow. Such impact is a testament to the effectiveness of increased insecticide-treated bednet (ITN) distribution and use, expansion of indoor residual spraying (IRS), rapid diagnostic tests for malaria (RDTs) becoming available at community level, and treatment using efficacious artemisinin-based combination therapies (ACTs).
In particular, ITN delivery to African countries has increased from 6 million in 2004 to over 142 million in 2013, with more than 900 million ITNs being delivered to malaria-endemic countries in sub-Saharan Africa between 2004 and 2014. Procurement of ACTs—crucial in the fight against malaria as they combine fast-acting compounds that kill the majority of parasites with a slower acting drug that clears the remaining parasites—by both the public and private sectors rose from 11 million in 2005 to 392 million in 2013.
Continuing to employ these tools, while finding more efficient and targeted ways to deliver them where they are needed most, is key for maintaining the dramatic reduction in malaria mortality and morbidity they provide. When these interventions are combined with new approaches, such as mass drug administration, they can serve as a foundation for elimination efforts going forward.