Who - World Malaria Report 2016

2016
WORLD MALARIA REPORT

a t l a s
p r o j e c t
WORLD MALARIA REPORT 2016
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World malaria report 2016.

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Contents
Foreword
Acknowledgements
Abbreviations
Key points
iv
vii
xi
xii
1. Global targets, milestones and indicators

2. Investments in malaria programmes and research
2
7
8
11
12
13
2.1 Total expenditure for malaria control and elimination

2.2 Funding for malaria-related research
2.3 Malaria expenditure per capita for malaria control and elimination
2.4 Commodity procurement trends
3. Preventing malaria
17
20
20
20
3.1 Population at risk sleeping under an insecticide-treated mosquito net

3.2 Targeted risk group receiving ITNs
3.3 Population at risk protected by indoor residual spraying
3.4 Population at risk sleeping under an insecticide-treated mosquito net or protected by indoor
residual spraying
3.5 Vector insecticide resistance
3.6 Pregnant women receiving three or more doses of intermittent preventive therapy
22
24
25
4. Diagnostic testing and treatment
27
4.1 Children aged under 5 years with fever for whom advice or treatment was sought from a trained
provider
4.2 Suspected malaria cases receiving a parasitological test
4.3 Suspected malaria cases attending public health facilities and receiving a parasitological test
4.4 Malaria cases receiving first-line antimalarial treatment according to national policy
4.5 ACT treatments among all malaria treatments
4.6 Parasite resistance
28
29
30
31
32
32
5. Malaria surveillance systems
35
36
37
6. Impact
39
40
42
45
46
47
48
50
50
Conclusions
References
Annexes
52
5.1 Health facility reports received at national level

5.2 Malaria cases detected by surveillance systems
6.1 Estimated number of malaria cases by WHO region, 20002015
6.2 Estimated number of malaria deaths by WHO region, 20002015
6.3 Parasite prevalence
6.4 Malaria case incidence rate
6.5 Malaria mortality rate
6.6 Malaria elimination and prevention of re-establishment
6.7 Malaria cases and deaths averted since 2000 and change in life expectancy
6.8 Economic value of reduced malaria mortality risk, estimated by full income approach
54
57
iii
Foreword
Dr Margaret Chan
Director-General
The World Malaria Report, published annually by WHO, provides an in-depth
analysis of progress and trends in the malaria response at global, regional and
country levels. It is the result of a collaborative effort with ministries of health in
affected countries and many partners around the world.
Our 2016 report spotlights a number of positive trends, particularly in sub-Saharan
Africa, the region that carries the heaviest malaria burden. It shows that, in many
countries, access to disease-cutting tools is expanding at a rapid rate for those
most in need.
Children are especially vulnerable, accounting for more than two thirds of global
malaria deaths. In 22 African countries, the proportion of children with a fever who
received a malaria diagnostic test at a public health facility increased by 77% over
the last 5 years. This test helps health providers swiftly distinguish between malarial
and non-malarial fevers, enabling appropriate treatment.
Malaria in pregnancy can lead to maternal mortality, anaemia and low birth
weight, a major cause of infant mortality. WHO recommends intermittent
preventive treatment in pregnancy, known as IPTp, for all pregnant women in
sub-Saharan Africa living in areas of moderate-to-high transmission of malaria.
The last 5 years have seen a five-fold increase in the delivery of three or more
doses of IPTp in 20 African countries.
Long-lasting insecticidal nets are the mainstay of malaria prevention. WHO
recommends their use for all people at risk of malaria. Across sub-Saharan Africa,
the proportion of people sleeping under treated nets has nearly doubled over the
last 5 years.
We have made excellent progress, but our work is incomplete. Last year alone,
the global tally of malaria reached 212 million cases and 429 000 deaths. Across
iv
Africa, millions of people still lack access to the tools they need to prevent and
treat the disease.
In many countries, progress is threatened by the rapid development and spread
of mosquito resistance to insecticides. Antimalarial drug resistance could also
jeopardize recent gains.
In 2015, the World Health Assembly endorsed the WHO Global Technical Strategy
for Malaria, a 15-year malaria framework for all countries working to control and
eliminate malaria. It sets ambitious but attainable goals for 2030, with milestones
along the way to track progress.
The Strategy calls for the elimination of malaria in at least 10 countries by the
year 2020 a target well within reach. According to this report, 10 countries and
territories reported fewer than 150 locally-acquired cases of malaria. A further
nine countries reported between 150 and 1000 cases.
But progress towards other global targets must be accelerated. The report finds
that less than half of the 91 malaria-affected countries are on track to achieve the
2020 milestones of a 40% reduction in case incidence and mortality.
To speed progress towards our global malaria goals, WHO is calling for new
and improved malaria-fighting tools. Greater investments are needed in the
development of new vector control interventions, improved diagnostics and more
effective medicines.
WHO announced that the worlds first malaria vaccine would be piloted in three
countries in sub-Saharan Africa. The vaccine, known as RTS,S, has been shown to
provide partial protection against malaria in young children. It will be evaluated as
a potential complement to the existing package of WHO-recommended malaria
preventive, diagnostic and treatment measures.
The need for more funding is an urgent priority. In 2015, malaria financing totalled
US$ 2.9 billion. To achieve our global targets, contributions from both domestic
and international sources must increase substantially, reaching US$ 6.4 billion
annually by 2020.
The challenges we face are sizeable but not insurmountable. Recent experience
has shown that with robust funding, effective programmes and country leadership,
progress in combatting malaria can be sustained and accelerated.
The potential returns are well worth the effort. With all partners united, we can
defeat malaria and improve the health of millions of people around the world.
vi
Acknowledgements
We are very grateful to the numerous people who contributed to the production
of the World Malaria Report 2016. The following people collected and reviewed
data from malaria endemic countries:
Ahmad Mureed and Fraidon Sediqi (Afghanistan); Lammali Karima (Algeria);
Pedro Rafael Dimbu and Yava Luvundo Ricardo (Angola); Giovanini Coelho and
Mario Zaidenberg (Argentina); Suleyman Mammadov (Azerbaijan); Anjan Kumar
Saha (Bangladesh); Carlos Ayala and Kim Bautista (Belize); Dos Santos Hounkpe
Bella (Benin); Tenzin Wangdi (Bhutan); Percy Halkyer and Ral Marcelo Manjn
Tellera (Bolivia [Plurinational State of]); Tjantilili Mosweunyane (Botswana);
Oscar Mesones Lapouble and Cassio Roberto Leonel Peterka (Brazil); Yacouba
Savadogo (Burkina Faso); Ndayizeye Flicien (Burundi); Antnio Lima Moreira
(Cabo Verde); Tol Bunkea (Cambodia); Kouambeng Celestin (Cameroon);
Christophe Ndoua (Central African Republic); Mahamat Idriss Djaskano (Chad);
Li Zhang (China); Gabriela Rey and Sandra Lorena Giron Vargas (Colombia);
Astafieva Marina (Comoros); Youndouka Jean Mermoz (Congo); Liliana Jimnez
Gutirrez and Enrique Prez-Flores (Costa Rica); Ehui Anicet and Parfait Katche
(Cte dIvoire); Kim Yun Chol (Democratic Peoples Republic of Korea); Joris
Losimba Likwela (Democratic Republic of the Congo); Luz A. Mercedes and Hans
Salas (Dominican Republic); Csar Daz and Adriana Estefana Echeverra Matute
(Ecuador); Ahmed El-Taher Khater (Egypt); Jaime Enrique Alemn Escobar and
Franklin Hernandez (El Salvador); Matilde Riloha (Equatorial Guinea); Selam
Mihreteab and Selam Mihreteab (Eritrea); Hiwot Solomon Taffese (Ethiopia);
Laure Garancher (French Guiana); Okome Nze Gyslaine (Gabon); Momodou
Kalleh (Gambia); Constance Bart-Plange (Ghana); Jaime Jurez and Erica Chvez
Vsquez (Guatemala); Nouman Diakite (Guinea); Jean Seme Fils Alexandre and
Quacy Grant (Guyana); Darlie Antoine and Moussa Thior (Haiti); Engels Ilich
Banegas Medina and Rosa Elena Meja (Honduras); A.C. Dhariwal (India); M.
Epid and Elvieda Sariwati (Indonesia); Leyla Faraji and Ahmad Raeisi (Iran [Islamic
Republic of]); Muthana Ibrahim Abdul Kareem (Iraq); Khalil Kanani (Jordan); James
Kiarie (Kenya); Almunther Alhasawi (Kuwait); Bouasy Hongvanthong (Lao Peoples
Democratic Republic); Najib Achi (Lebanon); Oliver J. Pratt (Liberia); Abdunnaser
Ali El-Buni (Libya); Rakotorahalahy Andry Joeliarijaona (Madagascar); Austin
Albert Gumbo (Malawi); Mohd Hafizi Bin Abdul Hamid (Malaysia); Diakalia
Kone (Mali); Mohamed Lemine Ould Khairy (Mauritania); Anita Bahena, Ezequiel
Daz Prez, Rosario Garca Surez and Hctor Olgun Bernal (Mexico); Souad
Bouhout (Morocco); Guidion Mathe (Mozambique); Aung Thi (Myanmar);
Mwalenga Nghipumbwa (Namibia); Rajendra Mishra and Uttam Raj Pyakurel
(Nepal); Martha Reyes and Ada Mercedes Soto Bravo (Nicaragua); Djermakoye
Hadiza Jackou (Niger); Audu Bala Mohammed (Nigeria); Majed Al-Zadjali (Oman);
Muhammad Suleman Memon (Pakistan); Margarita Ana Botello, Jos Lasso,
Carlos Victoria and Fernando Vizcano (Panama); John Deli (Papua New Guinea);
Miguel Angel Aragn and Cynthia Viveros (Paraguay); Mnica Guardo and Victor
Alberto Laguna Torres (Peru); Raffy Deray (Philippines); Maha Hammam Alshamali
(Qatar); Park Kyeongeun (Republic of Korea); Murindahabi Ruyange Monique
vii
(Rwanda); Jessica Da Veiga Soares (Sao Tome and Principe); Mohammed Hassan
Al-Zahrani (Saudi Arabia); Medoune Ndiop (Senegal); Samuel Juana Smith (Sierra
Leone); John Leaburi (Solomon Islands); Fahmi Essa Yusuf (Somalia); Bridget
Shandukani (South Africa); H.D.B. Herath (Sri Lanka); Abd Alla Ahmed Ibrahim
Mohammed (Sudan); Beatrix Jubithana and Juanita Malmberg (Suriname);
Zulisile Zulu (Swaziland); Nipon Chinanonwait (Thailand); Maria do Rosiro de
Fatima Mota (Timor-Leste); Tchadjobo Tchassama (Togo); Dhikrayet Gamara
(Tunisia); Damian Rutazaana (Uganda); Mary John (United Arab Emirates); Anna
Mahendeka (United Republic of Tanzania, [Mainland]); Abdul-wahid H. Al-mafazy
(United Republic of Tanzania [Zanzibar]); Esau Nackett (Vanuatu); Angel Manuel
Alvarez and Jesus Toro Landaeta (Venezuela [Bolivarian Republic of]); Nguyen Quy
Anh (Viet Nam); Moamer Badi (Yemen); Mercy Mwanza Ingwe (Zambia); Busisani
Dube and Wonder Sithole (Zimbabwe).
The following WHO staff in regional and subregional offices assisted in the design
of data collection forms; the collection and validation of data; and the review of
epidemiological estimates, country profiles, regional profiles and sections:
Birkinesh Amenshewa, Magaran Bagayoko, Steve Banza Kubenga and Issa
Sanou (WHO Regional Office for Africa [AFRO]); Spes Ntabangana (AFRO/
Inter-country Support Team [IST] Central Africa); Khoti Gausi (AFRO/IST East and
Southern Africa); Abderrahmane Kharchi Tfeil (AFRO/IST West Africa); Maria
Paz Ade, Janina Chavez, Rainier Escalada, Valerie Mize, Roberto Montoya, Eric
Ndofor and Prabhjot Singh (WHO Regional Office for the Americas [AMRO]);
Hoda Atta, Caroline Barwa and Ghasem Zamani (WHO Regional Office for the
Eastern Mediterranean [EMRO]); Elkhan Gasimov and Karen Taksoe-Vester (WHO
Regional Office for Europe [EURO]); Eva-Maria Christophel (WHO Regional Office
for South-East Asia [SEARO]); Rabindra Abeyasinghe, James Kelley, Steven Mellor
and Raymond Mendoza (WHO Regional Office for the Western Pacific [WPRO]).
Carol DSouza and Jurate Juskaite (Global Fund to Fight AIDS, Tuberculosis and
Malaria [Global Fund]) supplied information on financial disbursements from
the Global Fund. Adam Wexler (Kaiser Family Foundation) provided information
on financial contributions for malaria control from the United States of America.
Julie Wallace (United States Agency for International Development) and Iain Jones
(United Kingdom Department for International Development) reviewed financing
data from their respective agencies. Jeremy Lauer (WHO Department of Health
Systems Governance and Financing) edited the narrative on the economic
valuation of malaria mortality reduction. John Milliner (Milliner Global Associates)
provided information on long-lasting insecticidal nets delivered by manufacturers.
Peter Gething (University of Oxford), Samir Bhatt (Imperial College, University
of London) and the Malaria Atlas Project (MAP, www.map.ox.ac.uk) team, with
the support of the Bill & Melinda Gates Foundation and the Medical Research
Council (United Kingdom of Great Britain and Northern Ireland [United Kingdom]),
produced estimates of insecticide-treated mosquito net (ITN) coverage for African
countries using data from household surveys, ITN deliveries by manufacturers, ITNs
distributed by national malaria control programmes (NMCPs), and ITN coverage
indicators. They also produced estimates of Plasmodium falciparum parasite
prevalence in sub-Saharan Africa. Catherine Moyes and Antoinette Wiebe (MAP)
and Christen Fornadel (United States Presidents Malaria Initiative) provided data
on insecticide resistance and Anna Trett assisted with data compilation. Liliana
Carvajal and Valentina Buj (United Nations Childrens Fund [UNICEF]) reviewed
data and texts and made suggestions for improvement.
viii
Acknowledgements
Michael Lynch, John Painter and Nelli Westercamp (United States Centers for
Disease Control and Prevention) and Cristin Fergus (London School of Economics,
University of London) provided data analysis and interpretation for sections
on chemoprevention, diagnostic testing and treatment. Adam Bennett (Global
Health Group), Donal Bisanzio and Peter Gething (MAP) and Thom Eisele (Tulane
University) produced analysis of malaria treatment from household surveys. Li Liu
(Johns Hopkins Bloomberg School of Public Health), Dan Hogan and Colin Mathers
(WHO Department of Health Statistics and Information Systems) prepared estimates
of malaria mortality in children aged under 5 years, on behalf of the Child Health
Epidemiology Reference Group, and undertook calculations on life expectancy.
The maps for country and regional profiles were produced by MAPs ROADMAPII team; led by Mike Thorn, the team comprised Harry Gibson, Naomi Gray,
Joe Harris, Andy Henry, Annie Kingsbury, Daniel Pfeffer and Jen Rozier. MAP is
supported by the Bill & Melinda Gates Foundation and the Medical Research
Council (United Kingdom).
We are also grateful to:
Melanie Renshaw (African Leaders Malaria Alliance [ALMA]), Trenton Ruebush

(independent consultant) and Larry Slutsker (Program for Appropriate
Technology in Health [PATH]), who graciously reviewed all sections and
provided substantial comments for their improvement;
Claudia Nannini (WHO) for legal review;
Carlota Gui (WHO consultant) and Laurent Bergeron (WHO Global Malaria
Programme) for the translation into Spanish and French, respectively, of the
foreword and key points;
Claude Cardot and the Designisgood team for the design and layout of the
report;
Paprika (Annecy, France) for generating Annex 4;
Alex Williamson for the report cover; and
Hilary Cadman and the Cadman Editing Services team for technical editing of
the report.
The production of the World Malaria Report 2016 was coordinated by Richard
Cibulskis (WHO Global Malaria Programme). Laurent Bergeron (WHO Global
Malaria Programme) provided programmatic support for overall management of
the project. The World Malaria Report 2016 was produced by John Aponte (WHO
consultant), Maru Aregawi, Laurent Bergeron, Richard Cibulskis, Jane Cunningham,
Tessa Knox, Edith Patouillard, Pascal Ringwald, Silvia Schwarte, Saira Stewart and
Ryan Williams, on behalf of the WHO Global Malaria Programme. We are grateful
to our colleagues in the Global Malaria Programme who reviewed sections of the
report and provided helpful comments: Pedro Alonso, Amy Barrette, Andrea Bosman,
Gawrie Loku Galappaththy, Abdisalan Noor, Peter Olumese, Leonard Ortega, Camille
Pillon, Charlotte Rasmussen, Vasee Sathiyamoorthy and David Schellenberg. We also
thank Hiwot Taffese Negash and Simone Colairo-Valerio for administrative support.
Funding for the production of this report was gratefully received from the Bill
& Melinda Gates Foundation; Luxembourgs Ministry of Foreign and European
Affairs Directorate for Development Cooperation and Humanitarian Affairs; the
Spanish Agency for International Development Cooperation; the Swiss Agency for
Development and Cooperation through a grant to the Swiss Tropical and Public
Health Institute; and the United States Agency for International Development.
ix
Abbreviations
ACT
artemisinin-based combination
therapy
P.
Plasmodium
AIDS
acquired immunodeficiency
syndrome
PMI
Presidents Malaria Initiative
PPP
purchasing power parity
RDT
rapid diagnostic test
SDG
Sustainable Development Goal

seasonal malaria chemoprevention
AIM
Action and investment to defeat

malaria 20162030
AMFm
Affordable Medicine Facility

malaria
SMC
ANC
antenatal care
SP sulfadoxine-pyrimethamine
UI
uncertainty interval
AQ amodiaquine
UN
United Nations
CDC
Centers for Disease Control and

Prevention
UNICEF
United Nations Childrens Fund
CI
confidence interval
USA
United States of America
cITN
conventional insecticide-treated net
USAID
United States Agency for

International Development
CRS
creditor reporting system
VSL
value of a statistical life
DAC
Development Assistance Committee
WHO
WTA
willingness to accept
DDT dichloro-diphenyl-trichloroethane
GDP
gross domestic product
Global Fund
Global Fund to Fight AIDS,

Tuberculosis and Malaria
GTS
Global Technical Strategy for

Malaria 20162030
Abbreviations of WHO regions andoffices

AFR
WHO African Region
HIV
human immunodeficiency virus
AFRO
WHO Regional Office for Africa
HRP2
histidine rich protein 2
AMR
WHO Region of the Americas
IPTi
intermittent preventive treatment in

infants
AMRO
WHO Regional Office for the

Americas
IPTp
intermittent preventive treatment in

pregnancy
EMR
WHO Eastern Mediterranean Region
IQR
interquartile range
EMRO
WHO Regional Office for the Eastern

Mediterranean
IRS
indoor residual spraying
EUR
WHO European Region
ITN
insecticide-treated mosquito net
EURO
WHO Regional Office for Europe
LLIN
long-lasting insecticidal net
SEAR
WHO South-East Asia Region
M&E
monitoring and evaluation
SEARO
NMCP
national malaria control

programme
WHO Regional Office for South-East

Asia
WPR
WHO Western Pacific Region
OECD
Organisation for Economic

Co-operation and Development
WPRO
WHO Regional Office for the

Western Pacific
xi
Key points
1. Global targets, milestones and indicators
The targets of the Global Technical Strategy for Malaria 20162030 (GTS) are,
by 2030: to reduce malaria incidence and mortality rates globally by at least
90% compared with 2015 levels; to eliminate malaria from at least 35 countries
in which malaria was transmitted in 2015; and to prevent re-establishment of
malaria in all countries that are malaria free.
For malaria, Target 3.3 of the Sustainable Development Goals (SDGs) to end
the epidemics of AIDS, TB, malaria and neglected tropical diseases (NTDs) by
2030 is interpreted by WHO as the attainment of the GTS targets.
To track progress of the GTS, the World Malaria Report 2016 presents
information on 26 indicators.
The World Malaria Report is produced by the WHO Global Malaria Programme,
with the help of WHO regional and country offices, ministries of health in
endemic countries and a broad range of other partners.
The primary sources of information are reports from 91 endemic countries. This
information is supplemented by data from nationally representative household
surveys and databases held by other organizations.
2. Investments in malaria programmes and research
xii
Total funding for malaria control and elimination in 2015 is estimated at

US$2.9billion, having increased by US$ 0.06 billion since 2010. This total
represents just 46% of the GTS 2020 milestone of US$ 6.4 billion.
Governments of endemic countries provided 32% of total funding in 2015, of

which US$ 612 million was direct expenditures through national malaria control
programmes (NMCPs) and US$ 332 million was expenditures on malaria patient
care.
The United States of America is the largest single international funder of malaria
control activities, accounting for an estimated 35% of global funding in 2015,
followed by the United Kingdom of Great Britain and Northern Ireland (16%),
France (3.2%), Germany (2.4%), Japan (2.3%), Canada (1.7%), the Bill & Melinda
Gates Foundation (1.2%) and European Union institutions (1.1%). About one half
of this international funding (45%) is channelled through the Global Fund to Fight
AIDS, Tuberculosis and Malaria (Global Fund).
Spending on research and development for malaria was estimated at

US$611million in 2014 (the latest year for which data are available), increasing
from US$ 607 million in 2010, and representing more than 90% of the GTS
annual investment target of US$ 673 million.
Countries with the highest number of malaria cases are furthest from the per
capita spending milestones for 2020 set in the GTS.
Vector control
The proportion of the population at risk in sub-Saharan Africa sleeping under

an insecticide-treated mosquito net (ITN) or protected by indoor residual
spraying (IRS) is estimated to have risen from 37% in 2010 (uncertainty interval
[UI]: 2548%) to 57% in 2015 (UI: 4470%).
In sub-Saharan Africa, 53% of the population at risk slept under an ITN in 2015
(95% confidence interval [CI]: 5057%), increasing from 30% in 2010 (95% CI:
2832%),
The rise in the proportion of people at risk sleeping under an ITN has been
driven by an increase in the proportion of the population with access to an ITN
(60% in 2015, 95% CI: 5764%; 34% in 2010, 95% CI: 3235%).
The proportion of households with at least one ITN increased to 79% in 2015
(95% CI: 7683); thus, a fifth of households where ITNs are the main method of
vector control do not have access to a net.
The proportion of households with sufficient ITNs for all household members
was 42% (95% CI: 3945%).
IRS is generally used by NMCPs only in particular areas. The proportion of the
population at risk protected by IRS declined from a peak of 5.7% globally in 2010
to 3.1% in 2015, and from 10.5% to 5.7% in sub-Saharan Africa.
Reductions in IRS coverage may be attributed to cessation of spraying with

pyrethroids, particularly in the WHO African Region.
Of 73 malaria endemic countries that provided monitoring data for 2010

onwards, 60 reported resistance to at least one insecticide, and 50 reported
resistance to two or more insecticide classes.
Resistance to pyrethroids the only class currently used in ITNs is the most
commonly reported. A WHO-coordinated five-country evaluation showed that
ITNs still remained effective but there is still a need for new vector control tools.
Intermittent preventive therapy in pregnancy
In 2015, 31% of eligible pregnant women received three or more doses of

intermittent preventive treatment in pregnancy (IPTp) among 20 countries with
sufficient data, a major increase from 6% in 2010.
4. Diagnostic testing and treatment

Access to care
Among 23 nationally representative surveys completed in sub-Saharan Africa

between 2013 and 2015 (representing 61% of the population at risk), a median of
54% of febrile children aged under 5 years (interquartile range [IQR]: 4159%)
were taken to a trained provider.
xiii
A higher proportion of febrile children sought care in the public sector (median:
42%, IQR: 3150%) than in the private sector (median: 20%, IQR: 1228%).
A large proportion of febrile children were not brought for care (median: 36%,
IQR: 2642%).
Diagnostic testing
The proportion of febrile children who received a malaria diagnostic test was
greater if they sought care in the public sector (median: 51%, IQR: 3560%)
than if the children sought care in the formal private sector (median: 40%,
IQR: 2857%) or in the informal private sector (median: 9%, IQR: 412%). The
proportion receiving a test in the public sector has increased from 29% in 2010
(IQR: 1946%).
Data reported by NMCPs indicate that the proportion of suspected malaria

cases receiving a parasitological test in the public sector increased from 40% of
suspected cases in the WHO African Region in 2010 to 76% in 2015. This increase
was primarily due to an increase in the use of rapid diagnostic tests (RDTs),
which accounted for 74% of diagnostic testing among suspected cases in 2015.
HRP2 deletions, which allow malaria parasites to evade detection by common

RDTs, have been reported from more than 10 countries.
Treatment
xiv
Among 11 nationally representative household surveys conducted in sub-Saharan

Africa from 2013 to 2015, the median proportion of children aged under 5 years
with evidence of recent or current Plasmodium falciparum infection and a
history of fever, who received any antimalarial drug, was 30% (IQR: 2051%).
The median proportion receiving an artemisinin-based combination therapy
(ACT) was 14% (IQR: 545%). However, no clear conclusions can be drawn
from these findings because the ranges associated with the medians are wide,
indicating large variation among countries; in addition, the household surveys
cover only a third of the population at risk in sub-Saharan Africa.
Further investments are needed to better track malaria treatment at health

facilities (through routine reporting systems and health facility surveys) and
at community level to better understand the extent of barriers to accessing
malaria treatment.
The proportion of antimalarial treatments that are ACTs given to children with
both a fever in the previous 2 weeks and a positive RDT at the time of survey
increased from a median of 29% in 20102012 (IQR: 1755%) to 80% in 20132015
(IQR: 2995%).
Antimalarial treatments were more likely to be ACTs if children sought treatment

at public health facilities or via community health workers than if they sought
treatment in the private sector.
Plasmodium falciparum resistance to artemisinin has been detected in five

countries in the Greater Mekong subregion. In Cambodia, high failure rates
after treatment with an ACT have been detected for four different ACTs.
Key points
The proportion of health facility reports received at national level exceeded

80% in 40 of the 47 countries that reported on this indicator.
This indicator could not be calculated for 43 countries, either because the
number of health facilities that were expected to report was not specified
(two countries) or because the number of reports submitted was not stated
(17countries), or both (24 countries).
A total of 23 countries received reports from private health facilities, but these
comprised a minority of all reports received in these countries (median: 2.1%,
IQR: 0.613%).
In 2015, it is estimated that malaria surveillance systems detected 19% of cases

that occur globally (UI: 1621%).
The bottlenecks in case detection vary by country and WHO region. In four WHO
regions a large proportion of patients seek treatment in the private sector and
these cases are not captured by existing surveillance systems. In three WHO
regions a relatively low proportion of patients attending public health facilities
also receive a diagnostic test.
Case detection rates have improved since 2010 (10%), with most of the
improvement being due to increased diagnostic testing in sub-Saharan Africa.
6. Impact
Parasite prevalence
The proportion of the population at risk in sub-Saharan Africa who are infected
with malaria parasites is estimated to have declined from 17% in 2010 to 13% in
2015 (UI: 1115%).
The number of people infected with malaria parasites in sub-Saharan Africa

is estimated to have decreased from 131 million in 2010 (UI: 126136 million) to
114 million in 2015 (UI: 99130 million).
Infection rates are higher in children aged 210 years, but most infected people
are in other age groups.
Case incidence
In 2015, an estimated 212 million cases of malaria occurred worldwide (UI:

148304 million).
Most of the cases in 2015 were in the WHO African Region (90%), followed by
the WHO South-East Asia Region (7%) and the WHO Eastern Mediterranean
Region (2%).
About 4% of estimated cases globally are due to P. vivax, but outside the African
continent the proportion of P. vivax infections is 41%.
The incidence rate of malaria is estimated to have decreased by 41% globally

between 2000 and 2015, and by 21% between 2010 and 2015.
xv
Of 91 countries and territories with malaria transmission in 2015, 40 are

estimated to have achieved a reduction in incidence rates of 40% or more
between 2010 and 2015, and can be considered on track to achieve the GTS
milestone of a further reduction of 40% by 2020.
Reductions in case incidence rates need to be accelerated in countries with high

case numbers if the GTS milestone of a 40% reduction in case incidence rates
by 2020 is to be achieved.
Mortality
In 2015, it was estimated that there were 429 000 deaths from malaria globally
(UI: 235 000639 000).
Most deaths in 2015 are estimated to have occurred in the WHO African Region
(92%), followed by the WHO South-East Asia Region (6%) and the WHO Eastern
Mediterranean Region (2%).
The vast majority of deaths (99%) are due to P. falciparum malaria. Plasmodium
vivax is estimated to have been responsible for 3100 deaths in 2015 (range:
18004900), with 86% occurring outside Africa.
In 2015, 303 000 malaria deaths (range: 165 000450 000) are estimated to
have occurred in children aged under 5 years, which is equivalent to 70% of
the global total. The number of malaria deaths in children is estimated to have
decreased by 29% since 2010, but malaria remains a major killer of children,
taking the life of a child every 2 minutes.
Malaria mortality rates are estimated to have declined by 62% globally between
2000 and 2015 and by 29% between 2010 and 2015. In children aged under
5years, they are estimated to have fallen by 69% between 2000 and 2015 and
by 35% between 2010 and 2015.
Of 91 countries and territories with malaria transmission in 2015, 39 are estimated

to have achieved a reduction of 40% or more in mortality rates between 2010
and 2015. A further 10 countries had zero indigenous deaths in 2015.
If the GTS milestone of a 40% reduction in mortality rates is to be achieved by

2020, rates of mortality reduction must increase in countries with high numbers
of deaths.
Elimination
xvi
Between 2000 and 2015, 17 countries eliminated malaria (i.e. attained zero
indigenous cases for 3 years or more); six of these countries have been certified
as malaria free by WHO.
In progressing to malaria elimination, the 17 countries reported a median of

