There were an estimated 249 million cases of malaria around the globe last year, the World Health Organization (WHO) said Thursday (Nov 30), significantly more than before the Covid-19 pandemic and an increase of 5 million over 2021. Malaria remains a top killer of children.

Those new cases were concentrated in just five countries: Pakistan, Nigeria, Uganda, Ethiopia and Papua-New Guinea. Climate change was a direct contributor in three of them, said Dr Daniel Ngamije, who directs the WHO malaria program.

In July 2022, massive flooding left more than one-third of Pakistan underwater and displaced 33 million people. An explosion of mosquitoes soon followed. The country reported 3.1 million confirmed cases of malaria that year, compared with 275,000 the year before, with a fivefold increase in the rate of transmission.

“With the very heavy monsoons we expected these consequences, but not up to this magnitude,” said Dr Muhammad Mukhtar, director of Pakistan’s national malaria control program.

While floodwaters have receded in some areas, vast tracts of standing water remain, and the malaria parasite is now well-established and circulating in communities that had little prior immunity, Dr Mukhtar said.

More than 7 million bed nets were given out to displaced people, but people who are living in small tents or in big crowded halls have nowhere to hang them, Dr Mukhtar said. The country is relying on insecticide spraying to try to control mosquitoes and mass administration of anti-malarial drugs.

A NEWSLETTER FOR YOU

Friday, 12.30 pm

ESG Insights

An exclusive weekly report on the latest environmental, social and governance issues.

Sign Up

Pakistan has confirmed 2.3 million malaria cases so far this year and expects the total to be even higher than the total from 2022.

“It will take another one to two years for the situation to become normal if, God forbid, there is not another natural disaster,” Dr Mukhtar said.

In Pakistan, as in other places where weather emergencies drove malaria’s spread, new mosquito habitat was only part of the problem. The floods damaged 2,200 health facilities, leaving millions of people without access to treatment in affected districts.

The number of deaths from malaria worldwide stayed largely stable between 2021 and 2022, but at an estimated 608,000 it was still significantly higher than the total of 576,000 in 2019, before the pandemic.

Deaths had fallen steadily from 2000 to 2015, because of a wide push to make better diagnostics and treatments, as well as insecticide-treated bed nets, widely available across malarial areas in sub-Saharan Africa. But growing resistance to those drugs and insecticides, plus stagnating funding and changes in mosquito behavior, have combined to stall that progress. Covid has further disrupted both health services and supply chains.

The changing climate was also at least partly responsible for a rise in malaria in Ethiopia, with 1.3 million more cases than it had the year before, and Uganda with 600,000 more, Dr Ngamije of the WHO said. Highland areas that had long been too cool and dry to support the breeding of malaria-transmitting mosquitoes have started to report cases in those two countries.

Climate change is also driving malaria cases where people are displaced by drought, heat waves and storms, leaving them in substandard housing, Dr Ngamije said. Weather disasters disrupt the supply chains of malaria tests, treatments and insecticides. Food insecurity, rising in sub-Saharan Africa because of floods and droughts, means more children are malnourished, and thus more susceptible to severe malaria. Repeated malaria infections keep children out of school, and wipe out the savings of the lowest-income families in affected countries.

The malaria report did contain some good news. Azerbaijan, Belize and Tajikistan were all certified as malaria-free by the WHO in 2022.

More than 2 million children in Ghana, Kenya and Malawi had received at least one dose of a new malaria vaccine by the end of 2022. Vaccination coverage will be broadened to 12 more countries next year. There has been a 13 per cent drop in child deaths over four years in the areas where the first malaria vaccine has been administered. NYT