Conferencia: La contribución española en Malaria y los esfuerzos para la eliminación Ciencias de la Vida y de la Materia La Malaria en el mundo: control y eliminación Hoda Atta: Consultora Regional Malaria. Oficina Regional de la OMS para el Mediterráneo Oriental. Egipto. Madrid, 25 de abril de 2012

1. FUNDACIÓN RAMÓN ARECES
La Malaria en el mundo: control y eliminación
Hoda Atta
Madrid, 25 de abril de 2012

2. Progress and Challenges in
Malaria control and Elimination
in the Eastern Mediterranean
Region
Dr Hoda Youssef Atta
Regional Malaria Advisor
WHO / EMRO

3. Gaps … Coverage is increasing but….
 MIS showed some
increase in
treatment with
ACTs and
prevention by long
% of HH with at least one LLIN in
lasting treated LNs Sudan _N
,
 Sill far below from
universal coverage

4. Current Malaria Situation in the
PV 14%
Eastern Mediterranean Region
PF , 86%
Malaria-free countries
Focal transmission/targeting elimination
High-burden countries targeting control
Non-EMRO countries
 The Region is mainly a low
unstable transmission area
87% of surveys conducted
during 1985–2007 showed
falciparum prevalence below
86
10%
4
Source: Guerra et al, PLoS

5. Reported malaria Morbidity 2000–2010
No of Cases Millions
Reported Malaria Cases in EMR-2000-10
10
8
The reported
incidence of total 6
malaria cases 9,3 m 4
2000 to in 7,2 in
2010 (28% decrease 2
)
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Confirmed cases Total reported cases Reported confirmed
does not show any Sources:
Annual malaria surveillance reports from countries
reduction
78.2%
% reported confirmed
Burden of confirmed cases in 2010 by country
cases is carried
mainly by 3
countries 11.6% 5.1% 3.3% 1.2% 0.5%
5 Sudan (N&S) Pakistan Yemen Afghanistan Somalia other
5

6. Elimination achievements in last decade
1. WHO certified The United Arab Emirates
as malaria-free in 2007
2. WHO certified Morocco as malaria-free
in 2010
3. Syria eliminated malaria (PV) reported
last local case in 2004 ,
4. Iraq reported last cases in 2008

7. Saudia Arabia reported only 29 local cases -
99% reduction compared to yr 2000 ( mainly PF
) 45,000
40,000
35,000
30,000
25,000
20,000
15,000
10,000
5,000
1941
29
0
1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010
Iran has a low record of 1847 , 85%
reduction compared to yr2000. ( PF,PV )
Trend of Total and Local Cases- Iran (Islamic Republic of )
25000
Total Reported Cases
Local Cases
20000
15000
10000
5000
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

8. SPR% from school
survey, Tihama area, Yemen
Success of the malaria-
25%
free initiatives in 21.9%
20%
endemic areas 15%
10%
5% 4.5%
0%
Khartoum State in Sudan 2001 2002 2003 2004 2005 2006 2007 2008 2009
Recorded malaria cases in Socotra
Island (2000–2007)
3000
2333
2500
2000
1500
1000
500 107 158
60 30 4 0 0
0
8 2000 2001 2002 2003 2004 2005 2006 2007
8

9. Gaps … Coverage is increasing but….
 MIS showed some
increase in
treatment with
ACTs and
prevention by long
% of HH with at least one LLIN in
lasting treated LNs Sudan _N
,
 Sill far below from
universal coverage

10. Barriers in endemic countries
GRAET DOUBT ABOUT
Reported Malaria Cases in EMR-2000-10
RELAIBILITY OF REPORTED
Millions
%
MALARIA DATA AND REAL
10 30
MALARIA BURDEN 9
8 25
No of Cases
7 20
-Weakness of diagnostic 6
systems 5 15
4
-43% of facilities surveyed 3 10
in Sudan had functional 2 5
microcopy , 10.5% had 1
0 0
RDT
- Weak health information and
Total reported cases % confirmation
malaria surveillance system
10
10

11. Floods in Pakistan
Challenges
2010
 Climate change and natural
disasters. The malaria situation
in Pakistan has worsened since
the heavy floods in 2010.
 Complex emergencies duet to
political problems, civil
Imported malaria
unrest, war in many areas in
3500 3264
EMR 3000
2500 2164
 Considerable and increasing 2000 1166
1500 1184
population movement (legal and 1000 445343218
illegal) 500 90 85 71 59 23 7
0
Iran…
Syrian Arab…
 Increase in imported malaria with
Saudi Arabia
Egypt
Iraq
Jordan
Bahrain
Oman
Kuwait
Tunisia
UAE
Qatar
Morocco
risk of reintroduction of malaria to
countries that eliminated it. Oman
reported several outbreaks of
local cases in 2007-2011

12. Way forward
 More Political Commitment is needed to be
translated into national expenditure
 Strengthen the capacity of malaria programme
managers down to district level for planning and
management by regional training courses
 Support sub-regional initiatives ( e.g., malaria
free Arabian peninsula ) , regional networks
, inter-regional cooperation
 More emphasis on T3 – test treat track