184 indigenous cases 5 years before attaining zero cases (IQR: 78728) and
a median of 1748 cases 10 years before attaining zero cases (IQR: 4235731).
In 2015, 10 countries and territories reported fewer than 150 indigenous cases
and a further nine countries reported between 150 and 1000 indigenous cases.
Thus, there appears to be a good prospect of attaining the GTS milestone of
eliminating malaria from 10 countries by 2020.
Key points
Malaria has not been re-established in any of the countries that eliminated
malaria between 2000 and 2015.
Reduced malaria mortality, increased life expectancy and economic valuation
Between 2001 and 2015, it is estimated that a cumulative 6.8 million fewer
malaria deaths have occurred globally than would have occurred had incidence
and mortality rates remained unchanged since 2000.
The highest proportion of deaths was averted in the WHO African Region (94%).
Of the estimated 6.8 million fewer malaria deaths between 2001 and 2015,
about 6.6 million (97%) were for children aged under 5 years.
Not all of the deaths averted can be attributed to malaria control efforts. Some
progress is probably related to increased urbanization and overall economic
development, which has led to improved housing and nutrition.
As a consequence of reduced malaria mortality rates, particularly among

children aged under 5 years, it is estimated that life expectancy at birth has
increased by 1.2 years in the WHO African Region. This increase represents 12%
of the total increase in life expectancy of 9.4 years seen in sub-Saharan Africa,
from 50.6 years in 2000 to 60 years in 2015.
Globally, reductions in malaria mortality have led to an increase in life

expectancy of 0.26 years in malaria endemic countries, representing 5% of the
overall gain of 5.1 years.
Current methodologies suggest that the increased life-expectancy resulting

from malaria mortality reductions observed between 2000 and 2015 can be
valued at US$ 1810 billion in the WHO African Region (UI: US$13302480billion),
which is equivalent to 44% of the gross domestic product (GDP) of the affected
countries in 2015.
Globally, the malaria mortality reductions are valued at US$ 2040 billion (UI:
US$ 15602700 billion), which is 3.6% of the total GDP of malaria affected
countries.
The economic value of longer life is expressed as a percentage of GDP to provide

a convenient and well-known comparison, but is not meant to suggest that the
value of longevity is itself a component of domestic output, or that the value
of these gains enter directly into the national income accounts. Nonetheless,
the comparison suggests that the value of the gains in life expectancy due to
reductions in malaria mortality are substantial.
xvii
Avant-propos
Dr Margaret Chan
Directeur gnral
de lOrganisation mondiale de la Sant
(OMS)
Le Rapport sur le paludisme dans le monde, publi chaque anne par lOMS,
fournit une analyse dtaille des progrs et des tendances de la lutte contre le
paludisme au niveau mondial, rgional et national. Il sagit l du produit dun
effort collaboratif entre les ministres de la Sant des pays endmiques et de
nombreuses organisations partenaires dans le monde.
Notre rapport 2016 met en lumire plusieurs tendances positives, notamment
en Afrique subsaharienne o la maladie svit le plus. Il indique que laccs aux
interventions prventives et thrapeutiques augmente rapidement parmi les
populations qui en ont le plus besoin et ce, dans nombre de pays.
Les enfants sont particulirement vulnrables; ils reprsentent plus des deux
tiers des dcs dus au paludisme dans le monde. Des enqutes ralises dans
22 pays africains montrent que le pourcentage denfants ayant t soumis
un test de diagnostic du paludisme au sein dtablissements de soins publics a
augment de 77 % ces cinq dernires annes. Ce test permet aux prestataires de
sant de rapidement diffrencier les fivres palustres des autres, ce qui garantit
ladministration dun traitement appropri.
Le paludisme pendant la grossesse peut avoir des consquences dramatiques:
mortalit maternelle, anmie et enfants prsentant un poids insuffisant la
naissance, une cause principale de mortalit nonatale. LOMS recommande le
traitement prventif intermittent pendant la grossesse (TPIp) toutes les femmes
enceintes dAfrique subsaharienne vivant dans des zones de transmission modre
leve. Au cours des cinq dernires annes, le taux dadministration dau moins
trois doses de TPIp a t multipli par cinq dans 20 pays africains au total.
Les moustiquaires imprgnes dinsecticide longue dure sont essentielles la
prvention du paludisme et lOMS en recommande lutilisation lensemble de la
population risque. En Afrique subsaharienne, le pourcentage de la population
dormant sous moustiquaire a quasiment doubl ces cinq dernires annes.
xviii
Les progrs raliss sont excellents, mais il reste beaucoup faire. Pour la seule
anne 2015, les estimations font tat de 212millions de cas de paludisme et de
429000 dcs associs. En Afrique, la population nayant toujours pas accs aux
outils ncessaires pour prvenir et traiter la maladie se compte par millions.
Dans de nombreux pays, les progrs sont menacs par le dveloppement et
la propagation rapides de la rsistance des moustiques aux insecticides. La
rsistance aux antipaludiques pourrait aussi mettre en pril les avances rcentes.
En 2015, lAssemble mondiale de la Sant a approuv la Stratgie technique
mondiale de lutte contre le paludisme, un cadre oprationnel dune dure de
15ans pour tous les pays engags dans le contrle et llimination du paludisme.
Cette stratgie dfinit des cibles ambitieuses et nanmoins ralisables pour 2030,
avec des objectifs intermdiaires permettant un suivi des progrs.
Cette stratgie vise liminer le paludisme dans au moins 10 pays dici 2020, ce
qui semble ralisable. Le prsent rapport indique en effet que 10 pays et territoires
ont rapport moins de 150 cas de paludisme transmis localement, et que 9 autres
en ont recens entre 150 et 1000.
Nanmoins les progrs relatifs aux autres cibles mondiales doivent sacclrer.
Daprs ce rapport, plus de la moiti des 91 pays endmiques ne sont pas en voie
datteindre les objectifs de 40% de rduction de lincidence du paludisme et de
la mortalit associe dici 2020.
Pour acclrer les progrs vers les cibles mondiales lies au paludisme, lOMS
demande expressment le dveloppement de nouveaux outils antipaludiques
et lamlioration de larsenal existant. Des investissements plus importants sont
ncessaires pour mettre au point de nouvelles interventions de lutte antivectorielle,
des outils de diagnostic amliors et des mdicaments plus efficaces.
Le mois dernier, lOMS a annonc la mise en place de projets pilotes dans trois
pays dAfrique subsaharienne concernant le premier vaccin antipaludique. Ce
vaccin, RTS, S, a dmontr une protection partielle contre le paludisme chez les
jeunes enfants; il sera valu en tant quoutil complmentaire larsenal de
mesures recommandes par lOMS en matire de prvention, de diagnostic et
de traitement du paludisme.
Il est prioritaire et urgent daugmenter le financement de la lutte contre le
paludisme, estim US$ 2,9milliards en 2015. Pour atteindre les cibles mondiales,
les investissements nationaux et internationaux doivent en effet atteindre
US$6,4milliards par an dici 2020.
Les obstacles face nous ne sont ni ngligeables ni insurmontables. Lexprience
rcente a dmontr quavec des financements solides, des programmes efficaces
et un leadership national fort, les progrs en matire de lutte contre le paludisme
peuvent tre maintenus et acclrs.
Les perspectives de retour sur investissement sont sduisantes. Avec lensemble
des partenaires runis, nous pouvons vaincre le paludisme et amliorer la sant
de millions de personnes dans le monde.
xix
Points essentiels
1. Cibles, objectifs intermdiaires et indicateurs au niveau

mondial
Les cibles dfinies par la Stratgie technique mondiale de lutte contre le

paludisme 2016-2030 (le GTS) pour 2030 sont les suivantes: rduire, au
plan mondial, lincidence du paludisme et la mortalit associe dau moins
90% par rapport 2015, liminer le paludisme dans au moins 35 pays o il
y avait transmission en 2015 et empcher la rapparition du paludisme dans
tous les pays exempts.
Concernant le paludisme, la cible 3.3 des Objectifs de dveloppement durable,

savoir mettre fin lpidmie de sida, la tuberculose, au paludisme et aux
maladies tropicales ngliges dici 2030, est interprte par lOrganisation
mondiale de la Sant (OMS) comme latteinte des cibles du GTS.
Pour suivre les progrs raliss par rapport au GTS, le Rapport sur le paludisme
dans le monde dcrit les avances ralises par rapport 26 indicateurs.
Le Rapport sur le paludisme dans le monde est produit par le Programme

mondial de lutte antipaludique cr par lOMS, en collaboration avec les
bureaux nationaux et rgionaux de lOMS, les ministres de la Sant des pays
endmiques et de nombreuses organisations partenaires.
Les principales sources de donnes sont les rapports manant de 91 pays et

territoires endmiques, compltes par des informations issues des enqutes
nationales ralises auprs des mnages et des bases de donnes provenant
dautres organisations.
2. Investissements dans les programmes et la recherche

antipaludiques
xx
En 2015, le financement mondial pour le contrle et llimination du paludisme

a t estim US$ 2,9milliards, soit US$ 60millions de plus quen 2010.
Cemontant ne reprsente que 46% de lobjectif intermdiaire fix par le GTS
US$ 6,4milliards pour 2020.
Les gouvernements des pays endmiques ont contribu hauteur de 32% du

total des financements en 2015, dont US$ 612millions de dpenses directes
par le biais des programmes nationaux de lutte contre le paludisme (PNLP) et
US$332millions en prise en charge des patients souffrant dinfections palustres.
Avec une contribution estime 35% du financement mondial de la lutte contre

le paludisme en 2015, les tats-Unis arrivent en tte des bailleurs de fonds
individuels, suivis par le Royaume-Uni de Grande-Bretagne et dIrlande du
Nord (16%), la France (3,2%), lAllemagne (2,4%), le Japon (2,3%), le Canada

(1,7 %), la Fondation Bill & Melinda Gates (1,2%) et les institutions de lUnion
Europenne(1,1%). Environ la moiti de ce financement international (45%)
transite par le Fonds mondial de lutte contre le sida, la tuberculose et le
paludisme (Fonds mondial).
Les dpenses en matire de recherche et de dveloppement pour lutter contre

le paludisme ont t estimes US$ 611millions en 2014 (lanne la plus rcente
pour laquelle des donnes sont disponibles), contre US$ 607millions en 2010,
ce qui reprsente plus de 90% de lobjectif dinvestissements annuels fix
US$673millions par le GTS.
Les pays ayant le plus de cas de paludisme sont aussi ceux o les dpenses
nationales (rapportes au nombre dhabitants) sont les plus loignes de
lobjectif dfini par le GTS pour 2020.
3. Prvention du paludisme
Lutte antivectorielle
En Afrique subsaharienne, le pourcentage de la population risque dormant

sous moustiquaire imprgne dinsecticide (MII) ou ayant bnfici de la
pulvrisation intradomiciliaire dinsecticides effet rmanent (PID) aurait
augment de 37% en 2010 (incertitude comprise entre 25% et 48%) 57% en
2015 (incertitude: 44%-70%).
En Afrique subsaharienne, 53% de la population risque dort sous moustiquaire

en 2015 (intervalle de confiance [IC] de 95%: 50%-57%), contre 30% en 2010
(IC de 95%: 28%-32%).
Laugmentation du pourcentage de la population risque dormant sous MII est

due un accs accru aux moustiquaires (60% en 2015, IC de 95%: 57%-64%;
34% en 2010, IC de 95%: 32%-35%).
Le pourcentage des mnages possdant au moins une MII a augment,

pour atteindre 79% en 2015 (IC de 95%: 76%-83%); en dautres termes, un
cinquime des mnages pour lesquels les MII sont le principal moyen de lutte
antivectorielle nont pas accs une moustiquaire.
Le pourcentage des mnages avec un nombre de MII suffisant pour couvrir

tous les membres du foyer slve 42% (IC de 95%: 39%-45%).
La PID est gnralement utilise par les PNLP dans des zones spcifiques
uniquement. Le pourcentage de la population risque protge par PID a
baiss, passant dun pic de 5,7% au niveau mondial en 2010 3,1% en 2015, et
de 10,5% 5,7% en Afrique subsaharienne.
La baisse de la couverture en PID peut tre attribue larrt de la pulvrisation

base de pyrthodes, en particulier dans la rgion Afrique de lOMS.
Sur 73 pays endmiques ayant communiqu des donnes de suivi partir de

2010, 60 ont signal une rsistance au moins une classe dinsecticides, et 50
deux classes au moins.
La rsistance aux pyrthodes, la seule classe dinsecticides actuellement

utilise pour les MII, est la plus frquente. Quand bien mme une valuation
coordonne par lOMS dans cinq pays a montr que les moustiquaires taient
toujours efficaces, de nouveaux outils de lutte antivectorielle sont ncessaires.
xxi
Traitement prventif intermittent pendant la grossesse
Dans 20 pays disposant de donnes suffisantes, 31% des femmes enceintes

ligibles ont reu au moins trois doses de traitement prventif intermittent
pendant la grossesse (TPIp) en 2015, contre 6% en 2010.
4. Diagnostic et traitement
Accs aux soins
Sur 23 enqutes reprsentatives au niveau national et ralises en Afrique

subsaharienne entre2013 et2015 (reprsentant 61% de la population risque),
une mdiane de 54% des enfants de moins de 5 ans ayant eu de la fivre (cart
interquartile [I]: 41%-59%) ont t orients vers un prestataire de sant form.
Le pourcentage des enfants fivreux ayant sollicit des soins dans le secteur
public est plus important que dans le secteur priv, savoir une mdiane de
42% (I: 31%-50%) contre 20% (I: 12%-28%).
Le pourcentage denfants fivreux nayant pas sollicit de soins est important

(mdiane de 36%, I: 26%-42%).
Diagnostic
Le pourcentage denfants fivreux ayant t soumis un test de diagnostic est

plus important dans le secteur public (mdiane de 51%, I: 35%-60%) que
dans le secteur priv formel (mdiane de 40%, I: 28%-57%) ou le secteur
priv informel (mdiane de 9%, I: 4%-12%). Le pourcentage denfants ayant
t soumis un test dans le secteur public est en augmentation, car il tait de
29% en 2010 (I: 19%-46%).
Les donnes rapportes par les PNLP indiquent que le pourcentage de cas
suspects de paludisme soumis un test parasitologique dans le secteur
public a augment de 40% dans la rgion Afrique de lOMS 76% en 2015.
Cette hausse est principalement due une plus grande utilisation des tests de
diagnostic rapide (TDR) qui reprsentent 74% des moyens de dpistage parmi
les cas suspects de paludisme en 2015.
La suppression de la HRP2, permettant aux parasites du paludisme dchapper

la dtection par les tests de diagnostic rapide habituels, a t rapporte dans
plus de 10 pays.
Traitement
xxii
Sur 11 enqutes nationales ralises auprs des mnages entre2013 et2015

en Afrique subsaharienne, le pourcentage mdian des enfants de moins de
5 ans prsentant, ou ayant rcemment prsent une infection Plasmodium
(P.) falciparum avec des antcdents de fivre et ayant reu un mdicament
antipaludique slve 30% (I: 20%-51%). Le pourcentage mdian ayant
reu une combinaison thrapeutique base dartmisinine (ACT) est de
14% (I: 5%-45%). Ces rsultats ne permettent nanmoins de tirer aucune
conclusion prcise; en effet, les plages associes aux valeurs mdianes sont
larges, indiquant des carts importants entre pays. Par ailleurs, ces enqutes
ralises auprs des mnages ne couvrent quun tiers de la population risque
en Afrique subsaharienne.
Points essentiels
Des financements plus importants sont ncessaires pour mieux suivre laccs
au traitement antipaludique au niveau des tablissements de soins (par le biais
des systmes de reporting de routine et des enqutes auprs des tablissements
de soins) et au niveau communautaire et ce, dans le but de mieux mesurer
lampleur des obstacles.
Le pourcentage dACT parmi les traitements antipaludiques administrs

aux enfants ayant eu de la fivre dans les 2 semaines prcdant lenqute
et eu un rsultat positif au TDR au moment de lenqute a augment dune
valeur mdiane de 29% en 2010-2012 (I: 17%-55%) 80% en 2013-2015 (I:
29%-95%).
Le traitement antipaludique tait plus susceptible dtre par ACT si les enfants
sollicitaient des soins dtablissements de soins publics ou dagents de sant
communautaires que sils sorientaient vers le secteur priv.
La rsistance du parasite Plasmodium falciparum lartmisinine a t dtecte

dans cinq pays de la sous-rgion du Grand Mkong. Au Cambodge, des taux
dchec au traitement ont t observs pour quatre types dACT.
5. Systmes de surveillance du paludisme
Le pourcentage de rapports reus au niveau national et provenant des

tablissements de soins a dpass 80% dans 40 des 47 pays ayant donn des
informations sur cet indicateur.
Cet indicateur na pas pu tre calcul pour 43 pays et ce, pour diffrentes
raisons: ou il ntait pas mentionn combien dtablissements de soins devaient
rapporter (le cas pour 2 pays), ou le nombre de rapports soumis ntait pas
indiqu (le cas pour 17 pays), ou les deux (24 pays).
Au total, 23 pays ont reu des rapports de la part des tablissements de soins
privs, mais ces rapports ne reprsentent quune minorit de tous les rapports
reus dans ces pays (valeur mdiane: 2,1%, I: 0,6%-13%).
En 2015, il est estim que les systmes de surveillance du paludisme ont dtect
19% des cas au niveau mondial (incertitude: 16%-21%).
Les obstacles au dpistage des cas ne sont pas les mmes dun pays et dune
rgion de lOMS lautre. Dans quatre dentre elles, une large proportion des
patients sollicitent un traitement dans le secteur priv, et ces cas ne sont pas
capturs par les systmes de surveillance existants. Dans trois rgions de lOMS,
une part relativement faible des patients se rendant dans des tablissements
de soins publics reoivent un test de diagnostic.
Le taux de dpistage des cas a augment depuis 2010 (10%), principalement

en raison de lintensification du diagnostic en Afrique subsaharienne.
6. Impact
Prvalence parasitaire
Le pourcentage dinfections palustres parmi la population risque en Afrique

subsaharienne est estime en baisse, passant de 17% en 2010 13% en 2015
(incertitude: 11%-15%).
xxiii
En Afrique subsaharienne, le nombre de patients atteints dinfections palustres

aurait diminu de 131millions en 2010 (incertitude: 126-136 millions) 114millions
en 2015 (incertitude: 99-130 millions).
Le taux dinfection est plus lev chez les enfants de 2 10 ans; nanmoins la
plupart des infections (74%) concernent les tranches dge suprieures.
Incidence des cas

Au niveau mondial, le nombre de cas de paludisme est estim 212millions en
2015 (incertitude: 148-304millions).
En 2015, la plupart des cas (90%) ont t enregistrs dans la rgion Afrique de
lOMS, loin devant la rgion Asie du Sud-Est (7%) et la rgion Mditerrane
orientale (2%) de lOMS.
Les infections P. vivax sont estimes responsables denviron 4% des cas de
paludisme dans le monde mais, hors Afrique, cette proportion atteint 41%.
Au niveau mondial, lincidence du paludisme aurait diminu de 41% entre2000
et2015, et de 21% entre2010 et2015.
Entre2010 et2015, lincidence du paludisme aurait diminu dau moins 40%
dans 40 des 91 pays et territoires o la transmission du paludisme reste active
en 2015. On peut donc considrer que ces pays et territoires sont en bonne voie
pour atteindre une rduction de 40% dici 2020, qui est un objectif intermdiaire
du GTS.
Pour atteindre cet objectif dici 2020, la baisse doit sacclrer dans les pays o
lincidence du paludisme est la plus leve.
Mortalit
xxiv
Au niveau mondial, le nombre de dcs dus au paludisme a t estim

429000 en 2015 (incertitude: 235000-639000).
En 2015, la plupart de ces dcs sont survenus dans la rgion Afrique (92%),
loin devant la rgion Asie du Sud-Est (6%) et la rgion Mditerrane orientale
(2%) de lOMS.
Limmense majorit (99%) des dcs sont dus au paludisme P. falciparum.

Les infections P. vivax seraient lorigine de 3100 dcs en 2015 (incertitude:
1 800-4 900), dont 86% hors Afrique.
En 2015, le nombre de dcs dus au paludisme chez les enfants de moins de 5

ans a t estim 303000 (incertitude: 165000-450000), soit 70% du total
mondial toutes tranches dge confondues. Ce nombre serait en baisse de 29%
depuis 2010; cependant, le paludisme reste lune des principales causes de
mortalit infantile, tuant un enfant toutes les deux minutes.
Au niveau mondial, la mortalit lie au paludisme aurait diminu de 62%

entre2000 et2015, et de 29% entre2010 et2015. Chez les enfants de moins de
5 ans, elle aurait chut de 69% entre2000 et2015, et de 35% entre2010 et2015.
Entre2010 et2015, la mortalit lie au paludisme aurait diminu dau moins

40% dans 39 des 91 pays et territoires o la transmission du paludisme reste
active en 2015. Dix autres pays ont rduit zro le nombre de dcs dus au
paludisme indigne en 2015.
Pour rduire la mortalit lie au paludisme dau moins 40% dici 2020 (objectif
intermdiaire du GTS), la baisse doit sacclrer dans les pays payant le plus
lourd tribut la maladie.
Points essentiels
limination
Entre2000 et2015, 17 pays ont limin le paludisme (cest--dire rduit zro

le nombre de cas indignes pendant au moins trois ans) et 6 dentre eux ont
t certifis exempts de paludisme par lOMS.
Sur la voie de llimination du paludisme, ces 17 pays ont rapport une mdiane
de 184 cas indignes cinq ans avant davoir rduit le nombre de cas zro (I:
78-728) et une mdiane de 1748 cases dix ans auparavant (I: 423-5731).
En 2015, 10 pays et territoires ont rapport moins de 150 cas indignes, et 9 autres
pays en ont recens entre 150 et 1000. Il sagit l de rsultats encourageants
vers latteinte de lobjectif intermdiaire de 2020, savoir liminer le paludisme
dans au moins 10 pays.
La transmission du paludisme nest rapparue dans aucun des pays ayant

limin cette maladie entre2000 et2015.
Baisse de la mortalit lie au paludisme, augmentation de lesprance de vie et

valorisation conomique
Au total, 6,8millions de dcs dus au paludisme ont t vits au niveau mondial

entre2001 et2015, par rapport aux chiffres que nous aurions enregistrs si les
taux dincidence et de mortalit taient rests inchangs depuis 2000.
La plupart des dcs (94%) ont t vits dans la rgion Afrique de lOMS. Sur
les 6,8millions de dcs dus au paludisme vits entre2001 et2015, environ
6,6millions (97%) lont t parmi les enfants de moins de 5 ans.
Tous les dcs vits ne sont pas lis aux efforts de lutte contre le paludisme;
une partie dentre eux sexpliquent vraisemblablement par une urbanisation
accrue et la croissance conomique en gnral, lorigine de lamlioration
des conditions de logements et dune meilleure nutrition.
Consquence de la baisse de la mortalit due au paludisme, en particulier chez

les enfants de moins de 5 ans, lesprance de vie la naissance aurait augment
de 1,2 an dans la rgion Afrique de lOMS. Cette hausse reprsente 12% de
laugmentation de 9,4 ans de lesprance de vie en Afrique subsaharienne,
passe de 50,6 ans en 2000 60 ans en 2015.
Au niveau mondial, la baisse du risque de mortalit due au paludisme aurait

contribu une augmentation de lesprance de vie de 0,26 an dans les pays
endmiques, soit 5% des 5,1 ans gagns au total.
La baisse du risque de mortalit due au paludisme entre2000 et2015 et donc, les

gains en termes desprance de vie, peuvent tre valoriss US$ 1810milliards
dans la rgion Afrique de lOMS (incertitude: US$ 1330-2480milliards), soit
44% du produit intrieur brut (PIB) des pays affects en 2015.
Au niveau mondial, la baisse du risque de mortalit due au paludisme est

valorise US$ 2040milliards (incertitude: US$ 1 560-2 700 milliards), soit
3,6% du total du PIB des pays affects.
Ces valeurs de bien-tre conomique sont exprimes en termes de pourcentage

du PIB titre comparatif; elles ne sauraient laisser entendre que la valeur de
la longvit est une composante de la richesse nationale produite, ni que la
valeur de ces gains est directement intgre dans le revenu national. Cette
comparaison suggre seulement que la valeur conomique attache la baisse
de la mortalit due au paludisme est consquente.
xxv
Prefacio
Dra. Margaret Chan,

Directora General
Organizacin Mundial de la Salud
El Informe Mundial sobre Paludismo, publicado anualmente por la Organizacin
Mundial de la Salud (OMS), ofrece un anlisis en profundidad del progreso y las
tendencias en la respuesta al paludismo (o malaria) a nivel mundial, regional y
nacional. Es el resultado de un continuo esfuerzo colaborativo entre los Ministerios
de Salud de los pases endmicos y numerosas organizaciones colaboradoras en
todo el mundo.
Nuestro informe 2016 destaca una serie de tendencias positivas, en particular, en
el frica subsahariana, la regin que padece la mayor carga de paludismo. Esto
demuestra que, en muchos pases, el acceso a las intervenciones preventivas se
est expandiendo a un ritmo acelerado entre las poblaciones ms necesitadas.
Los nios son especialmente vulnerables y representan ms de dos tercios de las
muertes por paludismo a nivel mundial. En 22 pases africanos, la proporcin de
nios con fiebre que recibieron una prueba de diagnstico de paludismo en un
centro de salud pblico se increment un 77% en los ltimos 5 aos. Esta prueba
ayuda a los proveedores de salud poder distinguir rpidamente entre paludismo
y fiebres no paldicas, permitiendo asistir con un tratamiento adecuado.
El paludismo durante el embarazo puede causar mortalidad materna, anemia y
recin nacidos con bajo peso al nacer, una de las principales causas de mortalidad
infantil. La OMS recomienda el tratamiento preventivo intermitente durante el
embarazo, conocido como el TPIe, para todas las mujeres embarazadas en el
frica subsahariana, que viven en zonas de transmisin moderada y alta. En los
ltimos 5 aos, la tasa de administracin de al menos tres dosis de TPIe se ha
incrementado por cinco en 20 pases africanos.
Los mosquiteros (o toldillos) con insecticidas de larga duracin siguen siendo uno
de los pilares de la prevencin del paludismo y la OMS recomienda su uso para
toda poblacin en riesgo de contraer la enfermedad. En el frica subsahariana, la
proporcin de personas que duermen bajo mosquiteros tratados con insecticida
se ha duplicado por poco en los ltimos 5 aos.
Hemos hecho grandes progresos, pero nuestro trabajo sigue incompleto. Slo
en el ltimo ao, el recuento mundial del paludismo alcanz los 212 millones de
xxvi
casos y 429 000 muertes. En frica, millones de personas siguen sin acceso a las
herramientas necesarias para prevenir y tratar la enfermedad.
En muchos pases, el progreso se ve amenazado por el rpido desarrollo y la
propagacin de la resistencia del mosquito a los insecticidas. La resistencia a los
medicamentos antipaldicos tambin podra poner en peligro los logros recientes.
En 2015, la Asamblea Mundial de la Salud adopt la Estrategia tcnica mundial
contra la malaria 2016-2030, un marco operacional para los prximos 15 aos
para todos los pases que trabajan en el control y la eliminacin del paludismo.
Esta estrategia establece unos objetivos ambiciosos pero alcanzables para el
2030, con objetivos a corto y medio plazo que permiten hacer un seguimiento
del progreso.
La estrategia insta a la eliminacin del paludismo en al menos 10 pases para el
ao 2020: un objetivo a nuestro alcance. Segn este informe, 10 pases y territorios
han registrado menos de 150 casos de paludismo autctonos. Otros nueve pases
informaron entre 150 y 1000 casos.
Pero el progreso hacia los otros objetivos mundiales debe ser acelerado. El
informe llega a la conclusin de que menos la mitad de los 91 pases afectados
por el paludismo estn en vas de alcanzar los objetivos a medio plazo de 2020,
es decir, una reduccin del 40% en el caso de incidencia y mortalidad.
Para acelerar los progresos hacia nuestras metas a nivel mundial en relacin con
el paludismo, la OMS hace un llamamiento para nuevas y mejores herramientas
para la lucha contra la enfermedad. Se necesitan mayores inversiones en el
desarrollo de nuevas intervenciones de control vectorial, mejores diagnsticos y
medicamentos ms eficaces.
El mes pasado, la OMS anunci que la primera vacuna contra el paludismo ser
pilotada en 3 pases del frica subsahariana. La vacuna, conocida como RTS,S ha
demostrado proporcionar una proteccin parcial contra el paludismo en los ms
jvenes. Ser evaluada como un posible complemento al paquete de medidas
y herramientas existentes recomendadas por la OMS en materia de prevencin,
diagnstico y tratamiento.
La necesidad de contar con ms fondos es una prioridad urgente. Se estima
que en 2015, la financiacin para la lucha contra el paludismo super los
US$2,9milmillones. Para lograr nuestras metas a nivel mundial, las contribuciones
de fuentes nacionales e internacionales deben aumentar de manera considerable
para poder alcanzar los US$ 6,4 mil millones anuales para el ao 2020.
Los retos a los que nos enfrentamos son considerables, pero no insuperables. La
experiencia reciente ha demostrado que con una slida financiacin, programas
eficaces y liderazgo de los pases, el progreso en la lucha contra el paludismo
puede ser sostenido y acelerado.
Las ganancias potenciales bien valen el esfuerzo. Todos unidos, podemos derrotar
al paludismo y mejorar la salud de millones de personas alrededor del mundo.
xxvii
Puntos clave
1. Metas mundiales, hitos e indicadores
Las metas para el 2030 de la Estrategia tcnica mundial contra la malaria 20162030 (en adelante referido como el GTS, por sus siglas en ingls de Global
Technical Strategy for Malaria 2016-2030) consisten en: reducir a nivel mundial
la incidencia de casos de paludismo (o malaria) y la mortalidad asociada en
al menos un 90% en comparacin con los datos de 2015; eliminar el paludismo
en al menos 35 pases en los que haba transmisin en el 2015 y prevenir el
restablecimiento del paludismo en todos los pases que la han eliminado.
Respecto al paludismo en los Objetivos de desarrollo sostenibles (ODS), la

Meta 3.3 es poner fin a las epidemias del SIDA, la tuberculosis, la malaria y las
enfermedades tropicales desatendidas para el 2030 y es interpretado por la
Organizacin mundial de la salud (OMS) como el logro de las metas del GTS.
Para el seguimiento del progreso del GTS y de la Accin e inversin para

vencer a la malaria 2016-2030 (AIM), la OMS y el programa Roll Back Malaria
han definido conjuntamente una lista de 41 indicadores para utilizar a nivel
mundial, nacional y subnacional. De entre ellos, 12 son considerados clave para
monitorizar el GTS y el plan AIM a nivel mundial. El Informe mundial sobre el
Paludismo tiene como objetivo informar acerca de los avances realizados cada
ao en estos 12 y una seleccin de otros indicadores.
El Programa Mundial sobre Paludismo de la OMS produce el Informe mundial

sobre Paludismo en colaboracin con los equipos de las oficinas regionales
y nacionales de la OMS, Ministerios de Salud de los pases endmicos y un
amplio nmero de organizaciones colaboradoras.
Las principales fuentes de informacin son los informes procedentes de 91 pases

endmicos, complementados con datos procedentes de encuestas nacionales
representativas y bases de datos mantenidas por otras organizaciones.
2. Inversin en programas del paludismo e investigacin
xxviii
En 2015, la financiacin total para el control y eliminacin del paludismo era

aproximadamente de US$ 2,9 mil millones, US$ 60 millones ms que en 2010.
Esta cantidad no representa ms que el 46% de la meta fijada por el GTS en
US$ 6,4 mil millones para el 2020.
Los gobiernos de pases con paludismo endmico han contribuido con un 32%
del total de la financiacin en 2015, de los cuales US$ 612 millones han sido
costes directos de los programas nacionales de control de malaria (PNCM) y
US$ 332 millones han sido costes de tratamientos de pacientes con paludismo.
Los Estados Unidos de Amrica son el principal inversor internacional de fondos

para las actividades destinadas al control del paludismo, con una contribucin
estimada del 35% de la financiacin mundial para la lucha contra el paludismo
en 2015, seguido por el Reino Unido de Gran Bretaa e Irlanda del Norte (16%),
Francia (3,2%), Alemania (2,4%), Japn (2,3%), Canad (1,7%), la fundacin Bill
& Melinda Gates (1,2%) y las instituciones de la Unin Europea (1,1%). Alrededor
de la mitad de las inversiones internacionales (45%) son canalizadas a travs
del Fondo Mundial de lucha contra el sida, la tuberculosis y la malaria (Fondo
Mundial).
El gasto en investigacin y desarrollo para la lucha contra el paludismo se ha

estimado en US$ 611 millones en 2014 (el ltimo ao con datos disponibles),
incrementando la cifra de US$ 607 millones en 2010, y representando ms del
90% de la meta de la inversin anual fijada por el GTS en US$ 673 millones.
Los pases con el mayor nmero de casos de paludismo, son aquellos que
estn ms alejados de la meta de gasto per cpita para el 2020 establecida
por el GTS.
3. Prevencin del paludismo

Control de vectores
En el frica subsahariana, el porcentaje de la poblacin en riesgo de paludismo

que duerme bajo un mosquitero tratado con insecticida (MTI) o protegido con
el rociado residual intradomiciliario (RRI) se estima que habra incrementado
de un 37% en 2010 (Intervalo de incertidumbre [II]:25%48%) al 57% en 2015 (II:
44%70%).
Para los pases en el frica subsahariana donde los MTI son el principal mtodo
de intervencin para el control vectorial, 53% de la poblacin en riesgo duerme
bajo un MTI en 2015 (Intervalo de confianza [IC] de 95%: 50%57%), contra el
30% en 2010 (IC de 95%: 28%32%).
El crecimiento en el acceso a los MTI en los hogares (60% en 2015, IC de 95%:

57%64%; 34% en 2010, IC de 95%: 32%35%) ha logrado un gran aumento de
la poblacin en riesgo de paludismo que duerme bajo un MTI.
El porcentaje de hogares con al menos un MTI ha aumentado, alcanzando el

79% en 2015 (IC de 95%: 76%83%); por lo tanto, una quinta parte de los hogares
donde los MTI son la principal herramienta para la lucha antivectorial no tienen
acceso a una red tratada.
El porcentaje de hogares con un nmero suficiente de MTI para todos los

miembros del hogar se ha elevado a un 42% (IC de 95%: 39%45%)
El RRI es generalmente usado por los PNMC en zonas especficas. A nivel global,
el porcentaje de la poblacin en riesgo protegida por el RRI ha decado de un
mximo del 5,7% alcanzado en 2010 a un 3,1% en 2015, y de un 10,5% a un 5,7%
en el frica Subsahariana.
La reduccin en la cobertura del RRI podra ser atribuida al cese del rociamiento
con piretroides, en particular en la zona regional de frica de la OMS.
xxix
De los 73 pases endmicos que proporcionaron datos a partir del 2010 en

adelante; 60 reportaron una resistencia de al menos un insecticida y 50
reportaron resistencia a dos o ms clases de insecticida.
La resistencia a los piretroides (la nica clase de insecticida que se utiliza

actualmente en los MTI) es la que se registra con ms frecuencia. La ltima
evaluacin llevada a cabo en 5 pases y bajo la coordinacin de la OMS, lleg
a la conclusin de que los MTI seguan siendo efectivos, sin embargo se siguen
necesitando nuevas herramientas para el control vectorial.
Tratamiento preventivo intermitente durante el embarazo
En los 20 pases africanos con datos suficientes, 31% de las mujeres

embarazadas elegibles recibieron tres o ms dosis de tratamiento preventivo
intermitente durante el embarazo (TPIe) en 2015, contra el 6% en 2010.
4. Pruebas de diagnstico y tratamiento

Acceso al tratamiento
En las 23 encuestas representativas a nivel nacional y realizadas en el frica

subsahariana entre 2013 y 2015 (representando el 61% de la poblacin en
riesgo), una mediana de 54% de nios febriles por debajo de los 5 aos (Rango
intercuartil [RI]: 41%59%) fueron llevados a un proveedor de salud formado.
El porcentaje de nios febriles que solicit tratamiento en el sector pblico

(mediana: 42%, RI: 31%50%) fue ms alto que en el sector privado (mediana:
20%, RI: 12%28%).
El porcentaje de nios febriles que no solicitaron tratamiento es importante

