Progress in malaria prevention questioned by health experts
Leading malaria experts have questioned official data showing progress in tackling the disease and called for independent scrutiny of the slow-moving efforts by governments and international organisations to respond.
The latest World Malaria Report, published this week by the World Health Organization, found that estimated infections had fallen from 286m in 2000 to 228m last year, suggesting good progress in reducing the parasite’s heavy burden on human health and economic development.
It concluded that malaria deaths were down 31 per cent between 2010 and 2018 and called for an increase in the current figure of $4bn a year that goes towards eradication.
But Nicholas White, professor of tropical medicine at the University of Oxford and a global expert on malaria, criticised the WHO methodology.
He noted that the figures for infections in previous years had been significantly increased from those given in previous editions of the report, which had the effect of increasing the apparent success in lowering infections. In 2011, for instance, the 2000 estimate for infections was 223m.
“The number of cases reported for 2000 has gone up in every single World Malaria Report,” Sir Nicholas told the Financial Times. “You can’t trust the figures [and] something serious is going wrong.”
Sir Nicholas, who is also a professor at Mahidol university in Thailand, called for “a no-holds-barred inquiry” into efforts to tackle malaria, which he said could give greater value for money for the governments and institutions who provide funding. “If this was a company, you would sack the board and the chief executive,” he said.
His concern over the frequent data adjustments was shared by Richard Price, professor at the Menzies School of Health Research in Australia. “What is frustrating is that every year, all previous years’ numbers have changed. It is impossible to interpret trends when the methodology and systems change,” he said.
Prof Price added that “sometimes people who have a vested interest in the way we are going will not highlight major problems. People who are receiving funds do not want to rock the boat. We should put down milestones and hold people accountable.”
However, Abdisalan Noor of the WHO’s global malaria programme defended the organisation’s data-collection methodology, stressing that efforts had been stepped up to develop more reliable statistics. He pointed out more than 90 per cent of malaria infections occurred in countries in Africa without strong disease-surveillance systems, making the quick collection of reliable data very difficult.
“These are the best possible estimates available at the moment but we are fully aware of the uncertainties, which are fully reported in our reports. The only way out is not to point fingers but to seriously invest in country surveillance systems. The more perfect the data is, the less this controversy arises,” Prof Noor said.
He added: “A lot of people spend a lot of time criticising when the solution should be in coming together collectively to have reliable data.”
Karen Barnes, a pharmacology professor at the University of Cape Town, said the row added to concerns that efforts to tackle a disease were stagnating. More than 400,000 people died from malaria in 2018.
“One of the challenges is how to balance the optimism of what is possible while communicating how incredibly hard it is,” she said.