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The challenge

The Challenges
Children | Pregnant Women | Malaria and Poverty | Links to Other Diseases | Drug Resistance | Funding 

The challenge

Children and malaria

In Africa malaria is the biggest killer of children under five years old, who account for with nearly 90 percent of all malaria deaths. It is estimated that a child dies every minute from the disease.

Young children are much more vulnerable to all forms of malaria. In infants this is because their immune systems are not yet fully developed, while in under fives they have not yet developed effective resistance to the disease.

Malaria can have a devastating effect on children’s education. Repeated infections cause children to miss large periods of school and anaemia, a side-effect of frequent malaria attacks, interferes with children’s ability to  concentrate and learn and causes chronic fatigue. Repeated illnesses from malaria can also exacerbate any malnutrition, which can both decrease the effectiveness of anti-malaria drugs and increase children’s susceptibility to the other main killer diseases: diarrhoea and pneumonia.

The impact of malaria on children remains a serious obstacle to the achievement of many of the Millennium Development Goals (MDGs), including Goal 2 (universal primary education) and Goal 4 (the reduction of infant mortality).

Click here to see the Comic Relief celebrity appeal team talking about how mosquito nets have helped protect primary school children from malaria through the Comic Relief funded Malaria Consoritum project in Uganda and describing how malaria affects children.

Pregnant women and malaria

Pregnant women are far more vulnerable to malaria than other adults: they are four times more likely to contract and twice as likely to die from malaria than other adults. This is due to the typical immunosuppression associated with  pregnancy and increased levels of the hormones cortisol and oestrogen.

In Africa malaria in pregnancy is responsible for 400,000 cases of severe maternal anaemia and 200,000 newborn deaths each year. Placental infection, premature birth and low birth weight (a significant factor in infant mortality) are also caused by maternal malaria. In addition, severe maternal anemia increases the risk of perinatal complications. Malaria, therefore, is seriously hindering the achievement of MDG Goal 5 (improve maternal health).

Malaria and Poverty

The cost of malaria to Africa is estimated at $12.5 billion per year, which represents 1.3 percent of affected countries economic growth (GDP). In some countries, malaria accounts for up to 40 percent of total health expenditure and 20-50 percent of hospital admissions. Productivity is reduced and staff turnover increased by illness-related absenteeism and children’s education is severely disrupted. Rural and poor populations carry the overwhelming burden of malaria because access to effective treatment is extremely limited. In rural areas, infection rates are highest during the rainy season - a time of intense agricultural activity. Research indicates families affected by malaria harvest 60 percent less crops than other families.

Links to Other Diseases

Malaria-endemic countries are also plagued by diseases such as tuberculosis, polio, cholera and HIV/AIDS. These diseases have a cumulative effect, with one reducing a person’s ability to cope with another. HIV/AIDS sufferers are at a higher risk of malaria morbidity and malaria reduces the survival rate from AIDS. Vertical, un-integrated, disease-specific intervention programmes have exacerbated the problem as they do not allow for the overarching aim of achieving universal coverage of malaria control interventions.

Drug Resistance

In 2008, the first cases of resistance to artemisinin-based drugs were confirmed in Southeast Asia along the Thai-Cambodia border. Currently, the most effective malaria drugs are derived from artemisinin and used in combination with other drugs. The use of two different drugs together aims to ensure parasites resistant to one drug are killed by the other before resistance is transmitted. The spread of artemisinin resistance from Asia to Africa would be a devastating to malaria control and elimination.

For more information on Malaria Consortium’s role in helping to contain the spread of artemisinin resistance, please visit our Drug Resistance section.

Funding for malaria

 Funding for malaria control has increased dramatically in recent years, from $592 million in 2006 to over $1 billion in 2008, and $1.7 billion in 2009. The Roll Back Malaria Partnership estimates $5.2-$6 billion a year will be required to acheive  Global Malaria Action Plan targets for 2015. The current global recession is likely to decrease aid spending making funding for malaria uncertain.

History shows malaria control efforts must be sustained in order to be effective. In Sri Lanka malaria was nearly eliminated  by 1963, but eradication efforts were not sustained and the disease returned. By 1990 there were 250,000 cases. Fortunately, control measures were stepped up again and in 2008 there were only 673 reported. It is therefore crucial that financial contributions continue to grow to sustain malaria control programmes.