(mediana: 36%, RI: 26%42%)
Pruebas de diagnstico
xxx
El porcentaje de nios febriles que tuvieron una prueba de diagnstico del

paludismo ha sido mayor si solicitaban tratamiento en el sector pblico
(mediana: 51%, RI: 35%60%) que si recurran a un tratamiento en el sector
privado formal (mediana: 40%, RI: 28%57%) o el sector privado informal
(mediana: 9%, RI: 4%12%). El porcentaje de nios que tuvieron la prueba de
diagnstico en el sector pblico ha aumentado del 29% en 2010 (RI: 19%46%).
Los datos comunicados por los PNCM indican que el porcentaje de casos
sospechosos de paludismo que tienen una prueba parasitolgica en el sector
pblico ha aumentado de un 40% de casos sospechosos en la regin de frica
de la OMS en 2010 a un 76% en 2015. Este incremento es principalmente debido
a una mayor utilizacin de los test de diagnstico rpido (RDT, por sus siglas
en ingls Rapid diagnostic tests), que contribuyeron al 74% de las pruebas de
diagnstico entre los casos sospechosos en 2015.
En ms de 10 pases se han reportado deleciones del gen HRP2, lo cual permite

a parsitos del paludismo evadir la deteccin por los test de diagnsticos ms
comunes.
Puntos clave
Tratamiento
Entre las 11 encuestas representativas a nivel nacional que fueron llevadas a

cabo entre 2013 y 2015 en el frica subsahariana, la proporcin mediana de
nios por debajo de los 5 aos con evidencia de una infeccin de P. falciparum
reciente o presente e historia de fiebre que recibieron algn medicamento
antipaldico se elev a 30% (RI: 20%51%). De mediana, el 14% (RI: 5%45%)
recibi una terapia combinada con artemisinina (TCA). Sin embargo, no pudo
extraerse ninguna conclusin clara de estos resultados puesto que los rangos
asociados a las medianas eran muy amplios, indicando una gran variedad
entre los pases, a lo que hay que aadir que las encuestas solo representaban
un tercio de la poblacin en riesgo en el frica subsahariana.
Son necesarias mayores inversiones para poder mejorar el seguimiento de

los tratamientos en los centros de salud (a travs de los sistemas rutinarios de
reporte y de las encuestas a los centros de salud) y a nivel comunitario, para
poder entender hasta qu punto existen barreras que impiden el acceso a un
tratamiento contra el paludismo.
El porcentaje de tratamientos antipaldicos con TCA proporcionados a nios

con fiebre en las ltimas dos semanas y con un RDT positivo en el momento
de la encuesta, aument de una mediana inicial de 29% entre 2010-2012 (RI:
17%55%) al 80% en 2013-2015 (RI: 29%95%).
Los tratamientos antipaldicos fueron ms probables de ser TCA si los nios

buscaban tratamiento en centros de salud pblica o a travs de trabajadores
de salud de las comunidades, que si se dirigan al sector privado.
Se ha detectado resistencia de P. falciparum a la artemisinina en cinco pases

de la subregin del Gran Mekong. En Camboya, altos ndices de fracaso
despus de las TCA han sido detectados en cuatro diferentes.
5. Sistemas de vigilancia del paludismo
El porcentaje de informes recibidos a nivel nacional y procedente de los centros

de salud super el 80% en 40 de los 47 pases que informaron sobre este
indicador.
Este indicador no pudo ser calculado en 43 pases, por distintas razones: si

bien porque no se especific el nmero de centros de salud que se esperaba
para poder informar (en 2 pases) o bien porque no se especific el nmero
de informes entregados (en 17 pases), o por ltimo, con ambas situaciones
(en 24 pases).
En total, 23 pases recibieron informes de centros de salud privados, pero stos

representan una minora de todos los informes recibidos (mediana: 2,1%, RI:
0,6%13%).
En 2015, se estima que los sistemas de vigilancia del paludismo detectan el 19%
de los casos que ocurren a nivel mundial (II: 16%21%).
Los obstculos que se hallan en la deteccin de casos varan segn el pas y la

regin de la OMS. En cuatro de las regiones de la OMS una gran proporcin
de pacientes solicitan tratamiento en el sector privado, y en sus casos no se
xxxi
contabiliza en los sistemas de vigilancia existentes. En tres de las regiones de

la OMS una proporcin relativamente baja de los pacientes que asisten a los
centros de salud pblicos reciben una prueba de diagnstico.
La tasa de deteccin de casos ha mejorado y aumentado su cifra desde

2010 (10%), principalmente debido al incremento del uso de las pruebas de
diagnstico en el frica subsahariana.
6. Impacto
Prevalencia del parsito que provoca el paludismo
El porcentaje de las poblaciones en riesgo en el frica subsahariana con

infecciones por el parsito del paludismo ha descendido de un 17% calculado
en 2010 a un 13% en 2015 (II: 11%15%).
En el frica subsahariana, el nmero de personas infectadas por el parsito

del paludismo ha descendido de 131 millones en 2010 (II: 126 136 millones) a
114 millones en 2015 (II: 99 130 millones.
La tasa de infeccin es ms alta en nios entre 2 y 10 aos, aunque la mayor

parte de las personas afectadas se encuentran en rangos de edades superiores.
Casos de incidencia
A nivel mundial, se calcularon 212 millones de casos de paludismo en 2015 (II:

148 304 millones).
En 2015, la mayora de los casos fueron registrados en la regin de frica de

la OMS (90%), seguida de la regin de Asia sudoriental (7%) y la regin del
Mediterrneo oriental (2%).
Las infecciones por P. vivax son responsables de un 4% de los casos mundiales

de paludismo, sin embargo fuera del continente africano el porcentaje de
infecciones por P. vivax es de 41%.
A nivel mundial, la tasa de incidencia de casos del paludismo ha disminuido

un 41% entre 2000 y 2015, y un 21% entre 2010 y 2015.
De los 91 pases y territorios con transmisin de paludismo en 2015, se estima

que 40 han alcanzado una reduccin en las tasas de incidencia de 40% o ms
entre 2010 y 2015, y se puede considerar que estn en el camino de alcanzar
la meta del GTS de una reduccin adicional del 40% para el 2020.
Si se quiere alcanzar la meta del GTS en reducir de 40% la tasa de incidencia

de casos para el ao 2020, se debera acelerar la disminucin de la tasa de
incidencia de casos en pases con un alto nmero de casos reportados.
Mortalidad
xxxii
En 2015, se estimaron 429 000 muertes por paludismo en todo el mundo (II:
235 000 639 000).
En 2015, se estim que la mayora de las muertes ocurrieron en la regin de

frica de la OMS (92%), seguida de la regin de Asia sudoriental de la OMS
(6%) y la regin del Mediterrneo oriental de la OMS (2%).
Puntos clave
La inmensa mayora de las muertes (99%) por paludismo fueron debidas al

P. falciparum. Se estima que P. vivax pudo haber sido el responsable de 3100
muertes en 2015 (rango: 1800 4900), 86% de ellas fuera de frica.
En 2015, el nmero estimado de muertes causadas por paludismo en nios

menores de 5 aos fue de 303 000 (rango: 165 000 450 000), el equivalente
al 70% del total mundial. Se estima que el nmero de muertes ha disminuido
un 29% desde 2010, aunque sigue siendo una de las principales causas de
mortalidad infantil, acabando con la vida de un nio cada dos minutos.
A nivel mundial, la tasa de mortalidad por paludismo habra disminuido un

62% entre 2000 y 2015, y un 29% entre 2010 y 2015. En nios menores de 5 aos,
habra disminuido un 69% entre 2000 y 2015, y en un 35% entre 2010 y 2015.
Entre 2010 y 2015, la tasa de mortalidad por paludismo habra disminuido al

menos un 40% en 39 de los 91 pases y territorios con transmisin de paludismo
activa en 2015. Otros 10 pases no tuvieron muertes autctonas en 2015.
Si se quiere alcanzar la meta del GTS en reducir la tasa de la mortalidad en

ms de un 40% para el 2020, se debera acelerar la reduccin de la tasa de
mortalidad en pases con un alto nmero de muertes.
Eliminacin
Entre 2000 y 2015, 17 pases han eliminado el paludismo (es decir, que han
reducido a cero los casos autctonos en tres aos o ms) y entre los cuales, seis
pases han sido certificados por la OMS como libres de paludismo.
En el progreso hacia la eliminacin del paludismo, estos 17 pases han reportado

una media de 184 casos autctonos cinco aos antes de alcanzar los cero casos
(RI: 78 728) y una mediana de 1748 casos en diez aos antes de alcanzar los
cero casos (RI: 423 5731).
En 2015, 10 pases y territorios reportaron menos de 150 casos autctonos,

y otros 9 pases reportaron entre 150 y 1000 casos autctonos. Por tanto, en
perspectiva positiva, parecera que sera posible alcanzar la meta del GTS
para el 2020 y eliminar el paludismo en 10 pases.
El paludismo no ha sido reintroducida en ninguno de los pases que eliminaron

esta enfermedad entre 2000 y 2015.
Reduccin de la mortalidad por paludismo, el incremento de la esperanza de

vida y la evaluacin econmica
Entre 2001 y 2015, se estima que un total acumulado de 6,8 millones de muertes
por paludismo han sido evitadas a nivel mundial entre 2000 y 2015, en relacin
a la cifras que se hubiesen producido si la incidencia y las tasas de mortalidad
se hubiesen mantenido inalteradas desde 2000.
La mayora de las muertes (94%) fueron evitadas en la regin de frica de la

OMS. Del total estimado de 6,8 millones menos de muertes por paludismo
entre 2001 y 2015, alrededor de 6,6 millones (97%) fueron entre nios menores
de 5 aos.
No todas las muertes pueden ser atribuidas a los esfuerzos para controlar
el paludismo. Parte del progreso es probable que est relacionado con un
xxxiii
incremento de la urbanizacin y de un desarrollo econmico generalizado, lo

que ha llevado a la mejora de la vivienda y la nutricin.
xxxiv
Como consecuencia de la reduccin de la tasa de mortalidad por paludismo, en

particular, entre los nios menores de 5 aos, se ha estimado que la esperanza
de vida al nacer habra incrementado en ms de 1,2 aos en la regin de
frica de la OMS. Este incremento representara el 12% del aumento total de
la esperanza de vida de 9,4 aos en el frica subsahariana, que ha pasado
de 50,6 aos en 2000 a 60 aos en 2015.
A nivel mundial, la reduccin de la tasa de mortalidad por paludismo ha

contribuido a un incremento en la esperanza de vida de 0,26 aos en los pases
endmicos, siendo el 5% de los 5,1 aos ganados en total.
Los mtodos de anlisis actuales sugieren que el incremento en la esperanza

de vida originados por la reduccin de la mortalidad por paludismo observada
entre los aos 2000 y 2015 se puede valorar en US$ 1810 mil millones dentro de
la regin de frica de la OMS (II: US$ 1330 2480 mil millones), lo que equivale
al 45% del Producto Interior Bruto (PIB) de los pases afectados en 2015.
A nivel mundial, la reduccin del riesgo de mortalidad debido al paludismo

se valoriza en US$ 2040 mil millones (II: US$ 1560 2700 mil millones), siendo
alrededor del 3,6% del PIB.
Estos valores de bienestar econmico se expresan en trminos porcentuales

del PIB a ttulo comparativo, porque no pueden representar una parte actual
de la riqueza producida ni dar a entender que pueden medir el mismo tipo de
riqueza. Esta comparacin sugiere nicamente que el valor econmico que
se atribuye a la disminucin de la mortalidad por paludismo es substancial.
1. Global targets,
milestones and indicators
Since 2000, substantial progress has been made in fighting malaria. According
to the latest estimates, between 2000 and 2015, malaria case incidence was
reduced by 41% and malaria mortality rates by 62% (see Section 6 of this report).
At the beginning of 2016, malaria was considered to be endemic in 91 countries
and territories, down from 108 in 2000 (Figure 1.1). Much of the change can be
attributed to the wide-scale deployment of malaria control interventions(1).
Despite this remarkable progress, malaria continues to have a devastating impact
on peoples health and livelihoods. Updated estimates indicate that 212million
cases occurred globally in 2015, leading to 429000 deaths, most of which were
in children aged under 5 years in Africa.
Recognizing the need to hasten progress in reducing the burden of malaria, WHO
developed the Global Technical Strategy for Malaria 20162030 (GTS) (2), which
sets out a vision for accelerating progress towards malaria elimination. The WHO
strategy is complemented by the Roll Back Malaria advocacy plan, Action and
investment to defeat malaria 20162030 (AIM) (3). Together, these documents
emphasize the need for universal access to interventions for malaria prevention,
diagnosis and treatment; that all countries1 should accelerate efforts towards
malaria elimination; and that malaria surveillance should be a core intervention.
The GTS and AIM also recognize the importance of innovation and research and
a strong enabling environment, and share the same global targets for 2030 and
the same milestones for 2020 and 2025, as shown in Table 1.1. The time frame
of the GTS and AIM is aligned with that of the Sustainable Development Goals
(SDGs) (4). For malaria, Target 3.3 of the SDGs to end the epidemics of AIDS,
tuberculosis, malaria and neglected tropical diseases and combat hepatitis,
waterborne diseases, and other communicable diseases by 2030 is interpreted
as the attainment of the GTS and AIM targets. The indicator used to track progress
of Target 3.3 is malaria case incidence.
1. In order to facilitate reading throughout the report, countries is used as a generic term referring to
countries and areas or territories. The term area or territory is used only when mentioning one or more
areas/territories in lists of specific countries.
Figure 1.1 Countries endemic for malaria in 2000 and 2016.
Countries with 3 consecutive years of zero

indigenous cases are considered to have eliminated malaria. No country in the WHO European region reported indigenous
cases in 2015 but Tajikistan has not yet had 3 consecutive years of zero indigenous cases, its last case being reported in July
2014. Source: WHO database
Countries endemic for malaria, 2016

Countries not endemic for malaria, 2000
Countries endemic in 2000, no longer endemic in 2016

Not applicable
Table 1.1 Global targets for 2030 and milestones for 2020 and 2025. Source: (2)
Goals
Milestones
Targets
2020
2025
2030
1. Reduce malaria mortality rates globally

compared with 2015
40%
75%
90%
2. Reduce malaria case incidence globally

compared with 2015
>40%
75%
90%
3. Eliminate malaria from countries in which

malaria was transmitted in 2015
At least
10countries
At least
20countries
At least
35countries
4. Prevent re-establishment of malaria in all

countries that are malaria free
Re-establishment
prevented
Re-establishment
prevented
Re-establishment
prevented
world malaria report 2016
Global targets, milestones and indicators
The GTS highlights a minimal set of 14 outcome and impact indicators against
which progress in malaria control and elimination should be monitored, of which 12
are relevant at global level. The World Malaria Report 2016 aims to report on these
global indicators, and a selection of other indicators as shown in Table 1.2. It also
reports on the supply of key commodities to endemic countries (which influences
the progress of malaria control and elimination programmes) (Section 2.4); the
evolution of resistance to interventions by vectors and parasites (Sections 3.6 and
4.6, respectively). This year, the report also considers the gain in life expectancy
that the reductions in malaria mortality have brought about, and the economic
value society places on such changes (Section 6.7). The main text is followed by
methods, regional profiles, country trends in selected indicators and data tables.
Country profiles and methods are available online at http://www.who.int/malaria/
publications/world-malaria-report-2016/en/.
The World Malaria Report is produced by the WHO Global Malaria Programme,
with the help of WHO regional and country offices, ministries of health in endemic
countries, and a broad range of other partners. The primary sources of information
are reports from national malaria control programmes (NMCPs) in the 91 endemic
countries. This information is supplemented by data from nationally representative
household surveys (demographic and health surveys, malaria indicator surveys
and multiple indicator cluster surveys) and databases held by other organizations:
the Alliance for Malaria Prevention; the Global Fund to Fight AIDS, Tuberculosis
and Malaria (Global Fund), the Organisation for Economic Co-operation and
Development; Policy Cures; United Nations Childrens Fund (UNICEF); the
USPresidents Malaria Initiative; and WHO. Adescription of data sources and
methods is provided in Annex 1.
Table 1.2 Indicators reviewed in World Malaria Report 2016.
Indicators among minimal set of 14 recommended
indicators in GTS are highlighted in light grey.
Applicability of indicator
by transmission setting
Indicator
High
Low
Elimination or
prevention of
re-establishment
Inputs
Financing
1.1
1.2
Total malaria funding and expenditure per capita

for malaria control and elimination
Funding for malaria relevant research
Outcome
Vector control
2.1
2.4
Proportion of population at risk that slept under an

ITN the previous night
Proportion of population with access to an ITN
within their household
Proportion of households with at least one ITN for
every two people
Proportion of households with at least one ITN
2.5
Proportion of available ITNs used the previous night
2.2
2.3
Applicability of indicator
by transmission setting
Indicator
Vector control
2.6
Proportion of targeted risk group receiving ITNs
2.7
Proportion of population at risk protected by IRS in

the previous 12 months
Proportion of population at risk sleeping under an
ITN or living in house sprayed by IRS in the previous
12 months
Proportion of pregnant women who received
3doses of IPTp
Proportion of pregnant women who received
2doses of IPTp
Proportion of pregnant women who received 1 dose
of IPTp
Proportion of pregnant women who attended ANC
at least once
Proportion of children under 5 with fever in the
previous 2 weeks for whom advice or treatment was
sought
Proportion of patients with suspected malaria who
received a parasitological test
Proportion of children under 5 with fever in the
previous 2 weeks who had a finger or heel stick
Proportion of patients with confirmed malaria who
received first-line antimalarial treatment according
to national policy
Proportion of treatments with ACTs (or other
appropriate treatment according to national policy)
among febrile children <5
Proportion of malaria cases detected by
surveillance systems
Proportion of expected health facility reports
received
2.8
Chemoprevention 3.1
3.2
3.3
3.4
Case detection
4.1
Diagnostic
testing
5.1
5.2
Treatment
6.1
6.2
Surveillance
7.1
7.2
High
Low
Elimination or
prevention of
re-establishment
Impact
Prevalence
Incidence
Mortality
Elimination
8.1
9.1
10.1
11.1
Prevention of
12.1
re-establishment
Parasite prevalence: proportion of population with

evidence of infection with malaria parasites
Malaria case incidence: number and rate per
1000persons per year
Malaria mortality: number and rate per
100000persons per year
Number of areas/countries that have newly
eliminated malaria since 2015
Number of areas/countries that were malaria free in
2015 in which malaria has been re-established
Indicator highly relevant to setting
Indicator potentially relevant to setting
ACT, artemisinin-based combination therapy; ANC, antenatal care; GTS, Global Technical Strategy for Malaria 2016-2030;
IPTp, intermittent preventive treatment in pregrancy; IRS, indoor residual spraying; ITN, insecticide-treated mosquito net
2. Investments in malaria
programmes and research
Progress in reducing malaria incidence and mortality between 2000 and 2015
was made possible by large increases in the financing of malaria control and
elimination programmes. Further progress in reducing malaria depends on
increased investments in malaria programmes. The GTS estimated that annual
investments in malaria control and elimination need to increase to US$ 6.4 billion
per year by 2020 to meet the first milestone under that strategy of a 40% reduction
in malaria incidence and mortality rates.
The GTS also recognized that innovations in tools and approaches are needed
to achieve its targets, and estimated that an additional US$ 674 million (range:
US$ 530 million832 million) would be required annually for malaria research
and development.
This section of the report examines recent trends in the financing of malaria
programmes and of malaria research and development. It considers the indicators
listed in Box 2.1.
This section also considers the quantities of commodities delivered, because this
provides insight into malaria expenditures, and because the availability of supplies
is a key determinant of programme coverage.
Box 2.1 Indicators related to investments in malaria programmes

and research
>> Total expenditure for malaria control and elimination
>> Funding for malaria research and development
>> Expenditure per capita for malaria control and elimination
Investments in malaria programmes and research
2.1 Total expenditure for malaria control and elimination

Total funding for malaria control and elimination in 2015 is estimated at
US$2.9billion, rising just US$ 0.06 billion since 2010 and representing only 46%
of the GTS 2020 milestone of US$ 6.4 billion (Figure 2.1). Funding for malaria
increased year on year between 2005 and 2010, but subsequently fluctuated, with
totals for 2014 and 2015 lower than 2013. Pledges at the Global Fund replenishment
conference for funding in 20172019 increased by 8% compared with 20142016.
However, total funding needs to increase by a substantially greater amount if the
2020 milestone is to be achieved.
Governments of endemic countries provided 32% of total funding in 2015, of which
US$ 612 million was direct expenditure through NMCPs and US$ 332 million was
expenditure on patient service delivery care (Figure 2.2). Domestic government
contributions are greatest in the WHO African Region (US$ 528 million), followed by
the WHO Region of the Americas (US$ 202 million) and the WHO South-East Asia
Region (US$ 92 million). Domestic governments accounted for the greatest share
of funding for malaria in the WHO European Region (99%) and the WHO Region
of the Americas (88%), but represented 50% or less in the other WHO regions. The
level of domestic government financing reflects the size of the malaria burden in
each region, and the willingness and ability of governments to tackle this burden.
International funding accounts for most (68%) of the funding for malaria control
and elimination programmes. Such funding may be provided direct to endemic
countries through bilateral aid or through intermediaries such as the Global Fund,
World Bank or other multilateral institutions (Figure 2.2). The United States of
Figure 2.1 Investments in malaria control activities by funding source, 20052015. Annual values have
been converted to constant 2015 US$ using the gross domestic product implicit price deflator from the USA in order to measure
funding trends in real terms. Sources: ForeignAssistance.gov, Global Fund to Fight AIDS, Tuberculosis and Malaria, national
malaria control programme reports, Organisation for Economic Cooperation and Development (OECD) creditor reporting
system, the World Bank Data Bank, WHO estimates of malaria cases and treatment seeking at public facilities, and WHO
CHOICE unit cost estimates of outpatient visit and inpatient admission
Governments of endemic countries
Global Fund
USA
UK
World Bank
2013
2014
Others
US$ (billions)
2005
2006
2007
2008
2009
2010
2011
2012
2015
Global Fund, Global Fund to Fight AIDS, Tuberculosis and Malaria; UK, United Kingdom of Great Britain and Northern Ireland;
USA, United States of America
Figure 2.2 Annual flow of funding for malaria control and elimination, 20142015. Sources of funds are
listed on the left and destination WHO regions on the right. Intermediaries through which much donor funding is channelled
are shown in the middle. Sources: ForeignAssistance.gov, Global Fund to Fight AIDS, Tuberculosis and Malaria, national
malaria control programme reports, Organisation for Economic Cooperation and Development (OECD) creditor reporting
system, the World Bank Data Bank, WHO estimates of malaria cases and treatment seeking at public facilities, and WHO
CHOICE unit cost estimates of outpatient visit and inpatient admission
Government of
endemic countries
$944 m, 32%
Africa
$ 2083 m, 70%
USA $1048 m, 35%
UK $465 m, 16%
Americas
$ 230 m, 8%
Global Fund $911 m
France $94 m, 3%
Germany $72 m, 2%
Japan $68 m, 2%
Canada $51 m, 2%
BMGF $36 m, 1%
EU institutions
$33 m, 1%
Others $154 m, 5%
Eastern
Mediterranean
$122 m, 4%
Europe
$27 m, 1%
South
East Asia
$207 m, 7%
Western Pacific
$102 m, 3%
World Bank $74 m
Unspecified
recipients
$186 m, 6%
EU institutions, WHO, UNICEF $13 m
BMGF, Bill & Melinda Gates Foundation; EU, European Union; Global Fund, Global Fund to Fight AIDS, Tuberculosis and
Malaria; UK, United Kingdom of Great Britain and Northern Ireland; UNICEF, United Nations Childrens Fund; USA, United States
of America
America is the largest single international funder of malaria control activities; it

accounted for an estimated 35% of total malaria funding in 2015 (including bilateral
aid and contributions to intermediaries), followed by the United Kingdom of Great
Britain and Northern Ireland (16%), France (3.2%), Germany (2.4%), Japan (2.3%),
Canada(1.7%), the Bill & Melinda Gates Foundation (1.2%) and European Union
institutions (1.1%). Contributions from other countries represented 5% of total funding.
Nearly half of all international funding (45%) is channelled through the Global Fund.
The Global Fund is responsible for a significant share of malaria funding in the
WHO Eastern Mediterranean Region (62%), the WHO South-East Asia Region
(45%) and the WHO Western Pacific Region (35%). In the WHO African Region,
25% of funding comes from domestic governments, 33% from the Global Fund
and 29% from bilateral support from the United States Agency for International
Development (USAID).
Almost 90% of domestic funding is accounted for by health system spending
(Figure 2.3). In contrast, more than half of the funding from the Global Fund and
USAID is devoted to the delivery of preventive interventions. Around a sixth of
Global Fund, and a third of USAID funding is spent on treatment. The progress of
prevention and treatment programmes is therefore highly sensitive to variations
in donor spending.
Figure 2.3 Malaria financing, 20132015, by type of expenditure. Health-system spending includes planning,
monitoring and evaluation, communications and advocacy, supply management, training and human resources (apart
from those used for the delivery of services). Prevention includes procurement and delivery of insecticide-treated mosquito
nets, support of indoor residual spraying and delivery of intermittent preventive therapy in pregnancy. Treatment includes
commodities and resources for service delivery such as human resources, infrastructure and equipment. Sources: Global
Fund Enhanced Financial Reporting (EFR), USAID PMI malaria operational plans for 2013-2015 available at https://www.
pmi.gov/resource-library/mops/fy-2016, national malaria control programme reports, WHO estimates of malaria cases and
treatment seeking at public facilities, and WHO CHOICE unit cost estimates of outpatient visit and inpatient admission
Health systems
6%
Prevention
Treatment
6%
17%
24%
15%
32%
88%
Governments of endemic countries
59%
Global Fund
53%
USAID PMI
Global Fund, Global Fund to Fight AIDS, Tuberculosis and Malaria; PMI, Presidents Malaria Initiative; USAID, United States
Agency for International Development
10
2.2 Funding for malaria-related research

Spending on research and development for malaria rose from an estimated
US$607 million in 2010 to US$ 611 million in 2014 (the latest year for which data are
available). The 2014 total represents more than 90% of the GTS annual investment
target of US$674million (Figure 2.4). The largest research and development
spending category was antimalarial medicines (35%), followed by vaccines (28%)
and basic research (27%). Investments in diagnostics and vector-control tools were
each estimated to account for only 3% of the 2014 spending.
Public sector investors contributed to nearly half of total research and development
funding in 2014, with the US National Institutes for Health and the US Department
of Defence comprising 55% of this category (Figure 2.5). Philanthropic investment
sources (primarily the Bill & Melinda Gates Foundation and the United Kingdoms
Wellcome Trust) accounted for 28% of the total. Private sector funding sources,
namely pharmaceutical and biotechnology companies, accounted for 23% of total
spending in 2014.
Figure 2.4 Funding for malaria-related research

and development, 20102014. Source: Gfinder Public
Search Tool. Policy Cures. https://gfinder.policycures.org/Public

SearchTool/
Drugs
Vector control
800
Vaccines
Diagnostics
Figure 2.5 Source of funding for malariarelated research and development, 2014.
Source: Gfinder Public Search Tool. Policy Cures.
https://gfinder.policycures.org/PublicSearchTool/
Basic research
Unspecified
Unspecified
0%
GTS annual target: US$ 674 million

Private sector
22%
US$ (millions)
600
Public sector
50%
400
200
2010
2011
2012
2013
2014
Philanthropic
28%
GTS, Global Technical Strategy for Malaria 20162030
11
2.3 Malaria expenditure per capita for malaria control and

elimination
An analysis of malaria spending in relation to population at risk can help in
assessing the adequacy of current funding levels. The composition and costs of
malaria control and elimination programmes vary by setting. Based on resource
need estimates from the GTS, countries with more than 1 million cases require a
higher per capita spending (US$ 3.40) than those with between 10000 and 1 million
cases (US$2.50). Countries with fewer than 10000 cases require the highest per
capita spending (US$ 3.75) owing to the added cost of case-based surveillance,
which becomes feasible with low case numbers. Countries with more than 1 million
cases are furthest from the per capita spending milestones for 2020 set in the GTS
(Figure 2.6). Countries with fewer than 10000 cases are able to meet a greater
proportion of funding requirements from domestic sources because of a lower
total financial requirement (related to the lower number of cases) and generally
higher gross national incomes.
Figure 2.6 Malaria financing per person at risk, 20132015, by estimated number of malaria cases,
2015. The solid bar shows the interquartile range among countries endemic for malaria in 2015, and the white line shows the
median. The 10th and 90th percentiles are shown as black cross-bars. Sources: ForeignAssistance.gov, Global Fund to Fight
AIDS, Tuberculosis and Malaria, national malaria control programme reports, Organisation for Economic Co-operation and
Development creditor (OECD) reporting system and the Data Bank of the World Bank
International
10
Domestic
Total
2020 global milestone
US$ per person at risk
8
6
4
2
0
12
> 1 000 000 cases (33 countries)
10 0001 000 000 cases (32 countries)
<10 000 cases (26 countries)
2.4 Commodity procurement trends

Insecticide-treated mosquito nets
Between 2013 and 2015, a total of 510 million insecticide-treated mosquito nets
(ITNs) were reported by manufacturers as having been delivered to countries in
sub-Saharan Africa, which exceeds the minimum amount required to achieve
universal access to an ITN in the household (491 million)1. More ITNs were delivered
in 2014 (189 million) and 2015 (178 million) than in any previous year (Figure 2.7).
Decreasing prices may have contributed to increased procurement, with the
average procurement price falling from US$ 6.27 to US$ 4.36 per net between 2010
and 2014 (2015 prices). Six countries accounted for more than 50% of deliveries in
sub-Saharan Africa (Nigeria, 93 million ITNs; Democratic Republic of the Congo,
61 million; Ethiopia, 45 million; Uganda, 28 million; Burkina Faso, 20 million and
Kenya, 18 million). Outside sub-Saharan Africa, 73 million ITNs were delivered by
manufacturers between 2013 and 2015, with more than half of those deliveries
accounted for by five countries (India, 13 million ITNs; Indonesia, 9.3 million;
Myanmar, 8.9 million; Cambodia, 4.3 million and Papua New Guinea, 4.1 million).
Manufacturer deliveries are a forward indicator of in-country distribution and
household coverage with ITNs. NMCP distributions to households lag the deliveries
of ITNs to countries by an average of 0.51.0 years, and ITN coverage indicators,
reviewed in Section 3 of this report, lag 3-year cumulative totals of manufacturer
deliveries by about 1 year. A total of 128 million ITNs are projected to be delivered
to countries in sub-Saharan Africa in 2016, based on shipments up to October 2016.
The 3-year cumulative totals of manufacturer deliveries suggest that although ITN
coverage will rise further in 2016 it may drop in 2017.
1. Based on the assumption that every household received the exact number of nets required for 100%
access within households and that nets are retained for at least 3 years. In practice, ITNs are lost or
replaced before 3 years, so the number of ITNs required to achieve universal access is greater.
Figure 2.7 Number of ITNs delivered by manufacturers and delivered by NMCPs 20092016. Data
from NMCPs for 2016 and 2017 not yet available. Sources: Milliner Global Associates and NMCP reports
Manufacturer
deliveries:
250
Outside Africa
Sub-Saharan Africa
NMCP
deliveries:
Outside Africa
Sub-Saharan Africa
Number of ITNs (millions)
200
150
100
50
0
2009 2010
2010 2011
2011 2012
2012 2013
2013 2014
2014 2015
2015 2016
2016 2017
ITN, insecticide-treated mosquito net; NMCP, national malaria control programme
13
Rapid diagnostic tests

Sales of rapid diagnostic tests (RDTs) reported by manufacturers rose from
88million globally in 2010 to 320 million in 2013, but fell to 270 million in 2015
(Figure 2.8). The decrease in sales was most pronounced in Asia, with sales of
falciparum only tests falling from 22 million to less than 1 million between 2014
and 2015. In contrast, sales of falciparum only tests increased in Africa from
166million to 179 million, whereas combination tests decreased from 89 million to
61million between 2014 and 2015.
The number of RDTs distributed by NMCPs, while following a similar trend to
manufacturer sales before 2015, did not show the same dip in 2015. In sub-Saharan
Africa, the numbers distributed rose from 165 million in 2014 to 179million in 2015;
outside Africa, they rose from 25 million to 28 million. Some of the difference in
trends and levels may be due to incomplete reporting. The differences may also
be due to the fact that RDT sales reported by manufacturers include both public
and private health sectors, whereas RDTs distributed by NMCPs represent tests in
the public sector only. Because of inconsistencies in how data are reported, it is
not possible to establish how trends in each variable are linked over time. It is not
known to what extent the 2015 decline in reported manufacturer RDT deliveries
will affect the availability of diagnostic testing for patients with fever.
Figure 2.8 Number of RDTs sold by manufacturers and distributed by NMCPs, 20102015. Sources:
NMCP reports and data from manufacturers eligible for the WHO Foundation for Innovative New Diagnostics/US Centers for
Disease Control and Prevention Malaria Rapid Diagnostic Test Product Testing Program
350
Manufacturer deliveries
Sub-Saharan Africa:
P. falciparum only tests
Combination tests
Number of RDTs (millions)
300
Outside Africa:
P. falciparum only tests
Combination tests
250
NMCP deliveries
Sub-Saharan Africa
Outside Africa
200
150
100
50
0
2010
2011
2012
2013
NMCP, national malaria control programme; RDT, rapid diagnostic test
14
2014
2015
Artemisinin-based combination therapies

The number of courses of artemisinin-based combination therapy (ACT) procured
from manufacturers increased from 187 million in 2010 to a peak of 393 million in
2013, but subsequently fell to 311 million in 2015, of which 209 million were delivered
to the public sector (Figure 2.9). The number of ACT treatments distributed by
NMCPs to public sector health facilities also declined from 192 million in 2013
to 153 million in 2015. The discrepancy between manufacturer deliveries to the
public sector and the number of courses distributed through public facilities can
be accounted for, in part, by incomplete reporting by NMCPs. The WHO African
Region accounted for 98% of all manufacturer deliveries in 2015 (in cases where
the destination is known) and 97% of NMCP deliveries.
In the WHO African Region, the number of ACT treatments distributed by NMCPs in
the public sector (148million) is now fewer than the number of malaria diagnostic
tests provided (170 million) (Figure 2.10). The decreasing ratio of treatments to tests
in the public sector (87:100 in 2015) is a reflection that more patients are receiving a
diagnostic test before being treated. However, there is still scope for improvement
in the ratio of treatments to tests, because this ratio should approximate the
malaria test positivity rate of patients seeking treatment, which is generally 52%
(or 0.52) across all countries in sub-Saharan Africa.
from 2010 to 2013, and GF co-payment mechanism from 2014.

