On 23 June 2022, at the Kigali Summit on Malaria and Neglected Tropical Diseases (NTDs), heads of state and government of commonwealth countries have reaffirmed their commitment to end malaria and reduce NTDs by 2030, following the signing of the Kigali Declaration on NTDs. This follows previous commitments made, such as the 2018 pledge to halve malaria across the commonwealth by 2023, to eliminate blinding trachoma by 2020, and to combat other mosquito-borne diseases.
In recent years, an estimated 10.6 million malaria deaths and 1.7 billion malaria cases were averted from 2000 to 2020, with 26 countries reporting fewer than 100 indigenous cases of malaria in 2020, up from six countries in 2000. Since 2015, nine countries have been certified as malaria-free by the World Health Organization (WHO).
Additionally, 46 countries have eliminated at least one NTD and, between 2015 and 2019, more than one billion people were treated every year for one or more NTDs. In the period 2010 to 2020, the number of people requiring an NTD intervention was reduced by 600 million. Cases of African trypanosomiasis have fallen by 90% over the last 10 years, and only 15 cases of Guinea worm disease were reported in 2021 globally, compared to 3.5 million cases in the mid-1980s.
However, in 2020, an estimated 627,000 people died of malaria, and there were 241 million new cases of the disease, and despite several important NTD milestones in many countries, such as the elimination of transmission of dracunculiasis, onchocerciasis and yaws, and the elimination of human African trypanosomiasis, lymphatic filariasis, rabies and trachoma as public health problems, more than 1.7 billion people required treatment and care for NTDs in 2020.
Progress towards the 2023 malaria target for Commonwealth countries, as well as the 2030 targets of the WHO global malaria strategy, remains off track, with around half of the world’s population still missing out on the services they need to prevent, detect and treat the disease. Similarly, the targets set out in the WHO NTD road map for 2021 to 2030 also face severe risk due, in part, to disruptions caused by the COVID-19 pandemic, which saw most malaria-endemic countries experience moderate disruptions to malaria services, and some countries saw delays in the delivery of insecticide-treated net (ITN) campaigns. During the first year of the pandemic, disruptions to malaria services contributed to an increase of 14 million malaria cases, with at least two-thirds of the additional 69,000 deaths recorded in 2020, compared to 2019.
NTD programmes, especially community-based interventions such as preventive chemotherapy campaigns, were among the most severely and frequently affected across the spectrum of health services, while the number of people receiving treatment for an NTD fell by one-third in 2020, due to health service disruptions caused by the pandemic.
The WHO have highlighted the importance of strengthening primary health care as the foundation for universal health coverage and global health security, with increased domestic financing being critical, complemented by the engagement of new partners and donors, more international funding and the successful replenishment of the Global Fund.
Africa and Asia carry the highest burden of both malaria and NTDs and, as such, a continent-wide response will be required to galvanize political and societal commitment and facilitate greater regional coordination and cross-border collaboration between countries. Youth engagement and empowerment are also key to ensuring that the next generation of health practitioners and global health leaders can take the lead in ending long-standing disease burdens.
Participants in the Kigali Summit also emphasized the need for innovative tools and strategies to tackle malaria and NTDs. Innovation is needed, for example, to stay ahead of emerging biological threats, such as drug and insecticide resistance, and to address the growing inequalities and barriers in access to health services.
The Kigali Summit also acknowledged a pledge from Novartis to invest US$100 million in research and development towards combating several NTDs, including Chagas disease, leishmaniasis and dengue fever in addition to cryptosporidiosis, and an additional US$150 million in next generation antimalarials and in an optimized drug formulation for infants. These commitments were complemented by pledges of US$1 billion from Pfizer to the International Trachoma Initiative and US$80 million from the Wellcome Trust for research and development into snakebite treatments and additional NTD research.
Source: WHO, 23 June 2022