[JAKARTA, SciDev.Net] Malaria cases in the Asia Pacific region have surged in the last few years, reaching 4.8 million in 2024 and putting the region further off track to reaching its elimination goal by 2030, a summit heard.
Cases jumped 170 per cent between 2021 and 2024, according to analysis presented by the Asia Pacific Leaders Malaria Alliance at the ninth Asia Pacific Leaders’ Summit on Malaria Elimination, in Bali, Indonesia, this week (16-17 June).
Experts speaking at the event attributed the set-back to climate-fuelled outbreaks, the rise of drug and insecticide resistant strains, conflict and funding challenges.
Sarthak Das, chief executive officer of the Asia Pacific Leaders Malaria Alliance, which organised the event, said the likelihood of reaching the 2030 goal had gone down in the last two years.
On a scale of one to ten, “if you asked me two years ago, it’s a solid seven. Now it’s down to six”, said Das.
“The resurgence in Pakistan set us back,” he added.
He told SciDev.Net that the Pakistan floods of 2022, considered one of the world’s costliest natural disasters, showed how a climate-linked event can reverse years of gains in a country.
Cases surged from around 400,000 in 2021 to 2.7 million in 2023, prompting Pakistan to move its target for elimination to 2035. Das said the Solomon Islands had also pushed their target forward to 2034.
Das also highlighted the increase in Papua New Guinea, which has the highest malaria transmission outside of Africa, and the conflicts in Afghanistan and Myanmar, which also caused malaria cases to rise in Thailand.
The Asia Pacific region is one of the most vulnerable to climate change, warming faster than the global average, and the most heavily impacted by climate disasters.
Climate models cited by Asia Pacific Leaders Malaria Alliance predict localised changes in malaria risks for the region. The length of the transmission season is projected to increase in Nepal, northeast India, northern Myanmar and southwestern China, but decline in some lowland areas of Southeast Asia due to heat stress.
Climate change is also expanding the suitability of malaria to higher altitudes, threatening Nepal and the eastern highlands of Papua New Guinea.
Poor bed nets
Edward Walker, professor of biomolecular sciences at Michigan State University, US, questioned the overreliance on insecticide-treated bed nets as a strategy to eliminate malaria.
“There is no guarantee that people will use it daily,” Walker said.
He believes a better strategy would be to mosquito-proof entire houses where possible, putting screens in windows, doors and eaves — though he added this costs “between 10 to 100 times more”.
He also raised questions about the quality of some of the bed nets. A study in Papua New Guinea found a decrease in efficacy of bed nets sooner than expected, which contributed to the resurgence of malaria there.
At present there is no safe and effective vaccine that tackles the malaria carrying parasite Plasmodium vivax, the most common in Asia.
Funding shortfall
Peter Sands, executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, stressed the progress made in fighting malaria in the past decade, but urged countries to pledge more.
The Global Fund launched its eighth replenishment fundraising cycle in February, with the aim of raising US$18 billion for 2026-2028.
At present, Asia Pacific faces a shortage of US$478 million while the total funding gap globally is at US$4.3 billion, according to the organisation.
“What we are looking for is enough money to sustain the elimination programme,” Sands said.
He called on Asia Pacific countries, which have relied heavily on donors, to step-up and contribute more in the wake of cuts to international aid by the US and others.
The UK government confirmed last week that it would cut its aid budget from 0.5 to 0.3 per cent of gross national income by 2027.
Matthew Downing, deputy head of mission at the British Embassy in Jakarta, told SciDev.Net on the sidelines of the summit, however, that British lawmakers generally did not want to see health and climate funding reduced.
Former Indonesian president Susilo Bambang Yudhoyono told journalists there: “Malaria is not just a health issue. It is also an equity issue and a test of our commitment to the most vulnerable among us.
“It is a measure of our ability to work together across borders, across sectors and across generations of leadership.”
This piece was produced by SciDev.Net’s Asia & Pacific desk.