Sources: Companies eligible for procurement by WHO/United
Nations Childrens Fund and NMCP reports
Public sector
Private sector - AMFm/GF
ACT treatment courses (millions)
500
Public sector - AMFm/GF

Distributed by NMCPs
400
300
200
100
0
2010
2011
2012
2013
2014
2015
ACT, artemisinin-based combination therapy; AMFm,Affordable

Medicines Facilitymalaria; GF, Global Fund to Fight AIDS,
Tuberculosis and Malaria; NMCP, national malaria control
programme
Figure 2.10 Ratio of ACT treatment courses

distributed to diagnostic tests performed
(RDTs or microscopy), WHO African Region
2010-2015. Source: National malaria control
programme reports, WHO African Region, 20102015
Ratio of ACTs: tests undertaken and test positivity rate
Figure 2.9 Number of ACT treatment courses

delivered by manufacturers and distributed by
NMCPs, 20102015. AMFm/GF indicates AMFm operated
3.00
2.50
Ratio of ACTs: tests undertaken
2.00
1.50
1.00
0.50
0
Test positivity rate
2010
2011
2012
2013
2014
2015
ACT, artemisinin-based combination therapy; RDT,

rapid diagnostic test
15
16
Cases of malaria can be prevented by vector control (stopping mosquitoes

from biting human beings), by chemoprevention (providing drugs that suppress
infections) or, potentially, by vaccination. These prevention strategies are discussed
below.
Vector control
The most commonly used methods to prevent mosquito bites are sleeping under
an ITN and spraying the inside walls of a house with an insecticide indoor
residual spraying (IRS). Use of ITNs has been shown to reduce malaria incidence
rates by 50% in a range of settings, and to reduce malaria mortality rates by
55% in children aged under 5 years in sub-Saharan Africa (5,6). Historical and
programme documentation suggest a similar impact for IRS, but randomized
trial data are limited (7). These two core vector-control interventions use of ITNs
and IRS are considered to have made a major contribution to the reduction in
malaria burden since 2000, with ITNs estimated to account for 50% of the decline
in parasite prevalence among children aged 210 years in sub-Saharan Africa
between 2001 and 2015 (1). In a few specific settings and circumstances, ITNs and
IRS can be supplemented by larval source management (8) or other environmental
modifications that reduce the suitability of environments as mosquito habitats or
that otherwise restrict biting of humans.
17
Preventing malaria
Chemoprevention
In sub-Saharan Africa, intermittent preventive treatment of malaria in pregnancy
(IPTp) with sulfadoxine-pyrimethamine (SP) has been shown to reduce maternal
anaemia (7), low birth weight (1) and perinatal mortality (8). Intermittent preventive
treatment in infants (IPTi) with SP provides protection against clinical malaria and
anaemia (9); however, as of 2015, no countries have reported implementation of
an IPTi policy. Seasonal malaria chemoprevention (SMC) with amodiaquine (AQ)
plus SP (AQ+SP) for children aged 359 months reduces the incidence of clinical
attacks and severe malaria by about 80% (10,11) and could avert millions of cases
and thousands of deaths in children living in areas of highly seasonal malaria
transmission in the Sahel subregion (12). As of 2015, 10 countries had adopted the
policy (Burkina Faso, Chad, Gambia, Guinea, Guinea Bissau, Mali, Niger, Nigeria,
Senegal and Togo).
Vaccines
A number of malaria vaccine research projects are underway (13). The only
vaccine to have completed Phase 3 testing is RTS,S/AS01, which reduced clinical
incidence by 39% and severe malaria by 31.5% among children aged 517months
who completed four doses. Following the positive scientific opinion of the European
Medicines Authority under Article 58 (14), WHO recommended that RTS,S
be implemented on a pilot scale in parts of three to five sub-Saharan African
countries(15). The aim is to provide information on feasibility, safety and mortality
impact, to guide recommendations on the potential wider scale use of this vaccine
in 35 years time. The first phase of vaccination is expected to commence in 2018.
RTS,S is being considered as a complementary malaria control tool in Africa that
could potentially be added to, rather than replace, the core package of proven
malaria preventive, diagnostic and treatment interventions.
Indicators
Ensuring universal access of populations at risk to preventive interventions is
central to achieving the goals and milestones of the GTS. Accordingly, this section
reviews the indicators listed in Box 3.1 to assess the extent to which universal access
to interventions has been achieved. Use of ITNs is reported only for sub-Saharan
Africa, where malaria vectors are most amenable to control with this intervention.
Similarly, the analysis of IPTp is confined to sub-Saharan Africa, the region where
it is applicable. The coverage of IPTi, SMC and vaccines is not reported given their
current limited adoption.
18
Box 3.1 Indicators related to preventing malaria

>>
>>
>>
>>
>>
>>
Proportion of population at risk that slept under an ITN the previous night
Proportion of population with access to an ITN within their household
Proportion of households with at least one ITN for every two people
Proportion of households with at least one ITN
Proportion of existing ITNs used the previous night
Proportion of targeted risk group receiving ITNs (antenatal and immunization clinic
attenders)
Indoor residual spraying
>> Proportion of population at risk protected by IRS in the previous 12 months
Insecticide-treated mosquito nets and indoor residual spraying
>> Proportion of population at risk sleeping under an ITN or living in a house sprayed by
IRS in the previous 12 months
Intermittent preventive therapy in pregnancy

>>
>>
>>
>>
Proportion of pregnant women who received at least three doses of IPTp

Proportion of pregnant women who received 2 doses of IPTp
Proportion of pregnant women who received 1 dose of IPTp
Proportion of pregnant women who attended antenatal care at least once
19
Preventing malaria
3.1 Population at risk sleeping under an insecticide-treated

mosquito net
For countries in sub-Saharan Africa, it is estimated that 53% of the population at risk
slept under an ITN in 2015 (95%confidence interval [CI]: 5057%), increasing from 5%
in 2005 and from 30% in 2010 (95%CI: 2832%) (Figure 3.1). The rise in the proportion
of the population sleeping under an ITN has been driven by increases in the proportion
of the population that have access to an ITN in their house (in 2015 the proportion was
60%, 95% CI: 5764%). The proportion sleeping under an ITN is generally close to the
proportion with access to an ITN. Thus, while it continues to be important to encourage
consistent ITN use among those who have access to a net, ensuring access to ITNs for
those who do not have them is central to increasing overall use.
The proportion of households with one or more ITNs increased to 79% in 2015
(95%CI:7683%). However, this means that a fifth of households do not have access to
any nets. Moreover, the proportion of households with sufficient ITNs for all household
members was just 42% (95% CI: 3945%), substantially short of universal access (100%)
to this preventive measure. This reiterates the need to ensure that all households
receive sufficient nets so there is at least one for every two persons.
3.2 Targeted risk group receiving ITNs

In addition to mass distribution campaigns, WHO recommends the continuous distribution
of ITNs to all pregnant women attending antenatal care (ANC) and all infants attending
child immunization clinics (17). Data reported by NMCPs indicate that, between 2013
and 2015, mass campaigns accounted for 86% of ITNs distributed in sub-Saharan Africa,
while antenatal clinics accounted for 10% and immunization clinics for 4% (Figure 3.2).
The number of ITNs distributed through antenatal and immunization clinics can be
compared to the number of pregnant women attending ANC and the number of
children receiving immunization, to determine the extent to which these channels are
used for ITN delivery (18). Data reported by NMCPs in 20132015 indicate that 39% of
pregnant women that attended ANC and 20% of children that attended immunization
clinics received an ITN. Hence, these continuous distribution channels for ITNs appear
to be underused. Some of the gap can be attributed to countries not yet adopting a
policy to distribute ITNs through these channels; four countries that did not distribute
ITNs through ANC clinics accounted for 10% of the 61% gap, and nine countries that did
not distribute ITNs through immunization clinics accounted for 22% of the 80% gap.
3.3 Population at risk protected by indoor residual spraying

NMCPs reported that 106 million people worldwide were protected by IRS in 2015; this
figure includes 49 million people in the WHO African Region and 44 million people in
the WHO South-East Asia Region (of whom >41 million are in India). The proportion of
the population at risk protected by IRS declined globally from a peak of 5.7% in 2010
to 3.1% in 2015, with decreases seen in all WHO regions (Figure 3.3). The proportions of
the population protected by IRS are low because IRS is generally used only in particular
areas. Declining IRS coverage may be attributed to a change from pyrethroids to
more expensive insecticide classes, although heavy reliance on pyrethroids continues
particularly outside of the WHO African Region (Figure 3.4). Concurrent, sequential or
mosaic use of insecticide classes with different modes of action is one component of a
comprehensive insecticide resistance management strategy.
20
Figure 3.1 Proportion of population at risk with

access to an ITN and sleeping under an ITN,
and proportion of households with at least one
ITN and enough ITNs for all occupants, subSaharan Africa, 20052015. Source: Insecticide-
Figure 3.2 Proportion of ITNs distributed through

different delivery channels in sub-Saha
ran
Africa, 20132015. Source: National malaria control
programme reports
treated mosquito net coverage model from Malaria Atlas

Project (16)
Proportion of population at risk or households
100%
80%
Mass campaign,
86%
Child immunization
clinics, 4%
Household with at least 1 ITN

Population with access to an ITN in household
Household with enough ITNs for all occupants
Population sleeping under an ITN
Antenatal care
clinics, 10%
60%
40%
20%
0
2005
2010
2015
ITN, insecticide-treated mosquito net
Figure 3.3 Proportion of the population at risk

protected by IRS by WHO region, 20102015.
Source: National malaria control programme reports
Figure 3.4 Insecticide class used for indoor

residual spraying 20102015. Source: National
malaria control programme reports
12%
AFR
AMR
World
SEAR
EMR
WPR
Number of countries
8%
50
6%
40
30
20
10
0
4%
2010
2011
2012
2013
WHO African Region
2014
2015
2010
2011
2012
2013
Other WHO regions
2014
2015
50
2%
0
2010
2011
2012
2013
2014
2015
AFR, WHO African Region; AMR, WHO Region of the

Americas; EMR, WHO Eastern Mediterranean Region;
IRS, indoor residual spraying; SEAR, WHO South-East Asia
Region; WPR, WHO Western Pacific Region
Number of countries
Proportion of population at risk
10%
Pyrethroids only
Pyrethroids and other insecticides
Other insecticides only
40
30
20
10
0
21
Preventing malaria
3.4 Population at risk sleeping under an insecticide-treated

mosquito net or protected by indoor residual spraying
Combining data on the proportion of the population sleeping under an ITN with
information on the proportion protected by IRS and accounting for households
that may receive both interventions the proportion of the population in
sub-Saharan Africa protected by vector control was estimated at 57% in 2015
(uncertainty interval [UI], 4470%) compared with 37% in 2010 (UI, 2548%)
(Figure3.5). The proportion exceeded 80% in three countries in 2015: Cabo Verde,
Zambia and Zimbabwe.
Figure 3.5 Proportion of the population at risk protected by IRS or

sleeping under an ITN in sub-Saharan Africa, 20102015. Sources:
Insecticide-treated mosquito net coverage model from Malaria Atlas Project (16),
national malaria control programme reports and further analysis by WHO
ITN only
Proportion of population at risk
100%
ITN & IRS
IRS only
80%
60%
40%
20%
2010
2011
2012
2013
IRS, indoor residual spraying; ITN, insecticide-treated mosquito net
22
2014
2015
23
Preventing malaria
3.5 Vector insecticide resistance

Resistance of malaria vectors to the four insecticide classes currently used in ITNs
and IRS threatens malaria prevention efforts. Of the 73 malaria endemic countries
that provided monitoring data to WHO for 2010 onwards, 60 reported resistance
to at least one insecticide in one malaria vector from one collection site, and 50
reported resistance to two or more insecticide classes. Resistance to pyrethroids
the only class currently used in ITNs is the most commonly reported (Figure 3.6); in
2015, over three quarters of the countries monitoring this insecticide class reported
resistance. However, the impact of pyrethroid resistance on ITN effectiveness is
not yet well established. A WHO-coordinated five-country evaluation conducted
in areas with pyrethroid-resistant malaria vectors did not find an association
between malaria disease burden and levels of resistance, and showed that ITNs still
provided personal protection (19). Nevertheless, evidence of geographical spread
of resistance and intensification in some areas underscores the need to urgently
take action to manage resistance and to reduce reliance on pyrethroids.
Priority actions include establishing and applying national insecticide resistance
monitoring and management plans in line with the WHO Global plan for insecticide
resistance management in malaria vectors (GPIRM), released in 2012. New vector
monitoring and control tools and approaches are also urgently required. WHO
Test procedures for monitoring insecticide resistance in malaria vector mosquitoes
were updated in November 2016 to include bioassays for resistance intensity and
metabolic mechanisms. Information from national programmes and partners on
insecticide resistance in malaria vectors is collated by WHO in a global database.
Figure 3.6 Insecticide resistance and monitoring status for malaria endemic countries (2015), by
insecticide class and WHO region, 20102015. Source: National malaria control programme reports, African
Network for Vector Resistance, Malaria Atlas Project, Presidents Malaria Initiative (United States), scientific publications
Resistance reported
50
Resistance not reported
Not monitored
Number of countries
40
30
20
10
AFR
AMR EMR
EUR
SEAR WPR
Pyrethroids
AFR
AMR EMR
EUR SEAR WPR AFR
Organochlorine (DDT)
AMR EMR
EUR SEAR WPR
Carbamates
AFR
AMR EMR
EUR SEAR WPR
Organophosphates
AFR, WHO African Region; AMR, WHO Region of the Americas; DDT, dichloro-diphenyl-trichloroethane; EMR, WHO Eastern
Mediterranean Region; EUR, European Region; SEAR, WHO South-East Asia Region; WPR, WHO Western Pacific Region
24
3.6 Pregnant women receiving three or more doses of

intermittent preventive therapy
It is estimated that, in 2015, among 20 countries that reported, 31% of eligible
pregnant women (UI: 2932%) received three or more doses of IPTp in 36 African
countries that have adopted the policy a large increase from the 18% receiving
three or more doses in 2014 and 6% in 2010 (Figure3.7). The proportion still remains
below full coverage. Asignificant proportion of pregnant women do not attend
ANC (20% in 2015) and, of those who do, 30% do not receive a single dose of IPTp.
The proportion of women receiving IPTp varied across the continent, with
24countries reporting that more than 50% of pregnant women received one or
more doses, and 17 countries reporting more than 50% received two or more doses.
Only three countries reported that more than 50% of pregnant women received
three or more doses of IPTp.
Figure 3.7 Proportion of pregnant women receiving IPTp, by dose,

sub-Saharan Africa, 2010-2015. Source: National malaria control programme
reports and United Nations population estimates
95% uncertainty interval
100%
Proportion of pregnant women
80%
60%
Receiving at least
1 dose of IPTp
40%
Receiving at least
2 doses of IPTp
Receiving at least
3 doses of IPTp
20%
2010
2011
2012
2013
2014
2015
IPTp, intermittent preventive treatment in pregnancy
25
Box 4.1 Indicators related to diagnostic testing and treatment

Care seeking
>> Proportion of children under 5 with fever in the previous 2 weeks for whom advice or
treatment was sought
Diagnostic testing
>> Proportion of children under 5 with fever in the previous 2 weeks who had a finger or
heel stick
>> Proportion of patients with suspected malaria attending public health facilities who
received a parasitological test
Treatment
>> Proportion of patients with confirmed malaria who received first-line antimalarial
treatment according to national policy
>> Proportion of treatments with ACTs (or other appropriate treatment according to national
policy) among febrile children <5
26
4. Diagnostic testing
and treatment
Prompt diagnosis and treatment of malaria can cure a patient, preventing the
development of severe malaria and subsequent death. It also reduces the length
of time that patients carry malaria parasites in their blood, which in turn reduces
the risk of onward transmission.
Diagnostic testing
WHO recommends that every suspected malaria case be confirmed by microscopy
or an RDT before treatment (20). Accurate diagnosis improves the management
of febrile illnesses and ensures that antimalarial medicines are only used when
necessary. Only in areas where parasite-based diagnostic testing is not possible
should malaria treatment be initiated solely on clinical suspicion.
Treatment
Prompt and appropriate treatment of uncomplicated malaria is critical in
preventing progression to severe disease and death. WHO recommends ACTs
for the treatment of uncomplicated Plasmodium falciparum malaria. ACTs have
been estimated to reduce malaria mortality in children aged 123 months by 99%
(range: 94100%), and in children aged 2459 months by 97% (range: 8699%) (21).
Indicators
The ability of health systems to diagnose and treat cases is influenced by the extent
to which patients with suspected malaria seek treatment, and by the proportion
of patients who receive a diagnostic test and appropriate treatment after seeking
health care. This section of the report discusses indicators covering care seeking,
diagnostic testing and treatment, as listed in Box 4.1. It also considers the parasites
evolutionary responses to interventions; namely, the potential for selection of
parasites that can evade diagnostic tests and the evolution of drug resistance.
27
Diagnostic testing and treatment
4.1 Children aged under 5 years with fever for whom advice or
treatment was sought from a trained provider
Evidence on the extent to which patients with suspected malaria seek treatment
is derived mainly from household surveys that measure the proportion of children
with fever for whom advice or treatment is sought. A disadvantage of this indicator
is that it considers fever rather than confirmed malaria. Nonetheless, malaria
should be suspected in febrile children who live in malaria endemic areas, and
such children should be taken to a trained provider to obtain a diagnostic test and
treatment, if appropriate. Although the indicators measurement is largely confined
to sub-Saharan Africa and children aged under 5 years, sub-Saharan Africa
accounts for more than 90% of global malaria cases, with most cases occurring
in children aged under 5 years.
Among 23 nationally representative surveys completed in sub-Saharan Africa
between 2013 and 2015 (representing 61% of the population at risk), a higher
proportion of febrile children sought care in the public sector (median: 42%,
interquartile range [IQR]: 3150%) than in the private sector (median: 20%,
IQR:1228%), as shown in Figure 4.1. Most visits to the private sector were to the
informal sector (median: 11%, IQR: 721%), which comprises pharmacies, kiosks
and traditional healers, rather than to the formal private sector (median: 5%,
IQR:721%), which comprises private hospitals and clinics. Overall, a median of
54% (IQR: 4159%) of febrile children were taken to a trained provider (i.e. to public
sector health facilities, formal private sector facilities or community health workers).
A large proportion of febrile children are not brought for care (median: 36%,
IQR:2642%); possible reasons for this are poor access to health-care providers
or a lack of awareness among caregivers about necessary care for febrile children.
Figure 4.1 Proportion of febrile children seeking care, by health sector, sub-Saharan Africa,
20132015. Sources: Nationally representative household survey data from demographic and health surveys, and malaria
indicator surveys
Proportion of children <5 years

with fever in previous 2 weeks
100%
80%
60%
40%
20%
0
28
Public sector
Formal
private sector
Informal
private sector
Community
health worker
No treatment
sought
4.2 Suspected malaria cases receiving a parasitological test

Since 2010, WHO has recommended that all persons with suspected malaria
should undergo malaria diagnostic testing, by either microscopy or RDT. Household
surveys can provide information on diagnostic testing among febrile children aged
under 5 years across all sources of care. Among 22 nationally representative surveys
completed in sub-Saharan Africa between 2013 and 2015 that asked questions on
diagnostic testing, the proportion of febrile children who received a finger or a
heel stick, indicating that a malaria diagnostic test was performed, was greater
in the public sector (median: 51%, IQR: 3560%) than in both the formal private
sector (median: 40%, IQR: 2857%) and the informal private sector (median: 9%,
IQR: 412%), as shown in Figure 4.2. Although the proportion of children seeking
care from a community health worker was low, about a third received a diagnostic
test (median: 31%; IQR: 1146%). Combining the proportions of febrile children aged
under 5 years who sought care with the proportion who received a parasitological
test among those who sought care, a median of 31% of febrile children received
a parasitological test among the 22 nationally representative household surveys
analysed between 2013 and 2015 (IQR: 1637%).
Figure 4.2 Proportion of febrile children receiving a blood test, by health sector, sub-Saharan
Africa, 20132015. Proportions shown are among those that sought care. Sources: Nationally representative household
survey data from demographic and health surveys, and malaria indicator surveys
Proportion of febrile children

that sought care at treatment outlet
100%
80%
60%
40%
20%
0
Public sector
Formal
private sector
Informal
private sector
Community
health worker
29
4.3 Suspected malaria cases attending public health facilities

and receiving a parasitological test
Data reported by NMCPs indicate that the proportion of suspected malaria cases
receiving a parasitological test among patients presenting for care in the public
sector has increased in most WHO regions since 2010 (Figure 4.3). The largest
increase has been in the WHO African Region, where diagnostic testing increased
from 40% of suspected malaria cases in 2010 to 76% in 2015, mainly owing to an
increase in the use of RDTs, which accounted for 74% of diagnostic testing among
suspected cases in 2015.
The reported testing rate may overestimate the true extent of diagnostic testing
in the public sector, because, among other factors, the rate relies on accurate
reporting of suspected malaria cases, and reporting completeness may be higher
in countries with stronger surveillance systems and higher testing rates. A trend
of increased testing in the public sector is also evident in the results of household
surveys, where the proportion of febrile children who received a malaria diagnostic
test in the public sector rose from a median of 29% in 2010 (IQR: 1946%) to a
median of 51% in 2015 (IQR: 3560%) (Figure 4.4). However, the two sources of
information are not directly comparable because the numbers reported by NMCPs
relate to all age groups, and because household surveys are undertaken in only
a limited number of countries each year.
Figure 4.3 Proportion of suspected malaria

cases attending public health facilities who
receive a diagnostic test, by WHO region, 2010
2015. Source: National malaria control programme reports
100%
80%
60%
40%
AMR
SEAR
WPR
EMR
AFR
20%
0
2010
2011
2012
2013
2014
80%
60%
40%
20%
2015
AFR, WHO African Region; AMR, WHO Region of the

Americas; EMR, WHO Eastern Mediterranean Region;
SEAR, WHO South-East Asia Region; WPR, WHO Western
Pacific Region
30
survey data from demographic and health surveys, and

malaria indicator surveys
Proportion of children <5 years

with fever in previous 2 weeks
Proportion of suspected malaria cases
100%
Figure 4.4 Proportion of febrile children

attending public sector health facilities who
receive a blood test, sub-Saharan Africa,
20102015. Sources: Nationally representative household
20102012
20112013
20122014
20132015
4.4 Malaria cases receiving first-line antimalarial treatment

according to national policy
In recent years, more nationally representative household surveys have
administered an RDT to children included in the survey. Thus, it is now possible
to examine the treatment received by children with both a fever in the previous
2weeks and a positive RDT at the time of survey (Figure 4.5).
The median proportion of children aged under 5 years with evidence of recent
or current P. falciparum infection and a history of fever, and who received any
antimalarial drug was 30% among 11 household surveys conducted in sub-Saharan
Africa in 20132015 (IQR: 2051%). The median proportion receiving an ACT
was 14% (IQR: 545%). The low values can be attributed to two factors: many
febrile children are not taken for care to a qualified provider (Section 4.2) and, in
cases where children are taken for care, a significant proportion of antimalarial
treatments dispensed are not ACTs (Section 4.6). The apparent proportions and
trends indicated are uncertain because the interquartile ranges of the medians
are wide, indicating considerable variation among countries. Moreover, the
number of household surveys is comparatively small, covering an average of 37%
of the population at risk in sub-Saharan African in any one 3-year period. Further
investments are needed to better track malaria treatment at health facilities
(through routine reporting systems and surveys) and at community level, to gain
a greater understanding of the extent of barriers to accessing malaria treatment.
Figure 4.5 Proportion of febrile children with a positive RDT at

time of survey who received antimalarial medicines, sub-Saharan
Africa, 20102015. Sources: Nationally representative household survey data from
demographic and health surveys, and malaria indicator surveys
Any antimalarial
Proportion of children with fever in previous

2 weeks and positive RDT at time of survey
100%
ACT
80%
60%
40%
20%
20102021
20112013
20122014
20132015
ACT, artemisinin-based combination therapy; RDT, rapid diagnostic test
31
4.5 ACT treatments among all malaria treatments

Based on nationally representative household surveys, the proportion of
antimalarial treatments that are ACTs (for children with both a fever in the previous
2 weeks and a positive RDT at the time of survey) increased from a median of
29% in 20102012 (IQR: 1755%) to 80% in 20132015 (IQR: 2995%) (Figure 4.6).
However, the ranges associated with the medians are wide, indicating large
variation between countries, and the number of household surveys covering any
one 3-year period is comparatively small. Antimalarial treatments are more likely
to be ACTs if children seek treatment at public health facilities or via community
health workers than if they seek treatment in the private sector (Figure 4.7).
4.6 Parasite resistance

As the coverage of malaria programmes increases, malaria parasites respond to
the selection pressure applied and parasite evolution can potentially compromise
the effectiveness of current tools to diagnose and treat malaria.
Diagnostic testing
Some malaria parasites lack the HRP2 protein, the most common target antigen
used in RDTs for detection of P. falciparum. Hence, the parasites can evade
detection by diagnostic tests and subsequent treatment with an ACT. This not only
prevents a patient from receiving appropriate treatment, but also enables the
parasite to survive, reproduce and increase in prevalence.
In 20142015, HRP2 or 3 deletions were reported in studies from the China
Myanmar border, Ghana and South America (Bolivia, Brazil, Colombia and
Suriname). Other studies have reported HRP2 or 3 gene deletions in Democratic
Figure 4.6 Proportion of antimalarial treatments

that are ACTs received by febrile children that
are RDT positive at the time of survey, subSaharan Africa, 20052015. Sources: Nationally
representative household survey data from demographic

and health surveys, and malaria indicator surveys
80%
60%
40%
20%
0
20102012
20112013
20122014
20132015
ACT, artemisinin-based combination therapy; RDT, rapid

diagnostic test
32
Sources: Nationally representative household survey data

from demographic and health surveys, and malaria
indicator surveys
Proportion of antimalarial treatments
Proportion of antimalarial treatments
100%

that are ACTs received by febrile children, by
health sector, sub-Saharan Africa, 20132015.
100%
80%
60%
40%
20%
0
Public sector
Formal
private sector
Informal
private sector
ACT, artemisinin-based combination therapy
Community
health worker
Republic of the Congo, Eritrea, India, Mozambique, Uganda, the United Republic
of Tanzania, western Indonesia and western Kenya. Populations of P. falciparum
lacking one or both of the HRP2 or 3 genes are now present outside South America
in both high and low transmission areas, and with varying prevalence across
narrow geographical ranges. In South America, deletions were observed in
parasite samples collected before HRP2-based RDTs were introduced; deletions
have spread due to human migration.
To ensure detection of non-HRP2-expressing parasites, only RDTs that specifically
target Pf-pLDH (i.e. pan-pLDH-only tests) should be used. Currently, only a few
non-HRP2-based RDTs meet WHOs recommended procurement criteria.
Treatment
Plasmodium falciparum resistance to artemisinin has been detected in five
countries in the Greater Mekong subregion. Artemisinin resistance is defined as
delayed clearance of the parasites; it represents a partial resistance. Most patients
who have delayed parasite clearance after treatment with an ACT are still able
to clear their infections, except where the parasites are also resistant to the ACT
partner drug.
Resistance to ACT partner drugs can pose a challenge to the treatment of malaria
in some areas. In Cambodia, high failure rates after treatment with an ACT have
been detected for four different ACTs (Figure 4.8). Resistance to dihydroartemisininpiperaquine, first detected in Cambodia in 2008, has spread eastwards and was
detected in Viet Nam in 2015. Selection of an appropriate antimalarial medicine
is based on the efficacy of the medicine
against the malaria parasite. Monitoring
the therapeutic efficacy of antimalarial
Figure 4.8 Distribution of malarial multidrug resistance
medicine is therefore a fundamental
2016. Source: WHO database
component of treatment strategies.
WHO recommends that all malaria
endemic countries conduct therapeutic
Yunnan Province,
efficacy studies at least every 2years
China
to inform national treatment policy
(22). Studies of molecular markers of
drug resistance can provide important
additional information for detecting and
Myanmar
Lao Peoples Democratic Republic
tracking antimalarial drug resistance.
WHO collects information on therapeutic
efficacy and molecular markers in a
Thailand
global database.
Viet Nam
Cambodia
1 ACT
2 ACTs
4 ACTs
ACT, artemisinin-based combination therapy
33
34
Effective surveillance of malaria cases and deaths is essential for identifying

which areas or population groups are most affected by malaria, and for targeting
resources to communities most in need. Such surveillance also alerts ministries of
health to epidemics, enabling control measures to be intensified when necessary.
The transformation of surveillance into a core intervention constitutes the third
pillar of the GTS, and recommendations for establishing effective surveillance
systems have been published by WHO (23,24).
Surveillance systems do not detect all malaria cases for several reasons. First,
not all malaria patients seek care or, if they do, they may not seek care at health
facilities that are covered by a countrys surveillance system (Section 5.1). Second,
not all patients seeking care receive a diagnostic test (Section 5.2). Finally,
recording and reporting within the surveillance system is not always complete.
This section of the report summarizes indicators covering surveillance of malaria
cases, listed in Box 5.1.
Box 5.1 Indicators related to malaria surveillance systems

>> Proportion of expected health facility reports received at the national level
>> Proportion of malaria cases detected by surveillance systems
35
Malaria surveillance systems
5.1 Health facility reports received at national level

The completeness of health facility reporting is a good indicator of a surveillance
systems performance, because achieving a high reporting rate requires health
facilities to adhere to several processes. These processes include the enumeration
of a complete list of reporting units, compliance with reporting requirements and
monitoring of that compliance. A high reporting rate is also critical to the eventual
interpretation of indicators. Health facility reporting rates become less relevant
as countries progress towards elimination and begin to report individual cases.
Nonetheless, to ensure that coverage of surveillance systems is complete, the
number of health facilities testing for malaria should continue to be tracked.
In 2015, among the countries that could report on this indicator, most (40 of 47)
reported health facility reporting rates of over 80% (Figure 5.1). However, this
indicator could not be calculated for about half of the countries in which malaria
was endemic in 2015, either because the number of health facilities that were
expected to report was not specified (two countries) or because the number of
reports submitted was not stated (17 countries), or both (24 countries). A total of
23 countries received reports from private health facilities, but these comprised
a minority of all reports received in those countries (median: 2.1%, IQR: 0.613%).
Figure 5.1 Health facility reporting rates by WHO region, 2015. Source: National malaria control programme
reports
100%
100%
8099%
6079%
<60%
Unable to calculate
Proportion of countries
80%
60%
40%
20%
AFR
AMR
EMR
SEAR
WPR
World
AFR, WHO African Region; AMR, WHO Region of the Americas; EMR, WHO Eastern Mediterranean Region; SEAR, WHO SouthEast Asia Region; WPR, WHO Western Pacific Region
36
5.2 Malaria cases detected by surveillance systems

It is estimated that, in 2015, malaria surveillance systems detected 19% of cases that
occur globally (UI: 1621%) (Figure 5.2). The bottlenecks in case detection vary by
WHO region. In the WHO African Region, the WHO Eastern Mediterranean Region,
the WHO South-East Asia Region and the WHO Western Pacific Region, a large
proportion of patients seek treatment in the private sector, and these cases are
not captured by existing surveillance systems. Also, in the WHO African Region,
the WHO Eastern Mediterranean Region and the WHO Western Pacific Region, a
relatively low proportion of patients attending public health facilities also receive
a diagnostic test. The regional patterns are sometimes dominated by individual
countries with the highest number of cases; for instance, a large proportion of
patients in India seek treatment in the private sector. Case detection rates have
increased by 10% since 2010, with most of this improvement being due to increased
diagnostic testing in sub-Saharan Africa.
Figure 5.2 Bottlenecks in case detection 2015, by WHO region. Sources: Nationally representative household
survey data and national malaria control programme reports
100%
Seeking treatment
Seeking treatment at facility covered by surveillance system
Receiving diagnostic test
Case reported
Proportion of all malaria cases
80%
60%
40%
20%
AFR
AMR
EMR
SEAR
WPR
World
37
Box 6.1 Indicators related to impact

