U.S. Agency for International Development’s Malaria Programs
As many as 900 million cases of malaria occur every year, directly and indirectly causing up to 2.7 million deaths. Ninety percent of these deaths occur in Africa, and most of the victims are young children. Malaria affects the health and wealth of nations and individuals alike. In Africa, it is both a disease of poverty and a disease that causes poverty. It is a major constraint to economic development, with significant direct and indirect costs. As a result, the international community has remobilized in the past few years to develop and implement sustainable actions against malaria.
USAID has been a key partner in the global Roll Back Malaria (RBM) initiative since its inception in late 1998. The Agency has assisted 22 national malaria programs and three regional initiatives, building malaria control networks and developing new technologies and approaches. USAID provided significant support to “going to scale” efforts in national malaria control programs in Africa and to cross-border initiatives addressing the problem of drug resistance.
USAID is reducing malaria morbidity and mortality by focusing on six key areas:
Preventing malaria infection and illness. Access and use of insecticide-treated nets is one of the key intervention strategies for Roll Back Malaria. Proper use of insecticide-treated bednets (ITNs) can reduce overall child mortality by up to 30% and significantly reduce morbidity in children and pregnant women. However, less than 10 percent of African children are covered by an ITN. To help stimulate commercial investment in ITNs, USAID has launched NetMark, an innovative program that has formed partnerships with 13 major commercial firms to expand the availability of
affordable ITNs in five African nations. Over the next year NetMark will expand activities to an additional five countries.
Promoting effective treatment of malaria illness. Recognition of malaria symptoms and prompt, effective treatment are critical to saving the lives of children infected with malaria. USAID programs aim to increase the proportion of children with fever who receive prompt treatment with an effective drug within 24 hours. This approach involves improving symptom recognition and treatment-seeking behaviors at the household level, improving case management at health facilities, and developing national capacity to set appropriate policies and monitor antimalarial drug efficacy.
Protecting pregnant women from malaria. Each year, 22 million pregnancies in Africa are at risk of malaria. Pregnant women in areas of unstable transmission have little opportunity to develop immunity to malaria infection and are at higher risk of severe disease. Placental malaria infection increases the risk of low birthweight and other adverse birth outcomes. Intermittent preventive treatment of malaria as part of regular antenatal care can significantly reduce this risk to the newborn as well as the mother’s risk of anemia. USAID programs, particularly the Malaria Action Coalition promotes partnership between malaria and reproductive health to deliver this effective intervention to pregnant women in Africa.
Responding to the emergence and spread of drug-resistant malaria. Growing antimalarial drug resistance is challenging malaria control. New drugs exist but are significantly more costly than current therapies. With USAID support, an Institute of Medicine panel is developing guidance for the RBM partnership on the most efficient means of financing these newer, more effective treatments. USAID supports operations research to study issues affecting the introduction of combination drug therapies in Africa.
Developing new tools and approaches for malaria prevention and control. In collaboration with public and private partners, USAID focuses on developing and testing malaria vaccines through its Malaria Vaccine Development Program. Funding through the Environmental Health Project is developing tools for the targeting and cost-effective deployment of vector management interventions.
Addressing the needs of populations in complex humanitarian emergencies. There is a growing recognition that African populations in areas of war and conflict are at particular and increased risk of malaria. RBM has estimated that countries affected by complex emergencies account for more than 30 percent of the world’s annual malaria mortality. USAID is supporting a five-year World Health Organization effort to roll back malaria in complex emergency situations, with particular focus on Sudan, Angola, the Democratic Republic of Congo, and Liberia.
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