>> Parasite prevalence: proportion of population with evidence of infection with malaria
>>
>>
>>
>>
38
parasites
Malaria case incidence: number and rate per 1000 persons per year
Malaria mortality rate: number and rate per 100 000 persons per year
Number of countries that have newly eliminated malaria since 2015
Number of countries that were malaria free in 2015 in which malaria has been
re-established
6. Impact
The GTS set ambitious yet achievable targets for 2030; namely, to reduce malaria
incidence and mortality rates globally by at least 90% by 2030, with a milestone
of at least a 40% reduction by 2020 (2). The GTS also set a target to eliminate
malaria from at least 35 countries by 2030 (with a milestone of elimination in at
least 10 countries by 2020), and simultaneously to prevent the re-establishment
of malaria in all countries that were malaria free in 2015.
To assess progress towards the targets and milestones of the GTS, this section of
the report reviews the total number of malaria cases and deaths estimated to
have occurred in 2015, and reviews progress according to the indicators listed in
Box6.1. It also considers the gains in life expectancy that have occurred owing
to a reduction in malaria mortality rates, and the economic value of such gains.
The prevalence of infections with malarial parasites in people of all ages, including
children, can provide information on the level of malaria transmission in a country.
Parasite prevalence is most relevant for sub-Saharan Africa, where it is measured
through nationally representative household surveys. Such surveys can be brought
together in a geospatial model to facilitate the mapping of parasite prevalence
and the analysis of trends over time (see Annex 1). This form of analysis is restricted
to sub-Saharan Africa.
Malaria case incidence and mortality rates are relevant in all settings. Surveillance
systems do not capture all malaria cases and deaths that occur; hence, it is
necessary to use estimates of the number of cases or deaths in a country to make
inferences about global trends in malaria case incidence and mortality rates (as
described in Annex 1). The methods for producing estimates either adjust the
number of reported cases to account for the estimated proportion of cases that are
not captured by a surveillance system, or model the relationship between parasite
prevalence and case incidence or mortality. The latter method is used for countries
in sub-Saharan Africa for which surveillance data are lacking. The estimates aim
to fill gaps in reported data; however, because they rely on relationships between
variables that are uncertain, and draw on data that may be imprecisely measured,
the estimates have a considerable degree of uncertainty.
39
Impact
6.1 Estimated number of malaria cases by WHO region,

20002015
In 2015, an estimated 212 million cases of malaria occurred worldwide (UI:
148304million), a fall of 22% since 2000 and of 14% since 2010 (Table 6.1). Most
of the cases in 2015 were in the WHO African Region (90%), followed by the WHO
South-East Asia Region (7%) and the WHO Eastern Mediterranean Region (2%)
(Table 6.2, Figure 6.1). About 4% of estimated cases globally are caused by P.vivax,
but outside the African continent this proportion increases to 41% (Table 6.2). Most
cases of malaria caused by P. vivax occur in the WHO South-East Asia Region
(58%), followed by the WHO Eastern Mediterranean Region (16%) and the WHO
African Region (12%). About 76% of estimated malaria cases in 2015 occurred in just
13 countries (Figure 6.2). Four countries (Ethiopia, India, Indonesia and Pakistan)
accounted for 78% of P. vivax cases.
Table 6.1 Estimated malaria cases, 20002015. Estimated cases are shown with 95% upper and lower uncertainty
intervals. Source: WHO estimates
Number of cases (000s)

2000
2005
2010
2011
2012
2013
2014
2015
Lower
202 000
202 000
192 000
Estimated total
271 000
266 000
245 000
183 000
171 000
158 000
152 000
148 000
235 000
224 000
217 000
212 000
Upper
314 000
313 000
287 000
276 000
212 000
272 000
271 000
306 000
304 000
Lower
18 000
18 700
13 700
13 100
11 200
9 200
8 000
6 600
Estimated P. vivax
28 900
25 700
17 500
16 600
14 200
11 300
9 100
8 500
Upper
37 400
32 300
22 100
21 000
17 400
14 300
12 200
10 800
8%
10%
7%
7%
6%
5%
4%
4%
% cases P. vivax
Table 6.2. Estimated malaria cases by WHO region, 2015.
% change
20102015
-14%
-51%
Estimated cases are shown with 95% upper and
lower uncertainty intervals. Source: WHO estimates
Number of cases (000s)

AFR
AMR
EMR
EUR
SEAR
WPR
World
Outside
sub-Saharan Africa
Lower
131000
500
2400
13300
1000
148000
16300
Estimated total
191000
800
3800
14400
1200
212000
18100
Upper
258000
1200
7500
35200
2200
304000
40300
Lower
300
400
1100
3400
500
6600
5800
Estimated P. vivax
1000
500
1400
4900
700
8500
7400
Upper
2100
800
1700
6800
900
10800
9300
1%
69%
35%
34%
58%
4%
41%
% cases P. vivax
40
Figure 6.1 Estimated malaria cases (millions) by WHO region, 2015. The area of the circles is proportional
to the estimated number of cases in each region. Source: WHO estimates
P. falciparum
AFR 191
SEAR 14
EMR 3.8
WPR 1.2
P. vivax
AMR 0.8
Figure 6.2 Estimated country share of (a) total malaria cases and (b) P. vivax malaria cases, 2015.
Source: WHO estimates
Others, 24%
Niger, 2%
United Republic of Tanzania, 2%
Nigeria, 29%
(a)
Cameroon, 3%
Kenya, 3%
Democratic Republic of the Congo, 9%
Burkina Faso, 3%
Ghana, 3%
Mali, 4%
India, 6%
Uganda,
4%
Cte dIvoire, 4%
Mozambique, 4%
India, 49%
Others, 22%
(b)
Indonesia, 7%
Pakistan, 10%
Ethiopia, 12%
41
Impact
6.2 Estimated number of malaria deaths by WHO region,

20002015
In 2015, it was estimated that 429 000 deaths from malaria occurred globally
(UI: 235 000639 000), a decrease of 50% since 2000 and of 22% since 2010
(Table6.3). Most deaths in 2015 were estimated to have occurred in the WHO
African Region (92%), followed by the WHO South-East Asia Region (6%) and the
WHO Eastern Mediterranean Region (2%) (Table 6.4, Figure 6.3). Almost all deaths
(99%) resulted from P. falciparum malaria. Plasmodium vivax is estimated to have
been responsible for 3100 deaths in 2015 (range: 18004900), with most (86%)
occurring outside Africa.
In 2015, 303 000 malaria deaths (range: 165 000450 000) were estimated to
have occurred in children aged under 5 years, equivalent to 70% of the global
total (Table 6.4). The number of malaria deaths in children aged under 5 years
is estimated to have decreased by 60% since 2000 and by 29% since 2010.
Nevertheless, malaria remains a major killer of children, and is estimated to take
the life of a child every 2 minutes.
Table 6.3 Estimated malaria deaths 20002015.
Estimated deaths are shown with 95% upper and lower
uncertainty intervals. Source: WHO estimates
Number of deaths
2000
Lower
2005
2010
2011
2012
2013
2014
2015
655 000 525 000 370 000 334 000 303 000 287 000 248 000 235 000
Estimated deaths
Upper
864 000 741 000 554 000 511 000 474 000 452 000 435 000 429 000
-22%
1 087 000 955 000 740 000 687 000 635 000 610 000 656 000 639 000
Lower
4 600
4 600
3 300
3 300
2 800
2 400
2 200
1 800
Estimated P. vivax deaths
11 100
9 700
6 400
6 100
5 200
4 100
3 300
3 100
15 700
14 300
10 700
9 500
8 200
6 300
5 200
4 900
Upper
Lower
-52%
571 000 437 000 286 000 253 000 224 000 210 000 180 000 165 000
Estimated deaths <5 years 753 000 616 000 428 000 387 000 351 000 330 000 315 000 303 000
Upper
42
% change
20102015
947 000 794 000 573 000 520 000 470 000 446 000 476 000 450 000
% deaths P. vivax
1.3%
1.3%
1.2%
1.2%
1.1%
0.9%
0.8%
0.7%
% deaths <5 years
87%
83%
77%
76%
74%
73%
73%
70%
-29%
Table 6.4 Estimated malaria deaths by WHO region, 2015. Estimated deaths are shown with 95% upper and
lower uncertainty intervals. Source: WHO estimates
Number of deaths
AFR
Lower
AMR
230 000
90
EMR
900
EUR
SEAR
4 100
WPR
Outside
sub-Saharan
Africa
World
300
235 000
6 000
Estimated total deaths
394 000
490
7 300
26 200
1 500
429 000
30 000
Upper
549 000
1 100
14 600
67 100
6 800
639 000
77 000
Lower
70
60
250
700
120
1 800
1 500
380
110
510
1 800
260
3 100
2 700
Upper
1 000
190
830
3 400
420
4 900
4 300
Lower
171 000
20
300
1 100
100
165 000
2 000
Estimated deaths <5 years 292 000
130
2 400
7 100
500
303 000
8 000
18 300
2 300 450 000
21 000
Estimated P. vivax deaths
Upper
408 000
280
4 700
% deaths P. vivax
0,1%
22%
7%
7%
17%
0,7%
9%
% deaths <5 years
74%
26%
32%
27%
34%
70%
27%
AFR, WHO African Region; AMR, WHO Region of the Americas; EMR, WHO Eastern Mediterranean Region; EUR, WHOEuropean
Region; SEAR, WHO South-East Asia Region; WPR, WHO Western Pacific Region
Figure 6.3 Estimated malaria deaths (thousands) by WHO region, 2015.
proportional to the estimated number of cases in each region. Source: WHO estimates
The area of the circles is

P. falciparum
AFR 394
SEAR 26
EMR 7.3
WPR 1.5
P. vivax
AMR 0.5
43
Impact
In 2015, it is estimated that 13 countries accounted for 75% of malaria deaths

(Figure6.4). The global burden of mortality is dominated by countries in
sub-Saharan Africa, with Democratic Republic of the Congo and Nigeria together
accounting for more than 36% of the global total of estimated malaria deaths. Four
countries accounted for 81% of estimated deaths due to P. vivax malaria (Ethiopia,
India, Indonesia and Pakistan).
Figure 6.4 Estimated country share of (a) total malaria deaths and (b) P. vivax malaria deaths,
2015. Source: WHO estimates
Others, 25%
Niger, 2%
Nigeria, 26%
(a)
Kenya, 3%
Uganda, 3%
Democratic Republic of the Congo, 10%
Ghana, 3%
Cte dIvoire, 3%
India, 6%
Angola, 3%
Burkina Faso, 3%
Mali, 5%
Mozambique, 4%
United Republic of Tanzania, 4%
Others, 19%
India, 51%
Indonesia, 7%
(b)
Pakistan, 11%
Ethiopia, 12%
44
6.3 Parasite prevalence

The proportion of the population at risk in sub-Saharan Africa who are infected
with malaria parasites is estimated to have declined from 22% in 2005 (UI: 2023%)
to 17% in 2010 (UI: 1618%), and to 13% in 2015 (UI: 1115%) (Figure 6.5). The number
of people infected in sub-Saharan Africa is also estimated to have decreased, from
146million in 2005 (UI: 135156 million) to 131 million in 2010 (UI: 126136 million),
and to 114million in 2015 (UI: 99130 million). Infection rates are higher in children
aged 210, but the majority of infected people are in other age groups.
In 2015, it is estimated that 7 of the 43 countries in sub-Saharan Africa with malaria
transmission had more than 25% of their population infected with malaria parasites
(Burkina Faso, Cameroon, Equatorial Guinea, Guinea, Mali, Sierra Leone and
Togo); this number has decreased from 12 countries in 2010. Outside Africa, surveys
of parasite prevalence conducted in Papua New Guinea showed a fall in the
proportion of children infected, from 12.4% in 2009 to 1.8% in 2014 (25).
Figure 6.5 Estimated (a) parasite prevalence and (b) number of people
infected, sub-Saharan Africa, 20052015. Source: Malaria Atlas Project
(http://www.map.ox.ac.uk/) (1)
Proportion of population infected
(a) 40%
95% confidence interval
30%
Aged 210 years
20%
All ages
10%
2005
2006
2007
2008
2009
2010
2011
2012
2008
2009
2010
2011
2012
2013
2014
2015
Number of people infected (millions)
(b) 160
120
Other ages
80
40
Aged 210 years
0
2005
2006
2007
2013
2014
2015
45
Impact
6.4 Malaria case incidence rate

The incidence rate of malaria, which takes into account population growth, is
estimated to have decreased by 41% globally between 2000 and 2015, and by
21% between 2010 and 2015 (Figure 6.6). Reductions in incidence rates need to be
accelerated if the GTS milestone of a 40% reduction by 2020 is to be achieved(2).
Decreases in incidence rates are estimated to have been greatest in the WHO
European Region (100%) and the WHO South-East Asia Region (54%).
to have achieved a reduction in incidence rates of 40% or more between 2010
and 2015, and can be considered on track to achieve the GTS milestone of a
further reduction of 40% by 2020 (Figure 6.7). Another 20 countries achieved
reductions of 2040%. Most of the 40 countries with reductions of more than 40%
had fewer than 1 million cases in 2010; countries with more than 1 million cases had
smaller reductions. These data suggest that the GTS milestone of a 40% reduction
in case incidence by 2020 will be achieved only if reductions in case incidence are
accelerated in countries with high case numbers.
Incidence rates changed by less than or equal to 20% in 18 countries, and
increased by more than 20% in 13 countries between 2010 and 2015 (Figure
6.7). The proportion of countries with fewer than 10 000 cases that reported
increased incidence rates (21%) was higher than the proportion of countries with
10000 to 1 million cases (15%) and of countries with more than 1 million cases
(9%). These figures may be related to the greater variability in case incidence in
low-transmission settings. In addition, countries with fewer cases that previously
had high levels of malaria transmission may be more prone to resurgences if the
coverage of their malaria control programme is reduced.
Figure 6.6 Reduction in malaria case incidence

rate by WHO region, 20102015. No indigenous
cases were recorded in the WHO European Region in 2015.

Source: WHO estimates
Europe
100%
50
South-East Asia
Estimated number of cases in 2010:

10 000 to 1 000 000
< 10 000
Western Pacific
30%
African
21%
40
Number of countries
31%
World
> 1 000 000
54%
Americas
Eastern Mediterranean
Figure 6.7 Country-level changes in malaria

case incidence rate 20102015, by number of
cases in 2010. Source: WHO estimates
30
20
10
11%
21%
Decrease >40% Decrease 2040%
Change <20%
Increase >20%
Change in malaria incidence 20102015
46
6.5 Malaria mortality rate

Malaria mortality rates are estimated to have declined by 62% globally between
2000 and 2015, and by 29% between 2010 and 2015 (Figure 6.8). The rate of
decline between 2010 and 2015 has been fastest in the WHO Western Pacific
Region (58%) and the WHO South-East Asia Region (46%). In children aged under
5 years, malaria mortality rates are estimated to have fallen by 69% globally
between 2000 and 2015 and by 35% globally between 2010 and 2015. They fell by
38% in the WHO African Region between 2010 and 2015.
to have achieved a reduction of 40% or more in mortality rates between 2010
and 2015, 14 had reductions of 2040% and 8 experienced increases in mortality
rates of >20%. A further 10 countries reported no deaths in 2010 and in 2015 (the
remaining 20 countries experienced changes <20%). Reductions in mortality rates
were generally faster in countries with a smaller initial number of malaria deaths
(Figure 6.9). For the GTS milestone of a 40% reduction in mortality rates to be
achieved by 2020, rates of reduction will need to increase in those countries that
have higher numbers of deaths.
Figure 6.8 Reduction in malaria mortality

rate, by WHO region, 20102015. No deaths from
indigenous malaria were recorded in the WHO European
Region from 2010 to 2015. Source: WHO estimates
Western Pacific

mortality rate 20102015, by number of deaths
in 2010. Source: WHO estimates
58%
50
South-East Asia
46%
37%
African
World
31%
40
Number of countries
Americas
Estimated number of deaths in 2010:

>500
50100
<50
30
20
10
6%
29%
Decrease >40% Decrease 2040% Change <20%

Increase >20%
Change in malaria mortality rate 20102015
47
Impact
6.6 Malaria elimination and prevention of re-establishment

A target of the GTS is, by 2030, to eliminate malaria from 35 countries in which
malaria was transmitted in 2015, and a milestone is to eliminate malaria in
at least 10countries by 2020 (2). A further target of the strategy is to prevent
re-establishment of malaria in all countries that are malaria free.
A country must report zero indigenous cases of malaria for 3 consecutive years
before it is considered to have eliminated the disease. Between 2000 and 2015,
17 countries attained zero indigenous cases for 3 years or more (Figure 6.10), and
10 of these countries attained zero indigenous cases for 3 years within the period
20112015. Malaria has not re-established in any of these countries.
Countries that have attained zero indigenous cases for 3 years or more, and
that have sufficiently robust surveillance systems in place to demonstrate this
achievement, are eligible to request WHO to initiate procedures for certification
that they are malaria free. The process of certification is optional. Between 2000
and 2015, six of the 17 countries that attained zero indigenous cases for 3 years or
more were certified as free of malaria by WHO (Figure 6.10).
Figure 6.10 Countries attaining zero indigenous malaria cases since 2000.
Countries are shown by the

year that they attained 3 consecutive years of zero indigenous cases. Countries that have been certified as free of malaria are
shown in green, with the year of certification in brackets. Source: Country reports
2000
Egypt
United Arab Emirates (2007)
2001
2002
2003
2004
Oman
2005
2006
2007
Morocco (2010)
2008
Armenia (2011)
2009
Turkmenistan (2010)
Syrian Arab Republic
2010
2011
48
Iraq
2012
Georgia
Turkey
2013
Argentina
Kyrgyzstan (2016)
Uzbekistan
2014
Paraguay
2015
Azerbaijan
Costa Rica
Sri Lanka (2016)
In progressing to malaria elimination, the 17 countries reported a median of

184indigenous cases 5 years before attaining zero cases (IQR: 78728), and
a median of 1748 cases 10 years before attaining zero cases (IQR: 4235731)
(Figure6.11). However, three countries (Cabo Verde, El Salvador and Saudi Arabia)
did not reach zero cases by 2015, despite having fewer than 500 indigenous cases
in 20002005.
In 2015, 10 countries and territories reported fewer than 150 indigenous cases,1
and a further 9 countries reported between 150 and 1000 indigenous cases
(Figure6.12). Thus, there appears to be a good prospect of attaining the GTS
milestone of eliminating malaria from 10 countries by 2020. In April 2016,
WHO published an assessment of the likelihood of countries achieving malaria
elimination by 2020. The assessment was based not only on the number of cases
but also on the declared malaria objectives of affected countries and on the
informed opinions of WHO experts in the field (26).
1. Excludes Tajikistan, which reported zero indigenous cases in 2015 but has not yet attained 3years of
zero indigenous cases.
Figure 6.11 Indigenous malaria cases in the

years before attaining zero indigenous cases
for the 17 countries that eliminated malaria,
20002015. Median number of cases is shown as a blue
Figure 6.12 Number of indigenous malaria cases

for countries endemic for malaria in 2015, by
WHO region. Source: WHO estimates
AFR
line. Interquartile range is shaded in light blue. Source:

Country reports
<150
AMR
EMR
SEAR
WPR
10
Estimated cases in 2015
100 000
Number of malaria cases
10 000
1000
1501000
11
100010 000
10 000
1 000 000
29
100
>1 000 000
10
32
0
15 14 13 12 11 10 9
Number of years before attaining zero cases
10
15
20
25
Number of countries
30
35
AFR, WHO African Region; AMR, WHO Region of the Americas;

EMR, WHO Eastern Mediterranean Region; SEAR, WHO SouthEast Asia Region; WPR, WHO Western Pacific Region
49
Impact
6.7 Malaria cases and deaths averted since 2000 and change in
life expectancy
It is estimated that a cumulative 1.3 billion fewer malaria cases and 6.8 million
fewer malaria deaths occurred globally between 2001 and 2015 than would have
occurred had incidence and mortality rates remained unchanged since 2000. The
highest proportion of cases and deaths were averted in the WHO African Region
(94%). Of the estimated 6.8 million fewer malaria deaths between 2001 and 2015,
about 6.6 million (97%) were for children aged under 5 years.
Not all of the cases and deaths averted can be attributed to malaria control efforts.
Some progress is probably related to increased urbanization and overall economic
development, which has led to improved housing and nutrition. However, it has
previously been estimated that 70% of the cases averted between 2001 and 2015
were due to malaria interventions (1).
In the WHO African Region, reduced malaria mortality rates, particularly among
children aged under 5 years, have led to a rise in life expectancy at birth of
1.2years, accounting for 12% of the total increase in life expectancy of 9.4 years
from 50.6 years in 2000 to 60 years in 2015. Across all malaria endemic countries,
the contribution of malaria mortality reduction was 0.26 years or 5% of the total
increase in life expectancy between 2000 and 2015, from 66.4 years to 71.4 years
(Table 6.5, Figure 6.13).
6.8 Economic value of reduced malaria mortality risk, estimated

by full income approach
The full income approach attempts to assign a value to gains in life expectancy
by considering the importance that individuals and society place on reductions
Figure 6.13. Gains in life expectancy in malaria endemic countries, 20002015. Source: WHO estimates
Life expectancy at birth in 2000
Life expectancy (years)
80
Gain in life expectancy due to malaria mortality reduction

Gain in life expectancy due to reduction in deaths from other causes
70
60
50
40
AFR
AMR
EMR
EUR
SEAR
WPR
World
AFR, WHO African Region; AMR, WHO Region of the Americas; EMR, WHO Eastern Mediterranean Region; EUR, WHO
European Region; SEAR, WHO South-East Asia Region; WPR, WHO Western Pacific Region
50
in mortality (i.e. increased longevity). In monetary terms the method places a

value of US$ 1810 billion on the life-expectancy gains observed in sub-Saharan
Africa between 2000 and 2015, and US$ 2040 billion globally (Table 6.6). This is
equivalent to 44% of the gross domestic product (GDP) of the affected countries
in the WHO Africa Region in 2015, and 3.6% in affected countries globally. The
economic value of longer life is expressed here as a percentage of GDP in order
to provide a convenient and well-known comparison, but is not meant to suggest
that the value of longevity is itself a component of domestic output (i.e. GDP),
or that the value of these gains should enter directly into the national income
accounts (27). Nonetheless, the comparison suggests that the value of the gains
in life expectancy due to reduction in malaria mortality are substantial, and that
the total investments called for in the GTS in order to achieve the 2030 target of
a reduction in the malaria mortality rate of at least 90% would be repaid many
times over.
Table 6.5. Gains in life expectancy in malaria endemic countries, 20002015. Source: WHO estimates
Gain in life expectancy due to
reductions in mortality from
Life expectancy at birth
AFR
2000
2015
50.6
60.0
Malaria
Other causes
1.159
% gain due
to malaria
8.2
12.3%
AMR
73.7
76.9
0.003
3.2
0.1%
EMR
65.4
68.8
0.045
3.4
1.3%
0.0%
EUR
72.3
76.8
0.000
4.5
SEAR
63.5
69.0
0.034
5.4
0.6%
WPR
72.5
76.6
0.018
4.0
0.4%
World
66.4
71.4
0.255
4.8
5.0%
European Region; SEAR, WHO South-East Asia Region; WPR, WHO Western Pacific Region
Table 6.6. Economic value of reduced malaria mortality risk, estimated by full income approach,
20002015. Source: WHO estimates
Value of malaria mortality risk reduction
20002015 (US$ 2015, PPP, billions)
AFR
Value of malaria mortality risk reduction

as % of GDP
Estimate
Lower
Upper
Estimate
Lower
Upper
1 830
1 330
2 520
44.4%
32.6%
60.9%
AMR
15
13
17
0.1%
0.1%
0.1%
EMR
52
41
63
1.3%
1.1%
1.5%
0.0%
0.0%
0.0%
93
66
127
1.0%
0.8%
1.3%
EUR
SEAR
WPR
World
23
19
27
0.1%
0.1%
0.1%
2 012
1 510
2 710
3.6%
2.8%
4.8%
European Region; GDP, gross domestic product; PPP, purchasing power parity; SEAR, WHO South-East Asia Region; WPR, WHO
Western Pacific Region
51
Conclusions
The World Malaria Report 2016 is the first such report to be released during the era
of the GTS 20162030 (2). Because the latest data included in the report are mostly
from 2015, direct reporting on the progress of the GTS is not possible. However, the
World Malaria Report 2016 provides a baseline against which progress since 2015
can be assessed in the future. Also, by looking at trends in indicators since 2010,
the report can give an indication of where programmes are on track to meet the
GTS 2020 milestones and where progress needs to be accelerated.
Although malaria funding increased considerably between 2000 and 2010, it has
remained relatively stable since 2010. It totalled US$ 2.9 billion in 2015, representing
only 45% of the GTS funding milestone for 2020. Governments of malaria endemic
countries provided 31% of total funding in 2015, and the Global Fund accounted for
about half of international financing. Pledges to the Global Fund for financing for
20172019 have increased by 8% compared to 20142016 pledges. Total funding must
increase substantially if the GTS 2020 milestone of US$ 6.4 billion is to be achieved.
The coverage of malaria interventions rose between 2010 and 2015. More than half
of the population of sub-Saharan Africa (57%) now benefits from vector-control
interventions (IRS or ITNs), and an increased proportion of pregnant women receive
three doses of IPTp (31% in 2015). More than half of suspected malaria cases attending
public health facilities in the WHO African Region receive a diagnostic test, and the
proportion of malaria cases treated with effective antimalarial drugs is increasing.
Nevertheless, significant gaps in programme coverage remain. Access to vector
control has been greatly extended through mass-distribution campaigns; however,
increasing the coverage of chemoprevention, diagnostic testing and treatment
requires these interventions to be delivered through health systems that are frequently
under-resourced and poorly accessible to those most at risk of malaria. Moreover,
the potential for strengthening health systems in malaria endemic countries is often
constrained by low national incomes and per capita domestic spending on health
and malaria control. The limited ability to strengthen systems in order to deliver
interventions remains a significant challenge for ensuring universal access to malaria
prevention, diagnosis and treatment, as called for in Pillar 1 of the GTS (2).
Pillar 2 of the GTS calls for countries to accelerate efforts towards malaria
elimination and attainment of malaria free status (2). Ten countries eliminated
52
malaria between 2010 and 2015, and malaria has not been re-established in
any malaria free country since 2000. In 2015, 10 countries had fewer than
150indigenous cases, and another nine had between 150 and 1000 cases. Thus,
there appear to be good prospects of attaining the GTS milestone of eliminating
malaria from at least 10 countries by 2020 and preventing re-establishment of
malaria in all countries that are malaria free.
Malaria surveillance systems detected a higher proportion of malaria cases
globally in 2015 (20% of cases) than in 2010 (10%). Most of this improvement
resulted from increased diagnostic testing in sub-Saharan Africa. However, a large
proportion of people with malaria either do not seek treatment or seek treatment
in the private sector, where they are less likely to receive a diagnostic test or to
be reported in a malaria surveillance system. Although patients may seek care
at public health facilities, diagnostic testing is not yet universal, nor is reporting
complete. Addressing the bottlenecks in case detection, diagnosis and reporting
is critical in order to transform malaria surveillance into a core intervention, as
envisaged in Pillar 3 of the GTS.
Malaria case incidence rates are estimated to have decreased by 21% globally
between 2010 and 2015, and malaria mortality rates by 29%. If the GTS milestone
of a 40% reduction in case incidence and mortality rates by 2020 is to be achieved
globally, reductions in case incidence and mortality rates must be accelerated in
countries with high numbers of cases and deaths. However, these countries are
currently furthest from the per capita spending milestone for 2020 in the GTS (2).
Target 3.3 of the SDGs End the epidemics of AIDS, TB, malaria and NTDs by
2030 is interpreted by WHO as the attainment of the GTS targets. The analysis
summarized above indicates that the world is not on track to meet Target 3.3.
for malaria. In addition to SDG Target 3.3, reaching the GTS targets will also
contribute to other health-related goals of SDG 3, which are to ensure healthy
lives and promote well-being for all at all ages. It will also contribute to other
SDGs, particularly Goal 1 (end poverty in all its forms everywhere), Goal 4
(ensure inclusive and equitable quality education and promote lifelong learning
opportunities for all), Goal 5 (achieve gender equality and empower all women
and girls), Goal 8 (promote sustained, inclusive and sustainable economic growth,
full and productive employment and decent work for all) and Goal 10 (reduce
inequality within and among countries).
Although it will be challenging to reach the 2020 milestones of the GTS, recent
experience in combatting malaria has shown that much progress is possible, and
that such progress can greatly improve the health and well-being of populations.
Reduced malaria mortality rates have led to an increase of 1.2 years in life
expectancy at birth in the WHO African Region. This increase represents 12% of
the total increase in life expectancy seen in sub-Saharan Africa, from 50.6 years
in 2000 to 60 years in 2015, a highly significant contribution. Although placing a
monetary value on malaria mortality reductions or increased life expectancy is
difficult, current methodologies suggest that the change observed can be valued
at US$ 1810 billion (UI: US$ 13302480 billion), which is equivalent to 44% of the
GDP of the affected countries in 2015. Thus, the benefits of pursuing the goals
and milestones of the GTS are considerable, and make it worth overcoming the
challenges presented.
53
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56
Annexes
Annex 1 - Data sources and methods
Annex 2 - Regional profiles
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A - West Africa
B - Central Africa
C - East and Southern Africa
D - Region of the Americas
E - Eastern Mediterranean Region
F - South-East Asia Region
G - Western Pacific Region
Annex 3 - Country trends in selected indicators

>>
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A - Funding per capita for malaria control and elimination (in US$)
B - Proportion of population at risk sleeping under an ITN
C - Estimated malaria case incidence rate (cases per 1000 population at risk)
D - Estimated malaria mortality rate (deaths per 100 000 population at risk)
E - Estimated change in malaria incidence and mortality rates, 20102015
Annex 4 - Data tables

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A - Policy adoption, 2015

B - Antimalarial drug policy, 2015
C - Funding for malaria control, 20132015
D - Commodities distribution, 20132015
E - Household survey results, 20132015
F - Estimated malaria cases and deaths, 20002015
G - Population at risk and reported malaria cases by place of care, 2015
H - Reported malaria cases by method of confirmation, 20002015
I - Reported malaria cases by species, 20002015
J - Reported malaria deaths, 20002015
57
Annex 1 Data sources and methods
Figure 1.1 Countries endemic for malaria in 2000

and 2016
Data on the number of indigenous cases (an indicator

of whether countries are endemic for malaria) were
as reported to WHO by national malaria control
programmes (NMCPs). Countries with 3 consecutive
years of zero indigenous cases are considered to have
eliminated malaria.
Table 1.1 Global targets for 2030 and milestones

for 2020 and 2025
Targets and milestones are as described in the Global
Technical Strategy for Malaria 20162030 (GTS) (1) and
Action and investment to defeat malaria 20162030
(AIM) (2).
Table 1.2 Indicators reviewed in World Malaria

Report 2016
Indicators are as described in Monitoring and evaluation
of the Global Technical Strategy for Malaria 20162030
and Action and investment to defeat malaria 20162030
(3).
Figure 2.1 Investments in malaria control activities

by funding source, 20052015
Contributions from governments of endemic countries

are estimated as the sum of NMCP expenditures
reported by NMCPs for the World Malaria Report of
the relevant year plus the estimated costs of delivery of
patient-care services at government health facilities. If
data on NMCP expenditures were missing for 2015, data
from previous years were used after conversion to the
equivalent 2015 US$ value. The number of malaria cases
attending outpatient services at government facilities
was derived from WHO estimates of malaria cases (see
methods notes for Table 6.1) multiplied by the proportion
of estimated cases seeking care at government facilities.
Between 1% and 3% of uncomplicated cases were
assumed to have moved to the severe stage of disease,
and 5080% of these severe cases were assumed to
have been admitted to secondary or tertiary level
hospitals. Outpatients were assumed to have been
treated at health centres (with or without beds) or at
primary level hospitals (e.g. district hospitals). Inpatients
were assumed to have been admitted to primary,
secondary or teaching hospitals. Costs of outpatient

visits and inpatient bed-stays were estimated from the
perspective of the public health-care provider, using
WHO-CHOICE estimates.1 The estimates were updated
for 20052015 by rerunning the regression model using
the relevant gross domestic product (GDP) per capita
in each year. When no GDP data were available for a
given year, outpatient department and inpatient unit
costs were imputed using the values from the most
recent year with available unit-cost data, and were
adjusted with the GDP deflator. When no unit-cost
data were available for the full period, a unit cost
was imputed from the median unit cost in that year in
countries within the same World Bank income group.
Uncertainty around case and cost parameters was
estimated through probabilistic uncertainty analysis;
that is, by assigning a uniform distribution informed by
lower and upper estimates for each parameter. The
figure shows the mean total costs of service delivery for
patient care from 1000 estimations.
International financing data were obtained from several
sources. The Global Fund to Fight AIDS, Tuberculosis and
Malaria (Global Fund) provided disbursed amounts by
year and country for 20052015. Data on funding from
the government of the United States of America (USA)
were sourced from the US Foreign Aid Dashboard, with
the technical assistance of the Kaiser Family Foundation.
Funding data were available for the US Agency for
International Development (USAID), the US Centers
for Disease Control (CDC) and the US Department of
Defense. Country-level data were available for USAID
for 20062015. Financing data for other international
funders included annual disbursement flows for 2005
2014, obtained from the Organisation for Economic
Co-operation and Development (OECD) creditor
reporting system (CRS) database on aid activity. For
each year and each funder, the country-level and
regional-level project-type interventions and other
technical assistance were extracted. The 2014 value for
international annual contributions was used as the 2015
value, except for contributions from the United Kingdom
of Great Britain and Northern Ireland; for this value, a
linear increase was assumed based on trends from 2012
1. http://www.who.int/choice/en/
58
to 2014. To measure funding in real terms (i.e. correct for

inflation), all values were converted to 2015 US$ values,
using the GDP implicit price deflators published by the
World Bank. Estimates of total spent on malaria control
and elimination exclude household spending on malaria
prevention and treatment.
Figure 2.2 Annual flow of funding for malaria

control and elimination, 20142015
See methods notes for Figure 2.1 for sources of

information on funding from governments of malaria
endemic countries and on international flows to endemic
countries. Contributions from individual countries to the
Global Fund are shown when their 2014 and 2015 annual
average core contributions to the fund accounted for 3%
or more of the total amount of contributions received by
the fund in 2014 and 2015. Contributions from funding
sources to multilateral channels were estimated by
calculating the proportion of the total contributions
received by a multilateral in 2014 (2014 and 2015 in
the case of the Global Fund) that was contributed by
a funding source, then multiplying that figure by the
multilaterals estimated investment in malaria in 2015.
These data were sourced from the Global Fund and,
for other funders, from the OECD.Stat website2 using
the CRS and the Development Assistance Committee
(DAC) members total use of the multilateral system.
Contributions from non-DAC countries and other sources
were not available and were therefore not included in
this figure. All funding flows were converted to 2015
equivalents in US$ (millions).
Figure 2.3 Malaria financing, 20132015, by type

of expenditure
The Global Fund provided expenditure data by

category for 20132015. Expenditure categories were
health-system strengthening, supportive environment,
prevention and treatment. Expenditures related to
health-system strengthening included communication
and advocacy, human resources and technical
assistance, training, monitoring and evaluation (M&E),
procurement and supply management, and planning.
Expenditures related to supportive environment
included spending on policy development, civil2. http://stats.oecd.org/
society strengthening, stigma-reduction efforts,

and management and administration. For Figure
2.3, expenditures on health-system strengthening
and supportive environment were combined. For
expenditures of the US Presidents Malaria Initiative
(PMI), all operational plans that included planned
obligations for 20132015 were reviewed and
categorized as health-system strengthening, prevention
or treatment. PMI health-system-strengthening
categories included communications, capacitybuilding, surveillance, M&E, and research and strategic
information. Prevention expenditures included those
for long-lasting insecticidal nets (LLINs), indoor
residual spraying (IRS) and chemoprevention, which
encompass, for example, expenditures on commodities,
human resources, distribution and transport. Treatment
expenditures included any resources used for malaria
case management. Costs for in-country mission staffing
were excluded from the analysis (representing 12% of
total average spending). Government expenditures
included data reported by NMCPs for the relevant World
Malaria Report, in similar categories to those used by
the Global Fund. We included data from 36 countries
that had data for the expenditure categories for at least
2 years between 2013 and 2015.
Figure 2.4 Funding for malaria-related research

and development, 20102014
Data on funding for malaria-related research and

development for 20102014 were collected directly
from the G-Finder Public Search tool.3 All data were
converted to 2015 equivalents in US$.
Figure 2.5 Source of funding for malaria-related

research and development, 2014
See methods notes for Figure 2.4.
Figure 2.6 Malaria financing per person at risk,

20132015, by estimated number of malaria
cases, 2015
See methods notes for Figure 2.1 for sources of

information on malaria financing. The total population
of each country was taken from the 2015 revision of the
World population prospects (4) and the proportion at
3. https://gfinder.policycures.org/PublicSearchTool
59
risk of malaria was derived from NMCP reports. Funding

milestones for 2020 were derived from the costing of
the GTS (1).
Figure 2.7 Number of ITNs delivered by

manufacturers and distributed by NMCPs,
20092016
Data on the number of insecticide-treated mosquito
nets (ITNs) delivered by manufacturers to countries were
provided to WHO by Milliner Global Associates. Data
from NMCP reports were used for the number of ITNs
distributed within countries.
Figure 2.8 Number of RDTs sold by manufacturers

and distributed by NMCPs, 20102015
The numbers of rapid diagnostic tests (RDTs) distributed

by WHO region are the annual totals reported as having
been distributed by NMCPs. Numbers of RDT sales were
reported by 41 manufacturers that participated in RDT
product testing by WHO, the Foundation for Innovative
New Diagnostics, the CDC and the Special Programme
for Research and Training in Tropical Diseases. The
number of RDTs reported by manufacturers represents
total sales to the public and private sectors worldwide.
Figure 2.9 Number of ACT treatment courses

delivered by manufacturers and distributed by
NMCPs, 20102015
Data on artemisinin-based combination therapy (ACT)

sales were provided by eight manufacturers eligible for
procurement by WHO or the United Nations Childrens
Fund (UNICEF). ACT sales were categorized as being
to either the public sector or the private sector. Data
on ACTs distributed within countries through the public
sector were taken from NMCP reports to WHO.
Figure 2.10 Ratio of ACT treatment courses

distributed to diagnostic tests performed (RDTs
or microscopy), WHO African Region 20102015
The ratio was calculated using the number of ACTs

distributed, the number of microscopic examinations
of blood slides, and the number of RDTs performed
in the WHO African Region, as reported by NMCPs to
WHO. The test positivity rate was calculated as the
total number of positive tests (i.e. slide examinations or
RDTs) divided by the total number of tests undertaken,

as reported by countries in the WHO African Region.
Figure 3.1 Proportion of population at risk with

access to an ITN and sleeping under an ITN, and
proportion of households with at least one ITN
and enough ITNs for all occupants, sub-Saharan
Africa, 20052015
Estimates of ITN coverage were derived from a

model developed by the Malaria Atlas Project,4 using
a two-stage process. First, we defined a mechanism
for estimating net crop (i.e. the total number of ITNs
in households in a country at a given point in time),
taking into account inputs to the system (e.g. deliveries
of ITNs to a country) and outputs (e.g. loss of ITNs
from households). We then used empirical modelling
to translate estimated net crops into resulting levels of
coverage (e.g.access within households, use in all ages
and use among children aged under 5 years).
The model incorporates data from three sources:
the number of ITNs delivered by manufacturers to

countries, as provided to WHO by Milliner Global
Associates;
the number of ITNs distributed within countries, as
reported to WHO by NMCPs; and
data from nationally representative household
surveys from 39 countries in sub-Saharan Africa,
from 2001 to 2015.
Countries and populations at risk
The main analysis covered 40 of the 47 malaria endemic

countries or areas of sub-Saharan Africa. The islands of
Mayotte (for which no ITN delivery or distribution data
were available) and Cabo Verde (which does not distribute
ITNs) were excluded, as were the low-transmission
countries of Namibia, Sao Tome and Principe, South
Africa and Swaziland, for which ITNs comprise a small
proportion of vector control. Analyses were limited to
populations categorized by NMCPs as being at risk.
Estimating national net crops through time
As described by Flaxman et al. (5), national ITN systems

were represented using a discrete-time stock-and-flow
4. http://www.map.ox.ac.uk/
60
model. Nets delivered to a country by manufacturers

were modelled as first entering a country stock
compartment (i.e. stored in-country but not yet
distributed to households). Nets were then available
from this stock for distribution to households by the
NMCP or other distribution channels. To accommodate
uncertainty in net distribution, the number of nets
distributed in a given year was specified as a range, with
all available country stock (i.e. the maximum number of
nets that could be delivered) as the upper end of the
range and the NMCP-reported value (i.e. the assumed
minimum distribution) as the lower end. New nets
reaching households joined older nets remaining from
earlier time steps to constitute the total household net
crop, with the duration of net retention by households
governed by a loss function. Rather than fitting the loss
function to a small external dataset, as was done by
Flaxman et al. (5), the loss function was fitted directly
to the distribution and net crop data within the stockand-flow model itself. Loss functions were fitted on a
country-by-country basis, were allowed to vary through
time, and were defined separately for conventional
ITNs (cITNs) and LLINs. The fitted loss functions were
compared to existing assumptions about rates of net
loss from households. The stock-and-flow model was
fitted using Bayesian inference and Markov chain Monte
Carlo methods, which provided time-series estimates of
national household net crop for cITNs and LLINs in each
country, and an evaluation of underdistribution, all with
posterior credible intervals.
Estimating indicators of national ITN access

and use from the net crop
Rates of ITN access within households depend not

only on the total number of ITNs in a country (i.e. the
net crop), but also on how those nets are distributed
among households. One factor that is known to strongly
influence the relationship between net crop and net
distribution patterns among households is the size of
households, which varies among countries, particularly
across sub-Saharan Africa.
Many recent national surveys report the number of
ITNs observed in each household surveyed. Hence, it
is possible to not only estimate net crop, but also to
generate a histogram that summarizes the household
net ownership pattern (i.e. the proportion of households

with zero nets, one net, two nets and so on). In this way,
the size of the net crop was linked to distribution patterns
among households while accounting for household size
in order to generate ownership distributions for each
stratum of household size. The bivariate histogram
of net crop to distribution of nets among households
by household size made it possible to calculate the
proportion of households with at least one ITN. Also,
because the number of both ITNs and people in each
household was available, it was possible to directly
calculate the two additional indicators: the proportion
of households with at least one ITN for every two people,
and the proportion of the population with access to an
ITN within their household. For the final ITN indicator
the proportion of the population who slept under
an ITN the previous night the relationship between
ITN use and access was defined using 62 surveys in
which both these indicators were available (ITN useall
= 0.8133*ITN accessall ages + 0.0026, R = 0.773). This
ages
relationship was applied to the Malaria Atlas Projects
countryyear estimates of household access in order to
obtain ITN use among all ages. The same method was
used to obtain the countryyear estimates of ITN use
in children aged under 5 years (ITN usechildren under five =
0.9327x + 0.0282, R = 0.754).
Figure 3.2 Proportion of ITNs distributed through

different delivery channels in sub-Saharan
Africa, 20132015
Data on the number of ITNs distributed within countries
were as reported to WHO by 39 countries where ITNs
are the primary method of vector control.

protected by IRS by WHO region, 20102015
The number of persons protected by IRS was reported

to WHO by NMCPs. The total population of each country
was taken from the 2015 revision of the World population
prospects (4) and the proportion at risk of malaria was
derived from NMCP reports.
Figure 3.4 Insecticide class used for indoor

residual spraying, 20102015
Data on the type of insecticide used for IRS were
reported to WHO by NMCPs. Insecticides were
61
classified into pyrethroids or other classes (carbamates,

organochlorines or organophosphates). If data were not
reported for a particular year, data from the most recent
year were used. For the period 20102015 this method
of imputation was used for an average of 19 countries
each year.

protected by IRS or sleeping under an ITN in
sub-Saharan Africa, 20102015
The proportion of the population at risk sleeping under

an ITN was derived as described for Figure 3.1, and
the proportion benefiting from IRS was derived as
for Figure 3.4. In combining these proportions, the
extent to which populations benefit from one or both
of these interventions must be estimated. Analysis of
household survey data indicates that about half of the
people in IRS-sprayed households are also protected
by ITNs, but the extent of overlap between intervention
coverage can vary from 0% to 100% (if the proportions
sum to <1). To reflect this uncertainty, we assumed the
combined coverage to have a rectangular distribution
with the range of maximum (0%, ITNcoverage + IRScoverage
100%) to minimum (ITN coverage, IRScoverage). Palisades
@Risk software (version 6.0)5 was used to sample from
the distributions for each country, and a continental
estimate of vector-control coverage was obtained by
summing the combined ITN and IRS coverage of all
countries.
Figure 3.6 Insecticide resistance and monitoring

status for malaria endemic countries (2015), by
insecticide class and WHO region, 20102015
Insecticide resistance monitoring results were collected
from NMCP reports to WHO, the African Network for
Vector Resistance, the Malaria Atlas Project, PMI and
the published literature. In these studies, confirmed
resistance was defined as mosquito mortality <90% in
bioassay tests with standard insecticide doses. Where
multiple insecticide classes or types, mosquito species
or time points were tested, the highest resistance status
was considered.
5. https://www.palisade.com/risk/
62
Figure 3.7 Proportion of pregnant women

receiving IPTp, by dose, sub-Saharan Africa,
20102015
The total number of pregnant women eligible for

intermittent preventive treatment in pregnancy (IPTp)
was calculated by adding total live births calculated
from the United Nations (UN) population data and
spontaneous pregnancy loss (specifically, miscarriages
and stillbirths) after the first trimester. Spontaneous
pregnancy loss has previously been calculated by
Dellicour et al. (6). Country-specific estimates of IPTp
coverage were calculated as the ratio of pregnant
women receiving IPTp at antenatal care (ANC) clinics
to the estimated number of IPTp-eligible pregnant
women in a given year. ANC attendance rates were
derived in the same way, using the number of initial
ANC visits reported through routine information systems.
Local linear interpolation was used to compute missing
values. Annual aggregate estimates exclude countries
for which a report or interpolation was not available
for the specific year. Among 34 countries with IPTp
policy, IPTp1 dose coverage could be calculated for
34 countries, IPTp2 for 33 countries, and IPTp3 for 20
countries. Aggregate estimates of IPTp1 and IPTp2
coverage for 20 countries with IPTp3 estimates were
similar to estimates of IPT1 and IPTp2 coverage using
data from all countries.
Figure 4.1 Proportion of febrile children seeking

care, by health sector, sub-Saharan Africa, 2013
2015
Estimates were derived from 23 nationally representative

household surveys (demographic health surveys and
malaria indicator surveys) conducted between 2013 and
2015. The surveys asked caregivers whether their child
had had a fever in the 2 weeks preceding the survey,
whether care was sought for the fever and, if so, where
care was sought.
Figure 4.2 Proportion of febrile children receiving

a blood test, by health sector, sub-Saharan
Africa, 20132015

2015. The surveys asked caregivers whether their child had

had a fever in the 2 weeks preceding the survey; whether
care was sought for the fever and, if so, where care was
sought; they also asked whether the child had received a
finger or heel stick as part of the care (indicating that a
malaria diagnostic test was performed).
Figure 4.3 Proportion of suspected malaria cases

attending public health facilities who receive a
diagnostic test, by WHO region, 20102015
The proportion of suspected malaria cases receiving

a malaria diagnostic test in public facilities was
calculated from NMCP reports to WHO. The number
of malaria diagnostic tests performed comprised the
number of RDTs and the number of microscopic slide
examinations. Few countries reported the number of
suspected malaria cases as an independent value. For
countries reporting the total number of malaria cases as
the sum of presumed malaria cases (i.e. cases classified
as malaria without undergoing malaria parasitological
testing) and confirmed malaria cases, the number of
suspected cases was calculated by adding the number
of negative diagnostic tests to the number of presumed
and confirmed cases. Using this method, for countries
that reported only confirmed malaria cases as the total
number of malaria cases, the number of suspected
cases is equal to the number of cases tested. This
value is not informative in determining the proportion
of suspected cases tested; therefore, countries were
excluded from the regional calculation for the years
in which they reported only confirmed cases as total
malaria cases.
Figure 4.4 Proportion of febrile children attending

public health facilities who receive a blood test,
sub-Saharan Africa, 20102015
2015. The surveys asked caregivers whether their child
had had a fever in the 2 weeks preceding the survey;
whether care was sought for the fever and, if so, where
care was sought; and whether the child had received a
finger or heel stick as part of the care (indicating that a
malaria diagnostic test was performed). Median values
and interquartile ranges were calculated from available

surveys in 3 year moving averages.
Figure 4.5 Proportion of febrile children with

a positive RDT at time of survey who received
antimalarial medicines, sub-Saharan Africa,
20102015
Data from nationally representative household surveys

were used to examine the treatment received by children
who had had both a fever in the previous 2 weeks and
a positive RDT at the time of survey. Estimates were
derived from 29 nationally representative household
surveys (demographic health surveys and malaria
indicator surveys). The surveys must have undertaken
diagnostic testing with a histidine rich protein 2 (HRP2)
RDT at the time of the survey; also, they must have
asked caregivers whether their child had had a fever
in the 2 weeks preceding the survey, where care was
sought, and what treatment was received for the fever,
particularly whether the child received an ACT or other
antimalarial medicine.

that are ACTs received by febrile children that are
RDT positive at the time of survey, sub-Saharan
Africa, 20102015

that are ACTs received by febrile children, by
health sector, sub-Saharan Africa, 20132015
Figure 4.8 Distribution of multidrug resistance,

2016
Information was derived from WHOs database on

antimalarial treatment efficacy.6
Figure 5.1 Health facility reporting rates by WHO

region, 2015
Using data provided by NMCPs, reporting rates of

health facilities were calculated as follows: (the number
of health facility reports received in 2015) (number of
6. http://www.who.int/malaria/areas/drug_resistance/drug_efficacy_database/en/
63
health facilities providing treatment for uncomplicated

malaria reporting frequency).
and 80%. Countries that were approaching elimination

were assigned a value of more than 80%.
Figure 5.2 Bottlenecks in case detection 2015, by

WHO region
Table 6.1 Estimated malaria cases, 20002015
The procedure for estimating the proportion of cases

detected by surveillance systems follows the method
by which WHO estimates the number of malaria cases
in a country using data reported by NMCPs(7,8). The
procedure considers four proportions: the proportion
of cases that seek treatment, the proportion of cases
that seek treatment in health facilities covered by a
countrys malaria surveillance system, the proportion
of cases in these facilities that receive a diagnostic test
and the proportion of cases in these facilities that are
reported through the system. The proportion of malaria
cases seeking treatment was estimated using the latest
nationally representative household survey for a country.
If no household survey was available, the proportion was
derived by sampling at random from results for other
countries and areas in the region that had a household
survey: Bolivia (Plurinational State of), Botswana,
Cabo Verde, French Guiana, Guatemala, South Sudan,
Suriname, Thailand and Venezuela (Bolivarian Republic
of). For 13 countries approaching malaria elimination
(Algeria, Belize, Bhutan, China, Democratic Peoples
Republic of Korea, Ecuador, El Salvador, Iran [Islamic
Republic of], Malaysia, Mexico, Panama, Republic of
Korea and Saudi Arabia), it was assumed that 99% of
cases sought treatment. The proportion of cases seeking
treatment at a facility covered by a countrys surveillance
system was derived in a similar way; the types of facility
covered by a countrys surveillance system were provided
through NMCP reports. Reporting rates of health facilities
were calculated according to the methods notes for
Figure 5.1. The reporting rates were assigned to three
ranges (<50%, 5080% and >80%) to reflect uncertainty
about the number of cases represented in facility reports.
The rates were assigned a triangular distribution in the
outer ranges and a uniform distribution in mid-range,
with expected values in the low, mid and high ranges
of 33%, 65% and 87%, respectively. If the reporting
completeness was not available for 2015, the value from
the most recent year reported was used. If this value was
missing for all years, it was assumed to lie between 50%
64
The number of malaria cases was estimated by one of

two methods. The first method was used for countries
outside Africa and for low-transmission countries in
Africa. Estimates were made by adjusting the number
of reported malaria cases for completeness of reporting,
the likelihood that cases were parasite positive, and
the extent of health-service use. The procedure, which
is described in the World Malaria Report 2008 (7,8),
combines data reported by NMCPs (reported cases,
reporting completeness and likelihood that cases are
parasite positive) with data obtained from nationally
representative household surveys on health-service use.
The number of malaria cases caused by Plasmodium
vivax in each country was estimated by multiplying the
countrys reported proportion of P. vivax cases by the
total number of estimated cases for the country. The
second method was used for high-transmission countries
in Africa in which the quality of surveillance data did not
permit a robust estimate from the number of reported
cases. Estimates of the number of malaria cases were
derived from information on parasite prevalence
obtained from household surveys. First, data on parasite
prevalence from 27 573 georeferenced population
clusters between 1995 and 2014 were assembled within
a spatiotemporal Bayesian geostatistical model, along
with environmental and sociodemographic covariates,
and data on both the use of ITNs and access to ACTs.
The geospatial model enabled predictions of P.
falciparum prevalence in children aged 210 years, at
a resolution of 5 5 km2, throughout all malaria endemic
African countries for each year from 2000 to 2015.
Second, an ensemble model was developed to predict
malaria incidence as a function of parasite prevalence.
The model was then applied to the estimated parasite
prevalence in order to obtain estimates of the malaria
case incidence at 5 5 km2 resolution for each year from
2000 to 2015. Data for each 5 5 km2 area were then
aggregated within country and regional boundaries to
obtain both national and regional estimates of malaria
cases (9).
Table 6.2 Estimated malaria cases by WHO

region, 2015
See methods notes for Table 6.1.
Figure 6.1 Estimated malaria cases (millions) by

WHO region, 2015
Figure 6.3 Estimated country share of (a) total

malaria cases and (b) P. vivax malaria cases,
2015
Table 6.3 Estimated malaria deaths, 20002015
Numbers of malaria deaths were estimated by two main

categories of method.
Category 1 methods
Category 1 methods were used for countries outside

Africa and for low-transmission countries in Africa.
Method 1(a). For countries in which vital registration is
estimated to capture more than 50% of all deaths, and
a high proportion of malaria cases are confirmed by
parasite testing, reported malaria deaths are adjusted
for completeness of death reporting.
Method 1b. For countries considered in the elimination
programme phase as described in the World Malaria
Report 2015 (10), reported malaria deaths are adjusted
for completeness of case reporting.
Method 1c. For other countries for which a Category 1
method was used, a case fatality rate of 0.256% was
applied to the estimated number of P. falciparum
cases, which represents the average of case fatality
rates reported in the literature (11-13) and rates from
unpublished data from Indonesia, 20042009 (Dr Ric
Price, Menzies School of Health Research, personal
communication). A case fatality rate of 0.0375% was
applied to the estimated number of P. vivax cases,
representing the midpoint of the range of case fatality
rates reported in a study by Douglas et al. (14).
Category 2 method
A Category 2 method was used for countries in Africa

with a high proportion of deaths due to malaria. In this
method, child malaria deaths were estimated using
a verbal autopsy multicause model developed by the

Maternal and Child Health Epidemiology Estimation
Group to estimate causes of death in children aged
159 months (15). Mortality estimates were derived
for seven causes of post-neonatal death (pneumonia,
diarrhoea, malaria, meningitis, injuries, pertussis and
other disorders), four causes arising in the neonatal
period (prematurity, birth asphyxia and trauma, sepsis,
and other conditions of the neonate), and other causes
(e.g. malnutrition). Deaths due to measles, unknown
causes and HIV/AIDS were estimated separately. The
resulting cause-specific estimates were adjusted, country
by country, to fit the estimated mortality envelope of 159
months (excluding HIV/AIDS and measles deaths) for
corresponding years. Estimated prevalence of malaria
parasites (see methods notes for Table 6.1) was used as a
covariate within the model. The malaria mortality rate in
children aged under 5 years that was estimated with this
method was then used to infer malaria-specific mortality
in those aged over 5 years, using the relationship
between levels of malaria mortality in a series of age
groups and the intensity of malaria transmission (16).
Table 6.4 Estimated malaria deaths by WHO

region, 2015
Figure 6.3 Estimated malaria deaths (thousands)

by WHO region, 2015
Figure 6.4 Estimated country share of (a) total

malaria deaths and (b) P. vivax malaria deaths,
2015
Figure 6.5 Estimated (a) parasite prevalence

and (b) number of people infected, sub-Saharan
Africa, 20052015
Figure 6.6 Reduction in malaria case incidence

rate by WHO region, 20102015
See the methods notes for Table 6.1 for the estimation of
the number of malaria cases. Incidence rates were derived
by dividing estimated malaria cases by the population at
65
risk of malaria within each country. The total population

World population prospects (4), and the proportion at risk
of malaria was derived from NMCP reports.
Figure 6.7 Country-level changes in malaria case

incidence rate, 20102015, by number of cases
in 2010
See methods notes for Figure 6.6 for estimates of case
incidence. See methods notes for Table 6.1 for estimates
of number of cases.
Figure 6.8 Reduction in malaria mortality rate by

WHO region, 20102015
See methods notes for Table 6.3 for estimation of number

of deaths. Malaria death rates were derived by dividing
annual malaria deaths by the midyear population at
risk of malaria within each country. The total population
World population prospects (4), and the proportion at
risk of malaria was derived from NMCP reports. Where
death rates were quoted for children aged under 5 years,
the number of deaths estimated in children aged under
5 years was divided by the estimated number of children
aged under 5 years at risk of malaria.

mortality rate 20102015, by number of deaths
in 2010
See methods notes for Figure 6.8 for estimates of

mortality rates. See methods notes for Table 6.3 for
estimates of number of deaths.
Figure 6.10 Countries attaining zero indigenous

malaria cases since 2000
Countries are shown by the year in which they attained
zero indigenous cases for 3 consecutive years, according
to reports submitted by NMCPs.
Figure 6.11 Indigenous malaria cases in the years

before attaining zero indigenous cases, for the
17 countries that eliminated malaria, 20002015
For the 17 countries that attained zero indigenous cases

for 3 consecutive years between 2000 and 2015, the
number of NMCP-reported indigenous cases was
tabulated according to the number of years preceding
the attainment of zero cases. Data from years before
66
the peak number of cases were excluded. Thus, if

a country had experienced zero cases and malaria
returned, cases were only included from the year in
which they peaked. This inclusion criterion generates a
slope that is steeper than if cases from all years were
included (because some increases are excluded). In
some earlier years where data on indigenous case were
not available, the total number of reported cases was
used (i.e. for country years with larger numbers of cases,
in which the proportion of imported cases is expected
to be low).
Figure 6.12 Number of indigenous malaria cases

for countries endemic for malaria in 2015, by
WHO region
See methods notes for Table 6.1 for the estimation
of number of cases. For 18 countries (Algeria, Belize,
Bhutan, Cabo Verde, China, Democratic Peoples
Republic of Korea, Dominican Republic, Ecuador, El
Salvador, Iran [Islamic Republic of], Malaysia, Mexico,
Panama, Republic of Korea, Saudi Arabia, Suriname,
Swaziland and Tajikistan), estimates were based on
indigenous cases only; these values were very close to
the reported numbers of cases. For other countries in
which the numbers of locally transmitted and imported
cases were not individually available, estimates
included imported cases; however, imported cases
were expected to comprise only a small proportion of
the large total number of cases in these countries.
Figure 6.13 and Table 6.5 Gains in life expectancy

in malaria endemic countries, 20002015
The relative contribution of the decline in malaria
mortality risk to total life expectancy gain between
2000 and 2015 was estimated using WHO annual
life tables for 20002015 for countries with malaria
transmission in 2000, and WHO estimates of malaria
age-specific death rates (17). A cause-decomposition
of life expectancy gain approach was followed, with the
analysis conducted at WHO regional level (18).
Table 6.6 Economic value of reduced malaria

mortality risk, estimated by full income approach,
20002015
Malaria mortality risk reductions between 2000 and

2015 were valued using a full income approach. The
analysis, which covered 106 countries with malaria

transmission in 2000, was conducted from the current
perspective by estimating how much individuals would
need to be compensated in 2015 to accept malaria
mortality risks at their year 2000 levels.
decreases, individuals require a smaller percentage

of their income to accept an increase in mortality risk,
because of competing basic needs in lower income
populations, although this can vary across individual
and community characteristics (21,22).
Changes in malaria mortality risk were valued as the

payment that individuals would need to receive to
accept an increase in mortality risk (19). This approach,
referred to as value of a statistical life (VSL), is a common
method for valuing mortality risks in public policy studies
in high-income settings. It involves asking individuals
about their willingness to accept (WTA) compensation
for an increase in mortality risk, in stated-preference
surveys (20). These surveys have placed a value of
US$380 (range: US$ 189569) on a 1 in 10 000 increase
in mortality risk for a given year for individuals aged
50 years with an average life expectancy of 33 years,
living in OECD countries that had an average GDP per
capita of US$ 37 787 (in 2015 purchasing power parity
[PPP] adjusted US$) (20,21). For this reference VSL to
be applied to other settings, it is necessary to take into
account differences in life expectancy and the GDP per
capita using the following formula:
ec50
GDPpc
=VSLr
VSL
c

33 GDPr
Changes in malaria mortality risks were valued as the

sum of WTA of all individuals assumed to experience
these changes; 2015 life tables were used, and the
calculations were as described in Jamison et al. (19).
VSL conversions used the OECD consumer price index
data. 7 Calculations were conducted in 2015 US$, at
PPP with GDP data sourced from the World Bank. 8
Probabilistic uncertainty analysis through 1000 Monte
Carlo simulations was used to determine the mean
and 95% uncertainty range for the value of change
in mortality risk across malaria endemic countries in
20002015. The reference VSL was assigned a uniform
distribution (range: US$ 189569), as were elasticity
values (range: 11.4).
Where:
VSLc = VSL in country c;
ec50 = life expectancy at age 50 in country c;
33 = average remaining life expectancy, in years, at age
50 in OECD reference countries;
VSLr = VSL in OECD reference countries;
GDPc = 2015 GDP per capita in country c;
GDP r = average GDP per capita in group of OECD
reference countries, converted to 2015 equivalent; and
= income elasticity of the VSLc to changes in GDP.
The income elasticity that is, the responsiveness
of the VSL to a change in income was assumed to
range between 1 and 1.4 (20-22). An equal to 1
reflects situations where individuals require the same
proportional change in income as compensation for an
increase in mortality risk, irrespective of income level.
An greater than 1 reflects situations where, as income
7. https://data.oecd.org/price/inflation-cpi.htm#indicator-chart
(accessed 1 November 2016)
8. http://databank.worldbank.org/data/home.aspx (accessed 1 November 2016)
67
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69
Annex 2 A. Regional profile: West Africa
355 million
people at risk for
malaria in 2015
297 million
at high risk
Funding for
malaria increased
from
US$ 233 million
to
US$ 262 million
between 2010
and 2015
Estimated malaria
case incidence
decreased
by 15%
between 2010
and 2015
Estimated malaria
mortality rate
reduced
by 29%
between 2010
and 2015
A. Parasite prevalence, 2015
>85
0
Not applicable
B. Share of malaria cases, 2015

Others, 5%
Togo, 2%
Benin, 3%
Guinea, 4%
Niger, 5%
Bukina Faso, 6%
Nigeria, 55%
Ghana, 6%
Mali, 7%
Zero countries
eliminated
malaria
since 2010
70
Cte dIvoire, 7%
C. Malaria funding by source, 20102015
1000
D. Malaria funding per person at risk, average

20132015
Domestic
Global Fund
World Bank
USAID
UK
Others
Domestic
International
Cabo Verde
Liberia
Gambia
Ghana
800
Benin
US$ (million)
Senegal
Sierra Leone
600
Mali
Guinea-Bissau
Nigeria
Burkina Faso
400
Guinea
Cte dIvoire
Togo
200
Niger
Mauritania
Algeria
2010
2011
2012
2013
2014
2015
Global Fund, Global Fund to Fight AIDS, Tuberculosis and Malaria;

UK, United Kingdom of Great Britain and Northern Ireland; USAID,
United States Agency for International Development
E. Proportion of population sleeping under an

ITN or protected with IRS, 2015
12
16
F. Change in reported malaria incidence and

mortality rates, 20102015
Incidence
ITN
Mortality
2020 milestone: -40%
IRS
Liberia*
Cabo Verde
Cte dIvoire*
Guinea-Bissau
Benin*
Togo
Guinea*
Cte dIvoire
Sierra Leone
Ghana*
Benin
Burkina Faso*
Senegal
Guinea-Bissau*
Ghana
Senegal*
Gambia
Niger*
Burkina Faso
Sierra Leone*
Mali
Togo*
Guinea
Nigeria*
Liberia
Gambia*
Nigeria
Mauritania*
Niger
Cabo Verde*
Mauritania
Mali*
Algeria
Algeria*
0%
20
US$
20%
40%
60%
80%
100%
-100%
-50%
f Reduction
0%
50%
100%
Increase p
* Change in admission rate ()
71
Annex 2 B. Regional profile: Central Africa
174 million
people at risk for
malaria in 2015
161 million
at high risk
A. Parasite
prevalence, 2015
Funding for
malaria increased
from
US$ 65 million
to
US$ 116 million
between 2010
and 2015
>85
Estimated malaria
case incidence
decreased
by 33%
between 2010
and 2015
Estimated malaria
mortality rate
reduced
by 42%
between 2010
and 2015
0
Not applicable

Others, 4%
Burundi, 4%
Central African Republic, 4%
Chad, 6%
Angola, 9%
Cameroon, 16%
Zero countries
eliminated
malaria
since 2010
72
Democratic
Republic of the
Congo, 57%
500

20132015
Domestic
Global Fund
World Bank
USAID
UK
Others
Domestic
International
Sao Tome
and Principe
Equatorial Guinea
Angola
400
US$ (million)
Gabon
300
Democratic Republic
of the Congo
200
Central African
Republic
Burundi
Chad
100
Cameroon
Congo
2010
2011
2012
2013
2014
2015


12
16

Incidence
ITN
IRS
Sao Tome
and Principe*
Central African*
Republic*
Burundi*
Chad
Democratic Republic*
of the Congo*
Democratic Republic
of the Congo
Chad*
Central African
Republic
Angola*
Cameroon
Cameroon*
Angola
Sao Tome*
and Principe*
Congo
Congo*
Equatorial Guinea
Equatorial Guinea*
Gabon
20%
40%
60%
80%
100%

* Administrative ITN coverage
Mortality
Gabon*
Burundi
0%
20
US$
-100%
-50%
f Reduction
0%
50%
100%
Increase p
73
Annex 2 C. Regional profile: East and Southern Africa
319 million
people at risk for
malaria in 2015
232 million
at high risk
A. Parasite
prevalence,
2015
Funding
for malaria
decreased from
US$ 156 million
to
US$ 150 million
between 2010
and 2015
>85
Estimated malaria
case incidence
decreased
by 22%
between 2010
and 2015
0
Not applicable

Others, 7%
Madagascar, 5%
Estimated malaria
mortality rate
reduced
by 22%
between 2010
and 2015
Uganda, 18%
Ethiopia, 6%
Zambia, 6%
Mozambique,
18%
Malawi, 7%
Rwanda, 8%
Zero countries
eliminated
malaria
since 2010
74
United Republic
of Tanzania, 11%
Kenya, 14%
1000

20132015
Domestic
Global Fund
World Bank
USAID
UK
Others
Domestic
International
Swaziland
Zambia
Namibia
Rwanda
800
South Sudan
US$ (million)
Malawi
Zimbabwe
600
Mozambique
United Republic
of Tanzania
South Africa
400
Comoros
Uganda
Kenya
Eritrea
200
Madagascar
Botswana
Ethiopia
2010
2011
2012
2013
2014
2015


12
16

Incidence
ITN
IRS
Swaziland*
Botswana*
Zimbabwe
Madagascar
Rwanda
Mozambique
Uganda
Zambia
Kenya
Ethiopia
South Sudan
Comoros
Malawi
South Africa
Namibia*
United Republic of
Tanzania (Zanzibar)
United Republic of
Tanzania (Mainland)
Eritrea
0%
20%
40%
60%
80%
100%

* Administrative ITN coverage
20
US$
Mortality
South Sudan*
Namibia*
Rwanda*
Kenya*
Madagascar*
Malawi*
United Republic of*
Tanzania (Mainland)*
Uganda*
Zimbabwe*
Mozambique*
Swaziland*
Ethiopia*
Eritrea*
Zambia*
Botswana*
United Republic of*
Tanzania (Zanzibar)*
South Africa*
Comoros*
-100%
-50%
f Reduction
0%
50%
100%
Increase p
75
Annex 2 D. Regional profile: Region of the Americas
132 million
people at risk for
malaria in 2015
21 million
at high risk
A. Confirmed
malaria
cases per
1000
population,
2015
Funding for
malaria increased
from
US$ 170 million
to
US$ 201 million
between 2010
and 2015
Confirmed cases
per 1000 population
Insufficient data
0
00.1
0.11.0
1.010
Estimated malaria
case incidence
decreased
by 31%
between 2010
and 2015
Estimated malaria
mortality rate
reduced
by 37%
between 2010
and 2015
Three countries
achieved zero
indigenous cases
for 3 years
since 2010
76
1050
50100
> 100

Guyana, 3%
Others, 5%
Haiti, 9%
Venezuela
(Bolivarian
Republic of),
30%
Colombia, 10%
Peru, 19%
Brazil, 24%
300

20132015
Domestic
Global Fund
World Bank
USAID
UK
Others
US$ (million)
100
2010
2011
2012
2013
2014
International
Panama
Suriname
Mexico
Peru
El Salvador
Colombia
Brazil
Guyana
Venezuela
(Bolivarian Republic of)
Belize
Nicaragua
Dominican Republic
Bolivia
(Plurinational State of)
Honduras
Haiti
Guatemala
Ecuador
French Guiana
200
Domestic
2015

E. Proportion of cases due to P.falciparum and

P.vivax, 20132015
12
16

Incidence
P. falciparum
P. vivax
Mortality
Other
Nicaragua
Venezuela
Peru
Panama
Guatemala
Haiti
Bolivia
Guyana
Brazil
Mexico
Colombia
Ecuador
French Guiana
Dominican Republic
Honduras
El Salvador
Belize
Suriname
Haiti
Dominican Republic
Colombia
French Guiana
Guyana
Suriname
Ecuador
Venezuela
Honduras
Peru
Nicaragua
Brazil
Bolivia
Guatemala
Panama
Belize
El Salvador
Mexico
0%
20
US$
20%
40%
60%
80%
100%
-100%
-50%
f Reduction
0%
50%
100%
Increase p
* Changes in case incidence ()
77
Annex 2 E. Regional profile: Eastern Mediterranean Region
291 million
people at risk for
malaria in 2015
111 million
at high risk
A. Confirmed malaria cases per 1000population/parasite

prevalence (PP), 2015
Funding
for malaria
decreased from
US$ 55 million
to
US$ 45 million
between 2010
and 2015
Estimated malaria
case incidence
decreased
by 11%
between 2010
and 2015
Estimated malaria
mortality rate
reduced
by 6%
between 2010
and 2015
One country
achieved zero
indigenous cases
for 3 years
since 2010
78
Confirmed cases
per 1000 population
Insufficient data
0
00.1
0.11.0
1.010
1050
PP
>85
50100
> 100
Not applicable

Yemen, 8%
Afghanistan, 11%
Sudan, 36%
Somalia, 18%
Pakistan, 27%
200

20132015
Domestic
Global Fund
World Bank
USAID
UK
Others
Domestic
International
Saudi Arabia
Iran
(Islamic Republic of)
US$ (million)
150
Djibouti
Sudan
100
Somalia
Afghanistan
50
Yemen
Pakistan
2010
2011
2012
2013
2014
2015


P.vivax, 20132015
12
16

Incidence
P. falciparum
P. vivax
Mortality
Other
Djibouti
Saudi Arabia
Saudi Arabia
Djibouti
Afghanistan
Somalia
Somalia
Yemen
Pakistan
Sudan
Sudan
Pakistan
Yemen
Iran
Iran
Afghanistan
0%
20
US$
20%
40%
60%
80%
100%
-100%
-50%
f Reduction
0%
50%
100%
Increase p
79
Annex 2 F. Regional profile: South-East Asia Region
1.4 billion
people at risk for
malaria in 2015
237 million
at high risk
A. Confirmed malaria cases per 1000population, 2015
Confirmed cases
per 1000 population
Insufficient data
0
00.1
Funding
for malaria
decreased from
US$ 170 million
to
US$ 92 million
between 2010
and 2015
Estimated malaria
case incidence
decreased
by 54%
between 2010
and 2015
Estimated malaria
mortality rate
reduced
by 46%
between 2010
and 2015
One country
achieved zero
indigenous cases
for 3 years
since 2010
80
0.11.0
1.010
1050
50100
> 100
Not applicable

Myanmar, 2% Others, 0%
Indonesia, 9%
India, 89%
350

20132015
Domestic
Global Fund
World Bank
USAID
UK
Others
Domestic
International
Timor-Leste
Bhutan
300
Myanmar
250
US$ (million)
Bangladesh
200
Thailand
150
Democratic Peoples
Republic of Korea
100
Indonesia
50
Nepal
India
2010
2011
2012
2013
2014
2015


P.vivax, 20132015
12
16

Incidence
P. falciparum
P. vivax
20
US$
Mortality
Other
India
Bangladesh
Democratic Peoples
Republic of Korea
Myanmar
Indonesia
India
Myanmar
Timor-Leste
Indonesia
Nepal
Thailand
Thailand
Bhutan
Bangladesh
Nepal
Bhutan
Democratic Peoples
Republic of Korea
Timor-Leste
0%
20%
40%
60%
80%
100%
-100%
-50%
f Reduction
0%
50%
100%
Increase p
81
Annex 2 G. Regional profile: Western Pacific Region
740 million
people at risk for
malaria in 2015
32 million
at high risk
A. Confirmed malaria cases per 1000population, 2015

Confirmed cases
per 1000 population
Insufficient data
0
00.1
0.11.0
1.010
Funding for
malaria increased
from
US$ 29 million
to
US$ 50 million
between 2010
and 2015
Estimated malaria
case incidence
decreased
by 30%
between 2010
and 2015
Estimated malaria
mortality rate
reduced
by 58%
between 2010
and 2015
Zero countries
eliminated
malaria
since 2010
82
1050
50100
> 100
Not applicable

Solomon Islands, 3%
Others, 3%
Lao Peoples Democratic

Republic, 7%
Cambodia, 10%
Papua
New Guinea, 77%
200

20132015
Domestic
Global Fund
World Bank
USAID
UK
Others
Domestic
International
Malaysia
Vanuatu
Solomon Islands
150
US$ (million)
Papua New Guinea

Cambodia
100
Lao Peoples
Democratic Republic
Philippines
Viet Nam
50
Republic of Korea
0
China
2010
2011
2012
2013
2014
2015


P.vivax, 20132015
12
16

Incidence
P. falciparum
P. vivax
Other
Philippines
20
US$
Mortality
Lao Peoples
Democratic Republic
Cambodia
Papua New Guinea
Solomon Islands
Cambodia
Viet Nam
Viet Nam
Solomon Islands
Republic of Korea
Lao Peoples
Democratic Republic
Malaysia
China
Philippines
Vanuatu
Papua New Guinea*
Malaysia
Vanuatu
Republic of Korea
China
0%
20%
40%
60%
80%
100%
-100%
-50%
f Reduction
0%
50%
100%
Increase p
83
Annex 3 A. Funding per capita for malaria control and elimination
(in US$)
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cabo Verde
Cameroon
Central African Republic
Chad
Comoros
Congo
Cte dIvoire
Democratic Republic
of the Congo
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Guinea
Guinea-Bissau
Kenya
Liberia
Madagascar
Malawi
Mali
Mauritania
Mayotte
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Sierra Leone
South Africa
South Sudan
Swaziland
Togo
Uganda
United Republic
of Tanzania
Zambia
Zimbabwe
>20
15
10
5
0
>20
15
10
5
0
>20
15
10
5
0
>20
15
10
5
0
>20
15
10
5
0
>20
15
10
5
0
>20
15
10
5
0
>20
15
Domestic
Total
African Region
10
5
0
2005
84
2010
2015
2005
2010
2015 2005
2010
2015
Belize
Bolivia
Brazil
Colombia
Dominican Republic
Ecuador
El Salvador
French Guiana
Guatemala
Guyana
Haiti
Honduras
Mexico
Nicaragua
Panama
Peru
Suriname
Venezuela
Afghanistan
Djibouti
Iran
Pakistan
Saudi Arabia
Somalia
Sudan
Yemen
Tajikistan
Bangladesh
Bhutan
Democratic Peoples
Republic of Korea
India
Indonesia
Myanmar
Nepal
Thailand
Timor-Leste
Cambodia
China
Lao Peoples
Democratic Republic
Malaysia
Papua New Guinea
Philippines
Republic of Korea
Solomon Islands
Vanuatu
Viet Nam
>20
15
10
5
0
>20
15
10
5
0
>20
15
10
5
0
>20
15
10
5
0
>20
15
10
5
0
>20
15
10
5
0
>20
15
10
5
0
>20
15
10
5
0
2005
2010
2015
2005
2010
2015 2005
2010
2015
2005
2010
2015
Domestic
Total
Region of the Americas
Eastern Mediterranean Region
European Region
South-East Asia Region
85
86
Annex 3 B. Proportion of population at risk sleeping under an ITN
Angola
Benin
Burkina Faso
Burundi
Cameroon
Chad
Comoros
Congo
Cte dIvoire
Democratic Republic
of the Congo
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Guinea
Guinea-Bissau
Kenya
Liberia
Madagascar
Malawi
Mali
Mauritania
Mozambique
Niger
Nigeria
Rwanda
Senegal
Sierra Leone
South Sudan
Togo
Uganda
United Republic
of Tanzania
Zambia
100%
75%
50%
25%
0
100%
75%
50%
25%
0
100%
75%
50%
25%
0
100%
75%
50%
25%
0
100%
75%
50%
25%
0
100%
75%
50%
25%
0
2000
2005
2010
2015 2000
2005
2010
2015 2000
2005
2010
2015 2000
2005
2010
2015 2000
2005
2010
2015
Zimbabwe
100%
75%
50%
25%
0
2000
2005
2010
2015
Modelled data
African Region
No model estimates are available for Algeria, Botswana, Cabo Verde, Mayotte, Namibia,
SaoTome and Principe, South Africa and Swaziland, because ITNs are not the primary method
ofvector control in these countries
87
Annex 3 C. Estimated malaria case incidence rate

(cases per 1000 population at risk)
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cabo Verde
Cameroon
Chad
Comoros
Congo
Cte dIvoire
Democratic Republic
of the Congo
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Guinea
Guinea-Bissau
Kenya
Liberia
Madagascar
Malawi
Mali
Mauritania
Mayotte
Mozambique
Namibia
Niger
Nigeria
Rwanda
Senegal
Sierra Leone
South Africa
South Sudan
Swaziland
Togo
Uganda
United Republic
of Tanzania
Zambia
Zimbabwe
>750
500
250
<1
>750
500
250
<1
>750
500
250
<1
>750
500
250
<1
>750
500
250
<1
>750
500
250
<1
>750
500
250
<1
>750
500
Point estimate
African Region
250
<1
2000
88
2005
2010
2015 2000
2005
2010
2015 2000
2005
2010
2015
Belize
Bolivia
Brazil
Colombia
Dominican Republic
Ecuador
El Salvador
French Guiana
Guatemala
Guyana
Haiti
Honduras
Mexico
Nicaragua
Panama
Peru
Suriname
Venezuela
Afghanistan
Djibouti
Iran
Pakistan
Saudi Arabia
Somalia
Sudan
Yemen
Tajikistan
Bangladesh
Bhutan
Democratic Peoples
Republic of Korea
India
Indonesia
Myanmar
Nepal
Thailand
Timor-Leste
Cambodia
China
Lao Peoples
Democratic Republic
Malaysia
Papua New Guinea
Philippines
Republic of Korea
Solomon Islands
Vanuatu
Viet Nam
>500
250
<1
>500
250
<1
>500
250
<1
>500
250
<1
>500
250
<1
>500
250
<1
>500
250
<1
>500
250
<1
2000
2005
2010
2015 2000
2005
2010
2015 2000
2005
2010
2015 2000
2005
2010
2015
Point estimate
European Region
89
Annex 3 D. Estimated malaria mortality rate
(deaths per 100 000 population at risk)
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cabo Verde
Cameroon
Centra African Republic
Chad
Comoros
Congo
Cte dIvoire
Democratic Republic
of the Congo
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Guinea
Guinea-Bissau
Kenya
Liberia
Madagascar
Malawi
Mali
Mauritania
Mayotte
Mozambique
Namibia
Niger
Nigeria
Rwanda
Senegal
Sierra Leone
South Africa
South Sudan
Swaziland
Togo
Uganda
United Republic
of Tanzania
Zambia
Zimbabwe
400
300
200
100
0
400
300
200
100
0
400
300
200
100
0
400
300
200
100
0
400
300
200
100
0
400
300
200
100
0
400
300
200
100
0
400
300
200
Point estimate
African Region
100
0
2000
90
2005
2010
2015 2000
2005
2010
2015 2000
2005
2010
2015
Belize
Bolivia
Brazil
Colombia
Dominican Republic
Ecuador
El Salvador
French Guiana
Guatemala
Guyana
Haiti
Honduras
Mexico
Nicaragua
Panama
Peru
Suriname
Venezuela
Afghanistan
Djibouti
Iran
Pakistan
Saudi Arabia
Somalia
Sudan
Yemen
Tajikistan
Bangladesh
Bhutan
Democratic Peoples
Republic of Korea
India
Indonesia
Myanmar
Nepal
Thailand
Timor-Leste
Cambodia
China
Lao Peoples
Democratic Republic
Malaysia
Papua New Guinea
Philippines
Republic of Korea
Solomon Islands
Vanuatu
Viet Nam
>100
75
50
25
0
>100
75
50
25
0
>100
75
50
25
0
>100
75
50
25
0
>100
75
50
25
0
>100
75
50
25
0
>100
75
50
25
0
>100
75
50
25
0
2000
2005
2010
2015 2000
2005
2010
2015 2000
2005
2010
2015 2000
2005
2010
2015
Point estimate
European Region
91
Annex 3 E. Estimated change in malaria incidence and mortality rates,

20102015
Decrease
WHO region
& subregion
Country
African, West
Algeria
African, Central
Angola
African, West
Benin
African, South-East
Botswana
African, West
Burkina Faso
African, Central
Burundi
African, Central
Cameroon
African, West
Cabo Verde
African, Central
African, Central
Chad
African, South-East
Comoros
African, Central
Congo
African, West
Cte d'Ivoire
African, Central
Democratic Republic of the Congo
African, Central
Equatorial Guinea
African, South-East
Eritrea
African, South-East
Ethiopia
African, Central
Gabon
African, West
Gambia
African, West
Ghana
African, West
Guinea
African, West
Guinea-Bissau
African, South-East
Kenya
African, West
Liberia
African, South-East
Madagascar
African, South-East
Malawi
African, West
Mali
African, West
Mauritania
African
Mayotte
African, South-East
Mozambique
African, South-East
Namibia
African, West
Niger
African, West
Nigeria
African, South-East
Rwanda
African, Central
African, West
Senegal
African, West
Sierra Leone
African, South-East
South Africa
African, South-East
South Sudan
African, South-East
Swaziland
African, West
Togo
African, South-East
Uganda
African, South-East
United Republic of Tanzania
African, South-East
Zambia
African, South-East
Zimbabwe
>40%
Increase
>20%
Zero
indigenous
deaths
in 2015
92
2040%
Change
<20%
Change in estimated incidence rate
Change in estimated mortality rate
Decrease
WHO region
& subregion
Americas
Country
Belize
Bolivia (Plurinational State of)
Brazil
Colombia
Dominican Republic
Ecuador
El Salvador
French Guiana
>40%
2040%
Haiti
Honduras
Mexico
Peru
Suriname
Venezuela (Bolivarian Republic of)

Afghanistan
Djibouti
Iran (Islamic Republic of)
Pakistan
Saudi Arabia
Somalia
Sudan
Yemen
European
Tajikistan
South-East Asia
Bangladesh
Bhutan
Democratic People's Republic of Korea
India
Indonesia
Myanmar
Nepal
Thailand
Timor-Leste
Western Pacific
Cambodia
China
Lao People's Democratic Republic
Malaysia
Papua New Guinea
Philippines
Vanuatu
Viet Nam
Republic of Korea
Solomon Islands
Zero
indigenous
deaths
in 2015
Nicaragua
Panama
Increase
>20%
Guatemala
Guyana
Change
<20%
93
Annex 4 A. Policy adoption, 2015

WHO region
Country/area

ITNs/
LLINs are
distributed
free of
charge
ITNs/
LLINs are
distributed
to all age
groups
ITNs/ LLINs
IRS is
distributed recommended
through mass by malaria
campaigns
control
to all age
programme
groups
Chemoprevention
DDT is used
for IRS
IPTp used
to prevent
malaria
during
pregnancy
Seasonal
malaria
chemo
prevention
(SMC or IPTc)
is used
AFRICAN
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cabo Verde
Cameroon
Chad
Comoros
Congo
Cte d'Ivoire
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Guinea
Guinea-Bissau
Kenya
Liberia
Madagascar
Malawi
Mali
Mauritania
Mayotte
Mozambique
Namibia
Niger
Nigeria
Rwanda
Senegal
Sierra Leone
South Africa
South Sudan2
Swaziland
Togo
Uganda
Mainland
Zanzibar
Zambia
Zimbabwe
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
AMERICAS
Belize
Brazil
Colombia
Dominican Republic
94
Testing
Treatment
Patients of all
ages should
get diagnostic
test
Malaria
diagnosis is
free of charge
in the public
sector
RDTs used at
community
level
G6PD test is
recommended
before
treatment with
primaquine
ACT for
treatment of
P. f.
NA
NA
NA
Pre-referral Single dose of

treatment with primaquine
quinine or
is used as
artemether IM gametocidal
or artesunate
medicine for
suppositories P.falciparum1
Primaquine
is used for
radical
treatment of
P.vivax cases
Directly
observed
treatment with
primaquine is
undertaken
95
Annex 4 A. Policy adoption, 2015

WHO region
Country/area

ITNs/
LLINs are
distributed
free of
charge
ITNs/
LLINs are
distributed
to all age
groups
ITNs/ LLINs
IRS is
distributed recommended
through mass by malaria
campaigns
control
to all age
programme
groups
Chemoprevention
DDT is used
for IRS
IPTp used
to prevent
malaria
during
pregnancy
Seasonal
malaria
chemo
prevention
(SMC or IPTc)
is used
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
AMERICAS
Ecuador
El Salvador
French Guiana
Guatemala
Guyana
Haiti
Honduras
Mexico
Nicaragua
Panama
Peru
Suriname
EASTERN MEDITERRANEAN
Afghanistan
Djibouti
Pakistan
Saudi Arabia
Somalia
Sudan
Yemen
EUROPEAN
Tajikistan
SOUTH-EAST ASIA
Bangladesh
Bhutan
Democratic People's Republic of
Korea
India
Indonesia
Myanmar
Nepal
Thailand
Timor-Leste
WESTERN PACIFIC
Cambodia
China
Malaysia
Papua New Guinea
Philippines
Republic of Korea
Solomon Islands
Vanuatu
Viet Nam
ACT, artemisinin-based combination therapy; DDT, dichloro-diphenyl-trichloroethane; G6PD, glucose-6-phosphate dehydrogenase; IM, intramuscular; IPTc, intermittent
preventive treatment in children; IPTp, intermittent preventive treatment in pregnancy; IRS, indoor residual spraying; ITN, insecticide-treated mosquito net; LLIN, long-lasting
insecticidal net; NA, not applicable; NMCP, national malaria control programme; RDT, rapid diagnostic test; SMC, seasonal malaria chemoprevention
96
Testing
Treatment
Patients of all
ages should
get diagnostic
test
Malaria
diagnosis is
free of charge
in the public
sector
RDTs used at
community
level
G6PD test is
recommended
before
treatment with
primaquine
ACT for
treatment of
P. f.
Primaquine
is used for
radical
treatment of
P.vivax cases
Directly
observed
treatment with
primaquine is
undertaken
NA
Pre-referral Single dose of

treatment with primaquine
quinine or
is used as
artemether IM gametocidal
or artesunate
medicine for
suppositories P.falciparum1
NA
NA
NA
NA
NA
NA
NA
NA
NA
() = Actually implemented.
() = Not implemented.
(-) = Question not answered or not applicable.
1 Single dose of primaquine (0.75mg base/kg) for countries in the WHO Region of the Americas
2 In May 2013 South Sudan was reassigned to the WHO African Region (WHA resolution 66.21,
http://apps.who.int/gb/ebwha/pdf_files/WHA66/A66_R21-en.pdf)
97
Annex 4 B. Antimalarial drug policy, 2015

WHO region
Country/area
P. falciparum
P. vivax
Uncomplicated
unconfirmed
Uncomplicated
confirmed
Severe
AL
AL
AL
AL; AS+AQ
AS+AQ
AL
AS+AQ
AL
AL; AS+AQ
AL
AS+AQ
AS+AQ
AS+AQ
AS+AQ
AS+AQ
AL
AS+AQ
AL
AS+AQ
AS+AQ
AL
AL
AS+AQ
AS+AQ
AL
AS+AQ
AS+AQ
AL
AL
AL
AL; AS+AQ
AS+AQ
AL
AS+AQ
AL
AL; AS+AQ
AL
AS+AQ
AS+AQ
AS+AQ
AS+AQ
AS+AQ
AL
AS+AQ
AL
AL; AS+AQ
AS+AQ
AL
AL
AS+AQ
AS+AQ
AL
AL; AS+AQ
AL; AS+AQ
QN
QN
QN
QN
QN
QN
QN
QN
QN
QN
AL
AL
QN
QN
QN
QN
AL
QN
QN
QN
QN
QN
QN
QN
AS+AQ
AL
-
Prevention during
pregnancy
Treatment
AFRICAN
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cabo Verde
Cameroon
Chad
Comoros
Congo
Cte d'Ivoire
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Guinea
Guinea-Bissau
Kenya
Liberia
Madagascar
Malawi
Mali
Mauritania
Mayotte
AL
QN
AL
AL
AL
AL; AS+AQ
AL
AS+AQ
AS+AQ
AS+AQ
AS+AQ
AL; AS+AQ
AL
AL; AS+AQ
AL
AS+AQ
AL
AL
AL
AL
AL
AL; AS+AQ
AL
AS+AQ
AL; AS+AQ
AL; AS+AQ
AL; QN+CL; QN+D
AS+AQ
AL
AL; AS+AQ
AL
AL; AS+AQ
AL
AS+AQ
AL
AL
QN
QN
QN
QN
AL
QN
AS; QN
AL
QN
QN
QN
QN
QN
QN
QN
Belize
QN
-
Brazil
Colombia
Dominican Republic
Ecuador
CQ+PQ(1d)
AL+PQ
AL+PQ(1d);
AS+MQ+PQ(1d)
AL
CQ+PQ(1d)
AL+PQ
Mozambique
Namibia
Niger
Nigeria
Rwanda
Senegal
Sierra Leone
South Africa
South Sudan1
Swaziland
Togo
Uganda
Mainland
Zanzibar
Zambia
Zimbabwe
AS; QN
AS; QN
QN
AS; QN
AS; QN
QN
AS, AM;QN
AS, AM; QN
AS,QN
QN
QN
QN
AS, QN
AS
QN
AS; AM; QN
AS; AM; QN
QN
AS; AM; QN
AS
AS;QN
AS; AM; QN
AS; AM; QN
QN
AS; QN
QN
QN
QN; AS; QN+AS;
AS+D; QN+D
AS, QN
QN
AS; QN
AS; AM; QN
AS; QN
QN
AS; QN
AS; AM; QN
QN
AM; AS; QN
AS
AS; AM; QN
AS, QN
AS, AM; QN
AS, AM; QN
AS; QN
AS; AM; QN
QN
CQ
AS+AQ+PQ
CQ
CQ+PQ
AL
AL+PQ; CQ+PQ
AS+AQ+PQ
-
AMERICAS
98
QN+D+PQ
QN+CL
AS+D
QN+CL
AL; QN
AM+CL; AS+CL;
QN+CL
AS+AL
QN+CL
QN
CQ+PQ(14d)
CQ+PQ(7d)
CQ+PQ(7d)
CQ+PQ(14d)
CQ+PQ(14d)
CQ (3d)+PQ(7d)
WHO region
Country/area
P. falciparum
P. vivax
Uncomplicated
unconfirmed
Uncomplicated
confirmed
Severe
Prevention during
pregnancy
CQ+PQ(1d)
AL
AL+PQ(1d)
CQ+PQ(1d)
CQ+PQ(1d)
CQ+PQ
CQ+PQ(1d)
AL
AQ+PG
CQ+PQ
QN+T
MQ; SP
SP
AL+QN
AS+MQ; AS+SP
QN
AS; AL
QN
AM
QN
QN
AL
QN
Panama
AL+PQ(1d)
AS+M
QN
Peru
Suriname
AS+MQ
AL+PQ(1d)
AS+MQ+PQ
AS+MQ
-
AS+MQ
AS
AM; QN
CQ+PQ(14d)
CQ+PQ
CQ+PQ(14d)
CQ+PQ(14d)
CQ+PQ(14d)
CQ+PQ(14d)
CQ+PQ
CQ+PQ(7d)
CQ+PQ(7d);
CQ+PQ(14d)
CQ+PQ
CQ+PQ(14d)
CQ+PQ(14d)
CQ
AL
CQ
AL
AS+SP; AL
AS+SP
AS+SP+PQ
AL+PQ
AS+SP; AS+SP+PQ
AS+SP+PQ
AS+SP+PQ
AS+PQ
AS+SP; AL
AS+SP
AS; AM; QN
QN
AS;QN
AS;QN
AS; AM; QN
AS; AM; QN
QN; AM
QN; AM
QN
AS
AS
AS
AS; AM; QN
AS; AM; QN
AS
AM; QN
CQ+PQ(8w)
CQ+PQ(14d)
CQ+PQ(14d & 8w)
CQ+PQ(14d)
CQ+PQ(14d)
AL+PQ(14d)
AL+PQ(14d)
CQ+PQ(14d)
AL
AL
QN+D; QN+T
QN
AM; QN
AM; QN
CQ+PQ(14d)
CQ+PQ(14d)
Treatment
Americas
El Salvador
French Guiana
Guatemala
Guyana
Haiti
Honduras
Mexico
Nicaragua
Afghanistan
Djibouti
Pakistan
Saudi Arabia
Somalia
Sudan
Yemen
South-East Asia
Bangladesh
Bhutan
Korea
India
Indonesia
Myanmar
Nepal
Thailand
Timor-Leste
CQ+PQ(14d)
CQ
-
AS+SP+PQ
DHA-PP+PQ
AL; AM; AS+MQ;
DHA-PPQ; PQ
AL+PQ
DHA-PPQ
AL
QN+D; QN+T
QN+D+PQ
AM; AS; QN
AM; AS; QN
CQ+PQ(14d)
DHA-PP+PQ(14d)
AS+D; AS+T
AM; AS; QN
CQ+PQ(14d)
AS; QN
QN+D
QN+D
AS; QN
QN+D
AM; AS; QN
CQ+PQ(14d)
CQ+PQ(14d)
CQ+PQ(14d)
QN+T
AM; AS; QN
DHA-PPQ
AM; AS; PYR
CQ+PQ(8d)
QN+D
AS+AL
CQ+PQ(14d)
CQ
-
Western Pacific
Cambodia
China
AS+MQ; DHAPPQ+PQ
ART+NQ; ART-PPQ;
AS+AQ; DHA-PPQ
AL
AL
CQ
AS+MQ
AL
AL+PQ
-
AL
DHA-PPQ
AL
AL
DHA-PPQ
Western Pacific
Malaysia
Papua New Guinea
Philippines
Republic of Korea
QN+T
QN+T
DHA-PPQ
AM; AS
QN+CL; QN+D; QN+T QN+T; QN+D; QN+CL
-
CQ+PQ(14d)
AL+PQ
CQ+PQ(14d)
CQ+PQ(14d)
Western Pacific
Solomon Islands
Vanuatu
Viet Nam
QN
QN
QN+CL; QN+D
AL; AS
AS
AS; QN
AL+PQ(14d)
AL+PQ(14d)
CQ+PQ(14d)
AL=Artemether-lumefantrine AS=Artesunate D=Doxycycline PG=Proguanil QN=Quinine

AT= Atovaquone
DHA=Dihydroartemisinin PPQ=Piperaquine
SP=Sulphadoxine-pyrimethamine
AM=Artemether
CL=Clindamycline MQ=Mefloquine PQ=Primaquine T=Tetracycline
AQ=Amodiaquine
CQ=Chloroquine NQ=Naphroquine PYR=Pyronaridine
ART=Artemisinin
1 In May 2013, South Sudan was reassigned to the WHO African Region (WHA resolution 66.21, http://apps.who.int/gb/ebwha/pdf_files/WHA66/A66_R21-en.pdf)
99
Annex 4 C. Funding for malaria control, 20132015

WHO region
Country/area
Year
Contributions reported by donors

Global Fund
PMI/
USAID
The World Bank
UK4
AFRICAN
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cabo Verde
Cameroon
Chad
Comoros
Congo
Cte d'Ivoire
Equatorial Guinea
Eritrea
Ethiopia
Gabon
100
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
25 215 799
-249 158
28 548 000
29 000 000
27 645 452
13 105 187
16 653 000
16 500 000
0
9 399 940
5 963 608
9 421 000
9 500 000
22 752 851
4 774 243
9 229 000
9 500 000
4 254 781
281 893
11 238 171
13 731 500
892 644
10 878 702
8 613 320
12 276 042
1 991 913
34 674 177
12 587 947
3 541 013
1 107 319
735 866
45 346 542
27 496 568
58 206 877
78 117 103
41 869 000
50 000 000
-138 121
14 460 101
6 797 703
113 143 096
9 890 472
-118
-154 828
43 773 000
45 000 000
Contributions reported by countries

Government
0
1 705 134
1 335 355
64 047 348
27 851 717
47 356 258
980 000
1 082 000
1 947 775
2 142 552
1 605 618
58 920 267
3 126 963
576 253
1 134 923
2 001 113
464 515
397 920
253 251
1 520 070
5 246 883
43 709 021
12 122 087
160 000
530 000
530 000
7 493 400
9 122 400
1 184 508
137 147
94 797
114 685
1 651 000
1 675 000
446 000
54 723 090
53 942 249
913 958 253
7 812 690
8 104 841
7 014 345
2 582 747
0
0
19 705 028
226 596
123 200
27 677 576
Global Fund
The World Bank
PMI/
USAID
Other
bilaterals
WHO
UNICEF
Other
contributions6
0
0
0
5
12 000
19 286 339
5 378 690
2 675 645
27 200 000
27 000 000
28 000 000
3 555 239
40 580 540
5
5
5
5
0
0
280 899
40 645 351
2 433 376
42 735 771
19 481 377
6 027 330
4 523 416
555 169
64 285
325 273
15 293 706
147 856 497
54 918 697
5 342 710
2 852 385
0
0
0
0
697 173
284 328
0
0
0
8 552 723
8 571 017
8 579 441
9 260 000
9 229 345
9 500 000
0
0
0
0
70 804
9 454
2 602 730
0
5 415 537
1 123 490
0
37 800
19 048
11 800
65 000
79 050
32 595
130 448
19 638
19 142
904 218
460 000
221 000
0
20 500
100 000
0
0
0
521 760
136 540
305 704
453 631
475 936
47 445 292
0
0
0
942 955
379 610
2 533 200
1 277 376
1 324 385
118 341
14 718
5 415 537
669 000
2 000 000
5 596 000
5
5
30 125 205
6 141 762
499 000
1 074 877
224 643
0
0
74 853 096
33 611 939
14 414 815 784
86 281 277
102 540 781
107 594 221
0
15 871 769
4 906 745
6 216 618
85 723 876
93 201 479
18 448 416
0
0
0
239 735
0
0
0
0
0
0
0
0
0
0
0
0
0
13 119 140
0
9 839 355
9 839 355
0
37 001 000
34 000 000
34 000 000
0
244 000
0
2 952 042
0
0
0
0
0
0
0
0
0
29 370 000
3 800 000
0
0
0
0
0
24 838 023
23 018 218
54 574
20 000
40 000
104 000
30 000
45 000
45 000
68 000
36 338
6 245 966
0
0
2 100 000
2 933 630
2 667 358
216 491
5 576
51 630
6 221
10 000
18 000
24 975 817
29 250 235
15 070 138
1 790 452
7 196 262
808 130
58 832
46 081
111 677
0
0
0
0
0
11 276
34 855
47 147
0
0
0
673 440
0
58 500
0
0
3 827
0
244 000
22 954 890
35 020 370
0
0
4 490 030
0
0
15 000 000
13 114 670
272 289
101

WHO region
Country/area
Year

Global Fund
PMI/
USAID
The World Bank
UK4
AFRICAN
Gambia
Ghana
Guinea
Guinea-Bissau
Kenya
Liberia
Madagascar
Malawi
Mali
Mauritania
Mayotte
Mozambique
Namibia
Niger
Nigeria
Rwanda
Senegal
102
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
9 288 845
4 134 951
2 982 020
67 802 357
14 840 935
28 547 000
28 000 000
4 603 535
9 144 353
12 371 000
12 500 000
1 903 200
145 948
7 320 497
2 340 811
33 311 280
49 541 177
34 256 000
35 000 000
5 882 949
10 405 293
12 370 000
12 000 000
22 647 300
499 317
26 026 000
26 000 000
9 084 196
7 129 260
24 075 000
22 000 000
13 845 815
10 803 020
25 007 000
25 000 000
22 345 400
264 584
12 626 612
34 642 279
29 023 000
29 000 000
2 031 197
7 739 210
45 365 287
144 939 061
73 272 000
75 000 000
27 963 280
30 852 400
22 881 569
15 427 182
18 003 000
17 500 000
3 699 517
3 306 066
0
0
3 662 132
21 674 466
24 124 000
24 000 000
3 608 532
556 809
9 305 823
24 009 643
9 455

Government
726 578
799 091
793 818
8 736 726
8 855 177
9 832 327
3 015 335
956 833
48 178 445
0
100 000
1 372 093
1 178 804
1 520 205
284 306
11 341 797
15 286
23 658
25 400
4 266 640
1 871 915
1 756 941
5 670 552
1 130 593
2 328 000
173 720
65 800 000
4 186 129
5 146 910
14 811 934
2 996 923
4 051 428
2 668 014
2 859 000
8 999 547
5 541 401
0
531 541
10 724
11 084
47 033
13 986
24 800
2 069 404
Global Fund
4 919 685
5 934 320
2 887 213
67 804 357
64 952 156
39 759 327
15 603 972
28 859 411
701 363
2 952 761
The World Bank
PMI/
USAID
Other
bilaterals
0
0
0
27 000 000
4 730 000
28 000 000
10 000 000
12 052 476
12 500 000
0
0
0
38 817
825 000
520 000
0
0
3 979 774
0
WHO
UNICEF
16 000
132 833
Other
contributions6
100 000
120 814
2 406 568
47 050
32 514
60 000
26 229
150 000
3 062
0
7 519
0
105 114
21 886
73 734
16 869
36 639
10 419
218 811
7 231
16 581
23 457 627
100 000
340 647
0
0
0
0
56 422
1 127 907
29 994 536
2 524 013
23 199 442
880 267
8 023 075
22 777 197
18 180 392
26 392 018
21 201 959
0
600 000
0
2 497 243
37 646 902
4 357 070
882 630
2 910 095
2 796 269
19 000 000
2 494 013
9 324 003
100 362 906
137 920 815
126 250 194
11 000 000
3 500 000
0
0
0
29 000 000
29 023 096
29 000 000
0
0
0
0
0
0
0
7 040 569
52 220 588
0
0
72 000
60 462 012
73 771 000
75 000 000
0
0
36 736 654
20 157 565
12 322 449
200 000
100 000
100 000
100 000
27 000
70 248
86 567
934 980
861 615
964 784
1 050 830
1 020 102
1 000 000
32 512
125 209
60 006
12 490
12 491
0
0
1 293
200 000
9 780
2 000
1 600
1 600
0
10 893 838
1 002 778
1 715 622
1 668 679
4 675 836
15 023 299
2 427 578
0
0
0
0
0
0
0
1 000 000
23 457 627
25 635 413
27 000 000
25 920 000
26 000 000
23 000 000
19 118 000
12 234 171
25 500 000
25 500 000
25 500 000
369 500
0
213 615
299 000
3 369 341
298 946
150 000
150 000
737 588
254 170
70 000
92 000
95 000
120 000
11 767
46 000
67 000
3 092 000
1 437 552
574 693
42 583
42 000
67 000
100 000
2 668 555
268 993
1 688 356
29 089 771
48 916 476
64 945 727
14 026 642
10 399 555
0
0
32 400 000
32 400 000
32 400 000
12 000 000
12 000 000
6 429
0
0
18 000 000
0
0
0
24 500 000
25 302 960
23 666 000
832 402
604 058
44 890
1 082 008
0
5 326 854
139 501
0
0
136 929
0
4 000 000
1 249 000
18 500
3 000 000
1 000 000
44 000
0
4 809 717
25 705
103

WHO region
Country/area
Year

Global Fund
PMI/
USAID
The World Bank
UK4
AFRICAN
Sierra Leone
South Africa
South Sudan7
Swaziland
Togo
Uganda
United Republic of Tanzania8
Mainland
Zanzibar
Zambia
Zimbabwe
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
6 214 513
13 788 079
6 097 560
8 716 372
14 253 512
6 947 000
6 000 000
8 955 920
19 511 505
14 223 217
33 782 000
34 000 000
680 702
56 328 793
28 943 792
46 056 000
46 000 000
7 354 400
1 336 085
1 654 211
20 510 821
7 413 283
52 221 547
28 943 792
4 107 246
29 335 147
24 028 000
24 000 000
9 985 457
10 695 816
15 035 000
15 000 000
4 903 770
AMERICAS
Argentina
Belize
Brazil
Colombia
Dominican Republic
104
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2 112 710
1 318 174
-228 780
6 737 839
2 894 197
1 149 536
514 691
19 235 700

Government
26 898
3 074
190 741
13 511 860
17 096 911
0
0
556 245
678 718
11 847 354
5 139 088
8 035 963
8 035 963
937 500
6 022 000
30 523 723
15 152
407 082
185 325
15 462 950
22 640 090
706 200
520 000
780 000
1 082 700
1 082 700
1 082 700
261 500
270 000
297 500
787 966
718 391
531 609
73 291 509
72 248 286
60 803 769
23 100 498
11 493 708
13 059 553
1 966 812
1 883 503
2 663 837
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
Global Fund
The World Bank
PMI/
USAID
Other
bilaterals
13 216 219
13 525 631
5 353 621
1 952 807
0
0
0
46 437 577
0
6 900 000
6 156 320
0
152 277
68 180
41 140
0
1 715 525
1 203 444
1 714 840
4 897 544
17 304
20 146 401
24 195 015
74 643 525
142 485 233
147 632 422
28 982 597
140 356 602
145 506 422
28 982 597
2 128 631
2 126 000
3 418 520
0
0
0
0
0
0
0
0
0
33 781 000
33 000 000
33 000 000
40 602 700
1 975 000
1 060 714
37 117 700
450 000
1 060 714
3 485 000
1 525 000
19 361 732
24 362 218
10 614 665
7 460 006
7 626 664
33 425 777
0
0
0
0
10 121
189 879
365 193
1 631 520
1 170 000
0
0
0
4 832 745
3 257 687
0
1 158 508
852 947
72 511
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
WHO
UNICEF
Other
contributions6
64 000
50 000
101 207
7 874 921
17 912
100 847
112 855
2 200 067
40 000
2 934 000
0
1 000 000
0
4 108 159
132 445
20 250
0
0
0
1 779
222 460
4 896 045
4 899 062
2 528 703
0
480 412
2 487 550
0
480 412
41 153
50 000
850
850
0
500
500
0
350
350
1 359 595
5 676 820
41 153
0
0
0
0
0
41 153
0
24 000 000
24 000 000
24 000 000
13 000 000
12 000 000
12 000 000
3 500 000
204 466
27 318
20 000
1 006 000
0
6 000 000
6 500 000
0
0
0
14 223
6 761
12 747
0
0
0
18 700
47 495
129 288
142 406
96 194
73 391
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
39 623 353
32 222 500
0
50 000
77 966 100
0
0
77 966 100
170 500
90 060
42 500
39 649
0
0
0
0
0
0
0
0
38 991
0
0
0
0
0
0
21 930
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
23 382
106 598
213 094
105

WHO region
Country/area
Year

Global Fund
PMI/
USAID
The World Bank
AMERICAS
Ecuador
El Salvador
French Guiana
Guatemala
Guyana
Haiti
Honduras
Mexico
Nicaragua
Panama
Peru
Suriname
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
1 110 598
1 002 244
0
-2 089 393
4 388 420
379 266
3 902 655
4 531 760
954 631
967 393
0
2431682
1010094
0
549 463
158 751
0
Afghanistan
Djibouti
Pakistan
106
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
17 626 010
8 403 364
3 154 876
52 000
3 180 088
2 665 232
5 849 945
9 003 535
UK4

Government
1 852 740
2 444 718
2 854 844
0
0
1 385 919
542 663
2 610 850
883 314
800 439
1 023 795
2 433 241
971 742
543 312
25 256 768
23 827 054
46 662 926
980326
2596547
2886581
7 220 410
7 469 311
7 964 427
429 285
152 805
1 650 498
1 049 230
800 000
1 000 000
19 600 139
5 000 000
6 300 000
2 500 000
-
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
Global Fund
The World Bank
PMI/
USAID
735 047
983 835
0
0
0
0
0
0
0
0
0
0
0
0
0
0
19 719
98 057
3 498 024
3 278 171
8 232 108
809 474
451 597
337 939
1 248 119
1 161 379
1 415 674
1 106 404
792 634
0
0
0
0
0
0
0
0
105 373
92 461
56 824
297 569
115 708
288 169
0
0
0
2075252
1214811
1013568
0
100 000
10 000
0
0
0
550 000
479 600
975 757
0
0
0
16 651 753
9 083 870
4 571 460
0
2 979 260
2 418 943
8 057 177
10 718 906
5 910 215
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
13 376
0
0
102 864
62 156
99 330
113 187
118 071
0
0
0
37630
51323
59175
32 136
77 562
49 079
56 703
91 037
98 598
157 887
30 198
47 762
0
0
0
Other
bilaterals
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
470 000
6 000
0
0
0
0
0
0
0
0
0
0
0
0
400 000
400 541
400 541
WHO
UNICEF
Other
contributions6
141 000
56 948
54 340
11 563
0
0
0
0
0
0
0
0
0
0
0
0
0
71 370
140 486
47 500
169 000
24 413
0
0
0
0
0
0
0
0
0
0
18 457
0
0
0
4814
21868
28098
0
0
11 000
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
820 000
250 064
0
6 046
0
0
0
0
0
100 000
77 264
41 437
0
0
0
0
0
0
0
0
0
0
0
0
0
0
400 000
0
0
109 068
113 341
89 167
121 616
200 563
9 200
60 500
34 000
5 000
154 000
89 000
107

WHO region
Country/area
Year

Global Fund
PMI/
USAID
The World Bank
UK4
Saudi Arabia
Somalia
Sudan
Yemen
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2 266 628
9 672 384
35 680 104
16 053 353
0
0
5 973 123
2 017 535
EUROPEAN
Tajikistan
2013
2014
2015
1 308 106
1 032 277
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
16 404 817
4 395 406
SOUTH-EAST ASIA
Bangladesh
Bhutan
India
Indonesia
Myanmar
Nepal
Thailand
Timor-Leste
405 271
239 889
2 706 329
6 704 605
7 174 057
4 481 942
5 377 070
31 045 276
11 488 128
15 032 712
18 254 744
297 389
6 566 000
8 000 000
4 922 108
1 813 110
11 325 529
16 524 453
2 604 409
1 527 841
0
0
12 111 758
17 983 122
3 997 000
4 500 000
WESTERN PACIFIC
Cambodia
108
2013
2014
2015
11 283 400

Government
29 440 000
30 000 000
30 000 000
64 515
67 740
79 488
26 724 830
27 316 109
21 536 529
2 293 553
8 480
0
Global Fund
0
0
15 062 018
9 604 810
7 365 620
34 938 594
35 883 294
16 251 350
6 256 730
2 110 776
14 326 025
The World Bank
0
0
0
0
PMI/
USAID
Other
bilaterals
0
0
0
0
0
0
0
0
258 495
WHO
0
0
138 400
85 000
121 800
475 893
446 160
471 552
200 000
465 713
390 259
633 740
773 000
-
1 714 393
1 057 879
35 000
75 000
4 134 615
5 586 290
935 897
180 328
179 104
1 895 000
1 957 000
2 042 000
51 336 600
43 802 468
48 419 018
15 288 402
16 108 194
10 940 000
1 028 807
5 272 824
1 910 485
2 315 400
5 893 255
7 546 409
7 934 078
2 981 432
791 375
8 033 087
8 912 484
9 507 849
399 189
3 484 029
714 343
692 698
5
5
5
390 420
487 909
2 706 329
1 571 206
6 817 631
4 811 540
16 129 032
5 244 575
34 580 791
15 913 410
10 966 688
14 863 117
42 620 577
31 629 898
3 110 685
5 199 862
9 937 671
20 175 612
13 830 845
4 372 545
3 482 955
2 610 355
13 240 888
2 917 174
4 042 964
UNICEF
Other
contributions6
0
0
140 000
0
0
1 986 444
1 674 350
65 000
0
0
0
0
4 299 233
0
0
0
0
0
0
0
0
0
0
0
0
0
10 000
5 552
25 000
98 000
30 200
0
0
0
0
0
0
0
0
0
0
0
0
5 400 000
6 565 881
6 500 000
451 400
2 800 000
0
0
278 311
345 667
685 341
0
0
0
0
0
3 996 624
4 500 000
4 500 000
0
0
0
400 000
277 282
277 282
142 500
25 000
25 000
46 500
46 500
45 000
139 166
0
0
65 012
0
0
0
166 639
0
0
0
0
3 525 000
3 490 400
1 691 397
1 000 000
0
0
0
0
5 561 917
0
0
0
70 833
0
0
120 000
27 280
431 792
334 029
406 393
0
0
0
109

WHO region
Country/area
Year

Global Fund
PMI/
USAID
The World Bank
UK4
WESTERN PACIFIC
China
Malaysia
Papua New Guinea
Philippines
Republic of Korea
Solomon Islands
Vanuatu
Viet Nam
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
1 856 499
-1 738 247
3 256 001
2 322 590
695 423
22 970 152
10 970 461
4 806 916
6 932 455
0
4 249 171
3 777 902
-2 733
PMI, United States Presidents Malaria Initiative; UK, Funding from the United Kingdom of Great Britain and Northern Ireland government; UNICEF, United Nations Childrens Fund;
USAID, United States Agency for International Development
1 Source: The Global Fund
2 Source: www.foreignassistance.gov
3 Source: OECD Database
4 Source: OECD Database
5 Budget not expenditure
6 Other contributions as reported by countries: NGOs, foundations, etc.
7 South Sudan became an independent State on 9 July 2011 and a Member State of WHO on 27 September 2011. South Sudan and Sudan have distinct epidemiological profiles
comprising high-transmission and low-transmission areas, respectively. For this reason data up to June 2011 from the high-transmission areas of Sudan (10 southern states
which correspond to contemporary South Sudan) and low-transmission areas (15 northern states which correspond to contemporary Sudan) are reported separately.
8 Where national totals for the United Republic of Tanzania are unavailable, refer to the sum of Mainland and Zanzibar.
* Negative disbursements reflect recovery of funds on behalf of the financing organization.
110

Government
16 812 725
20 843 118
17 620 404
1 122 915
247 375
211 874
39 845 997
57 535 038
64 881 663
388 000
377 000
1 637 421
5 235 686
5 861 758
6 165 334
519 102
556 200
538 495
270 180
260 505
281 324
812 377
812 377
166 359
4 523 810
2 666 667
2 666 666
Global Fund
The World Bank
PMI/
USAID
Other
bilaterals
UNICEF
Other
contributions6
0
0
0
0
0
0
4 038 937
2 475 938
6 458 501
0
0
0
120 132
0
216 986
0
0
600 000
20 000
113 000
198 357
0
0
0
0
0
0
43 620
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1 987 523
1 820 735
1 017 390
1 692 091
1 064 592
424 136
0
0
0
315 326
0
0
0
0
0
852 472
654 985
464 914
287 615
287 615
175 894
410 000
640 700
560 000
WHO
25 311 547
695 052
19 431 536
8 612 874
7 395 343
6 087 433
0
0
0
1 305 840
1 362 022
2 232 220
1 162 890
1 310 500
687 267
5 254 143
15 263 816
5 528 000
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
22 220
0
0
0
0
0
674 896
0
0
0
0
0
0
0
200 000
111
Annex 4 D. Commodities distribution, 20132015

WHO region
Country/area
Year
No. of ITN + LLIN

sold or delivered
No. of people
protected by IRS
No. of RDTs
distributed
First-line treatment
courses delivered
(including ACT)
ACT treatment
courses delivered
AFRICAN
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cabo Verde
Cameroon
Chad
Comoros
Congo
Cte d'Ivoire
Democratic Republic
of the Congo
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Guinea
112
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
0
0
1182519
2978937
2138331
584285
6203924
0
50000
9959820
239559
481107
731981
5752583
726767
0
0
0
2751112
150000
555334
1170566
230043
6321676
1218640
377252
13576
16969
14005
180595
447
1821267
12627282
3663080
7947747
13918109
15419488
8397
10010
86597
0
2054194
11709780
13388552
17233074
21666
10000
10730
138149
1046510
93375
1926300
5190887
8423676
5268245
73145
357706
17407
419353
58370
694729
789883
802597
176887
205831
143268
0
0
0
0
0
298475
25780
308586
0
0
0
31150
22475
20275
0
0
185252
194566
77643
129000
165944
275857
320881
328915
23150388
16709249
0
800290
350442
438234
2936037
2154924
-
0
900000
2500000
1332948
1486667
1600
1135
5728612
6224055
8290188
2857991
3089202
5075437
920382
1573992
25000
303582
759245
994779
1144686
1057033
23565
5375
14813
39375
19746
0
3891695
5600100
9746694
13962862
13574891
17630
9801
393780
54516
645
18300000
7416167
13148960
907880
603900
875850
3840000
9309200
3778325
2436825
2870250
2412597
603
266
747
2814900
3185160
1101154
1177261
3953
1386
5797938
7494498
7824634
3836437
4772805
4798379
4824
46
26
1048811
1270172
826434
420000
522270
1043674
814449
1038000
1326091
60868
4750
577
0
0
1304959
2358567
3296991
14941450
19008927
9871484
40911
14577
182911
216195
255602
12800000
7321471
7036620
984423
468767
319182
351677
8330784
14267045
2715640
370771
1312802
1645493
0
92
2814900
3185160
1101154
1177261
3953
1386
5797938
7494498
7824634
3836437
4263178
4798376
3144
41
26
497022
1270172
826434
420000
522270
1043674
814449
1038000
1326091
60868
4750
550
0
0
1304959
2358567
3296991
7112841
19008927
9871484
40911
182911
216195
255602
9164641
5321471
6049320
984423
468767
319182
351677
8330784
14267045
2715640
1402400
644829
-
WHO region
Country/area
Year
No. of ITN + LLIN

sold or delivered
No. of people
protected by IRS
No. of RDTs
distributed
courses delivered
(including ACT)
ACT treatment
courses delivered
AFRICAN
Guinea-Bissau
Kenya
Liberia
Madagascar
Malawi
Mali
Mauritania
Mayotte
Mozambique
Namibia
Niger
Nigeria
Rwanda
Senegal
Sierra Leone
South Africa
South Sudan1
Swaziland
Togo
Uganda
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
116268
1109568
1641982
5450064
11637493
95775
236996
6458693
105442
11249042
636318
1423507
1100000
636465
3790403
6080030
105000
178922
240000
39400
5252
3315727
6112245
5126340
104249
163526
409400
2048430
6253448
8559372
23328225
27628073
5249761
1373582
2066915
14596
11385
113221
3902145
3785595
556135
441859
3846204
395061
0
0
0
3144818
0
5399
3808
468575
4042425
8600
13219306
10615631
1442500
0
0
0
0
0
1579521
1307384
1327326
826386
836568
494163
381
450
9647202
5597770
3659845
598901
467930
386759
0
0
0
132211
316255
1562411
1243704
153514
124692
143571
690090
708999
514833
0
0
2318129
5650177
1178719
332968
0
3971
0
0
2581839
3219122
3895232
917200
5000000
5500000
4319000
610225
58248
1640095
2839325
4962600
8197250
8462325
4101525
2563993
4381050
225680
269941
360000
10547052
17374342
17219225
185025
30120
2561900
4197381
3039594
13200766
10679235
604565
444729
2015100
30909
58005
72407
1453000
1193075
2570500
2522058
2057306
2494935
242123
499086
16007
764670
21575
58700
989436
1633891
1633891
19048750
17157725
27110800
171540
8300000
10839611
11052564
1332055
100535
2172536
1648093
2040289
7601460
8735160
6240060
3080130
2211118
3761319
56015
176192
13477650
15976059
13653685
90377
79215
6556070
5731036
3698674
32568349
22145889
1204913
1917021
4392006
8752
1456
1704
976840
703712
958492
2201370
1391273
1687031
8272
14036
0
3125448
356
588
491
964927
1134604
1508016
24375450
21698700
30166620
171540
7000000
10614717
10321221
443900
96787
2172536
1648093
2040289
7601460
8735160
6240060
3080130
2211118
3761319
56015
176192
109000
13477650
15976059
13653685
87520
6556070
5731036
3698674
32568349
22145889
1204913
1917021
4392006
8752
1456
1704
976840
703712
958492
2201370
1391273
1687031
5444
14036
0
3125448
307
558
396
802904
1208529
1208529
24375450
21698700
30166620
113

WHO region
Country/area
Year
No. of ITN + LLIN

sold or delivered
No. of people
protected by IRS
No. of RDTs
distributed
courses delivered
(including ACT)
ACT treatment
courses delivered
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2547391
619189
21141998
2489536
510000
20794000
57855
109189
347998
3362588
6368026
2010000
1743542
84087
3793027
2224900
14684925
3537097
2000000
14386280
255930
224900
298645
1063460
5538574
5930141
3106659
3460871
3548246
21785950
24126300
17031950
21491950
24126300
16416675
294000
615275
9221210
7500000
11310350
1671832
2446996
1981613
20382485
19937820
10164660
20377410
19937820
10160910
5075
3750
15926301
13000845
14365969
815260
960455
847333
20382485
19937820
10164660
20377410
19937820
10160910
5075
3750
15926301
13000845
14365969
815260
960455
847333
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2324
2452
4152
20965
23580
17514
147736
229947
146196
169500
25100
54139
6733
105906
20337
120532
10000
0
0
2920
2990
282788
49905
600049
27921
152996
24201
0
0
66920
25118
36149
4500
7500
15000
17100
83279
0
0
0
0
4600
45000
64687
21413
21413
36796
30280
16573
11138
324477
287150
276278
154000
519333
252500
49510
6066
100090
94321
15076
6424
37500
16932
37450
1700
41000
25592
146
0
0
121121
116490
125975
49401
47775
214032
127601
56675
59282
17055
11422
11581
43617
69155
142253
0
0
0
15000
100050
46950
101700
43600
2960
0
71000
54425
50220
0
0
0
139525
50459
108900
0
0
0
0
8000
4275
9750
0
19029
15620
12527
0
0
0
-
26
19
13
7342
7401
6907
452990
334740
290580
68879
86228
108469
579
496
661
378
686
10865
8
9
0
31479
12354
9984
109625
2030300
37248
54466
2974
4592
3133
1162
1142
2307
705
874
562
42670
65252
66609
0
0
0
959
325
6907
122290
59690
94380
48285
32489
55469
4
7
3
161
227
0
0
0
0
13655
12354
3219
0
2
8
8
4
6
6
0
0
0
0
0
6504
10416
13618
AFRICAN
Mainland
Zanzibar
Zambia
Zimbabwe
AMERICAS
Belize
Bolivia
Brazil
Colombia
Dominican Republic
Ecuador
El Salvador
French Guiana
Guatemala
Guyana
Haiti
Honduras
Mexico
Nicaragua
Panama
Peru
114
WHO region
Country/area
Year
No. of ITN + LLIN

sold or delivered
No. of people
protected by IRS
No. of RDTs
distributed
courses delivered
(including ACT)
ACT treatment
courses delivered
AMERICAS
Suriname
Venezuela (Bolivarian
Republic of)
2013
2014
2015
2013
2014
2015
4892
3000
0
467
2666
1041
0
0
4369755
4189850
2739290
24425
17625
0
-
800
401
120979
136389
300
144
27659
32005
35509
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
359622
4325552
58830
25700
25000
0
169084
70360
91845
2238300
1519947
1822015
750000
1450000
125000
525000
413000
291085
5803319
4432714
2729334
1405837
375899
847946
0
0
0
36630
281203
289249
217773
1161825
1103480
1685264
1736400
752851
131661
90060
61362
15645
3902712
3942110
2460816
2204429
2188436
798707
188370
355160
98065
20800
40761
114450
1170000
857690
770074
809520
617640
424140
1800000
2200000
4344150
233311
412350
334525
11135
21625
8920
6230
8830
37971
2150000
907200
890500
974
1155
1444
292000
155450
386200
2630400
3823175
2551310
303847
215486
153682
11135
21625
200
8920
3400
8830
2042
590840
162880
80000
974
1155
1444
292000
155450
386200
2077204
3823175
2551310
303847
215486
153682
2013
2014
2015
100000
50000
-
437436
387010
-
1
0
-
1
0
-
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
612000
728773
2380759
93726
10609
26000
0
0
864750
0
0
7241418
913135
6416947
56337
1508557
904613
3398941
1395865
1064518
304437
670000
528850
251500
253037
99572
24607
0
0
32824
144669
70926
2651612
2617120
1146750
45854424
45150612
41849017
253815
103285
53497
48626
129545
345000
372000
235000
106374
362469
348713
51627
110707
93019
186700
259171
16875
0
0
253320
16200000
15562000
21182000
1047504
879650
300000
1497545
3048440
1309300
65500
60000
56000
160000
258823
15400
121991
86592
90818
42390
75479
40742
518
118
416
15673
11212
29272
147000
211500
2123760
300008
212346
406614
371663
281103
243515
38113
24500
3350
15069
19314
8125
1042
347
80
42390
58770
35708
518
118
416
0
0
0
147000
211500
2123760
300008
212165
406614
371663
281103
243515
325
195
300
15069
19314
8125
513
105
56
Afghanistan
Djibouti
Pakistan
Saudi Arabia
Somalia
Sudan
Yemen
EUROPEAN
Tajikistan
SOUTH-EAST ASIA
Bangladesh
Bhutan
Democratic People's
Republic of Korea
India
Indonesia
Myanmar
Nepal
Thailand
Timor-Leste
115

WHO region
Country/area
Year
No. of ITN + LLIN

sold or delivered
No. of people
protected by IRS
No. of RDTs
distributed
courses delivered
(including ACT)
ACT treatment
courses delivered
WESTERN PACIFIC
Cambodia
China
Lao People's Democratic
Republic
Malaysia
Papua New Guinea
Philippines
Republic of Korea
Solomon Islands
Vanuatu
Viet Nam
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
2013
2014
2015
5418
70411
1517074
0
19899
29611
439677
276655
152791
317943
622673
285946
1625831
1613140
991440
715125
996180
932736
0
5250
5250
371124
47258
10721
94232
42916
38211
0
526366
658450
0
0
447639
504936
1697188
13113
4691
682288
615384
489030
0
1108220
1175136
847845
98971
128673
175683
3033
0
1310820
616670
620093
1085325
538500
483600
821000
160000
312075
324225
1032600
963900
1000000
70550
201775
79300
4900
1677
47450
107425
35000
50000
53400
412530
434160
459332
117547
118483
128004
4127
43150
67555
58470
50092
86456
3850
3923
2311
915330
802080
728310
24771
30095
16989
443
638
699
146439
147430
242456
24000
24000
20256
218389
194397
97570
117547
114159
122013
3919
9350
20710
58470
50092
86456
2873
3182
1616
915330
802080
728310
24771
30095
16989
146439
147430
242456
24000
24000
20256
141570
106100
45000
ACT, artemisinin-based combination therapy; IRS, indoor residual spraying; ITN, insecticide-treated mosquito net; LLIN, long-lasting insecticidal net; RDT, rapid diagnostic test
116
DHS 2013
DHIS 2015

-
24
60
32
14
39
34
27
41
41
34
22
12
37
38
30
28
20
39
32
44
19
27
47
79
49
38
66
58
57
64
66
55
36
18
70
65
52
48
37
53
48
59
45
47
47
40
46
71
65
77
61
93
71
63
66
80
75
60
35
23
91
90
86
85
71
78
79
50
77
85
85
47
83
85
34
67
33
41
50
39
39
60
60
37
13
63
58
52
54
31
47
41
35
36
49
49
21
47
66
% of
% of
% of the
popula- existing population with ITNs tion who
access
in HH
slept
to an ITN used the under
in their previous an ITN
household night
the
previous
night
% of
children
<5years
who
slept
under
an ITN
the
previous
night
41
75
40
52
51
38
43
73
74
49
16
78
73
61
61
36
58
50
43
46
59
59
22
55
76
% of
pregnant
women
who
slept
under
an ITN
the
previous
night
31
10
13
12
17
30
13
12
32
% of HH
sprayed
by IRS
within
last 12
months
48
63
42
41
35
23
26
40
42
37
30
34
51
43
41
47
% of HH
with = 1
ITN for
2pers.
and/or
sprayed
by IRS
within
last 12
months
50
28
24
22
13
18
23
10
40
% of
women
who
received
at least
3doses
of IPT
during
ANC
visits
during
their last
pregnancy
17
10
10
21
12
19
38
27
36
53
33
23
46
28
89
77
83
61
51
59
59
68
63
90
87
48
77
14
10
18
99
93
38
18
46
66
78
29
17
93
41
43
92
85
78
31
18
19
10
69
58
49
67
80
73
73
80
66
59
43
64
14
49
36
24
40
18
11
36
30
13
11
22
14
12
49
13
42
39
35
34
37
19
19
13
48
31
for
who
who
whom received had a
advice an ACT finger
or
among or heel
treatthose
stick
ment
who
was received
sought
any
antimalarial
a
a
hemo- positive
globin microsmeacopy
sureblood
ment
smear
<8g/dL
% children <5 years with

fever
in last 2 weeks
% of children aged
6-59months with
ACT, artemisinin-based combination therapy; ANC, antenatal care; DHS, demographic and health survey; HH, households; IPT, intermittent preventive treatment; IRS, indoor residual spraying; ITN, insecticide-treated
mosquito net; MIS, malaria indicator survey
Cambodia
DHS 2014
DHS 2014
Zambia
WESTERN PACIFIC
MIS 2015
DHS 2014
Togo
Uganda
DHIS 2015
-
DHS 2013
DHS 2014
DHIS 2015
DHS 2013
DHS 2013
DHIS 2015
DHS 2013
DHS 2013
Sierra Leone
Senegal
Rwanda
Nigeria
Namibia
Mali
MIS 2014
Malawi
DHS 2013
DHS 2013
Liberia
DHIS 2015
Madagascar
Kenya
DHS 2014
DHS 2014
Ghana
24
DHS 2013
Gambia
24
DHIS 2015
Democratic Republic DHS 2013

of the Congo
DHS 2014
23
Chad
47
MIS 2014
DHS 2013
% of HH % of HH
that
with
have enough
at least ITNs for
one ITN individuals
who
slept
in the
house
the
previous
night
Burkina Faso
Source
Burundi
AFRICAN
WHO region
Country/area
Annex 4 E. Household surveys results, 20132015
117
Annex 4 F. Estimated malaria cases and deaths, 20002015

WHO region
Country/area
2000
Lower
Point
2005
Upper
Lower
Point
Upper
AFRICAN
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cabo Verde
Chad
Comoros
Congo
Cte dIvoire
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Guinea
Guinea-Bissau
Kenya
Liberia
Madagascar
Malawi
Mali
Mauritania
Mozambique
Namibia
Niger
118
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
3 300 000
17 000
1 700 000
5 600
12 000
1
5 500 000
36 000
1 900 000
7 300
4 600 000
16 000
210
1 100 000
5 100
810 000
4 400
65 000
9
750 000
2 100
6 500 000
27 000
17 000 000
87 000
120 000
540
21 000
3
1 100 000
450
290 000
330
310 000
520
6 800 000
15 000
3 200 000
12 000
350 000
1 200
5 500 000
8 700
950 000
5 400
69 000
9
3 300 000
12 000
3 900 000
21 000
31 000
510
7 400 000
31 000
47 000
6
1 900 000
11 000
<50
<10
4 800 000
22 000
2 700 000
7 400
27 000
70
7 200 000
39 000
2 800 000
10 000
6 300 000
20 000
490
<10
1 600 000
6 400
1 700 000
6 200
110 000
280
1 100 000
2 800
8 700 000
33 000
24 000 000
100 000
190 000
680
70 000
140
21 000 000
47 000
440 000
460
410 000
740
9 200 000
19 000
4 200 000
15 000
570 000
1 600
7 200 000
14 000
1 400 000
6 700
1 700 000
4 400
4 800 000
16 000
5 000 000
27 000
250 000
920
9 400 000
40 000
84 000
210
3 700 000
14 000
6 400 000
28 000
3 900 000
9 500
77 000
240
9 000 000
55 000
4 000 000
12 000
8 200 000
26 000
1 400
2 300 000
8 200
2 800 000
9 000
190 000
620
1 500 000
3 600
11 000 000
40 000
31 000 000
140 000
270 000
870
170 000
590
34 000 000
74 000
630 000
590
540 000
990
12 000 000
25 000
5 200 000
20 000
790 000
2 000
9 300 000
16 000
2 100 000
8 700
5 600 000
18 000
6 400 000
20 000
6 200 000
34 000
730 000
1 200
12 000 000
51 000
150 000
520
5 700 000
20 000
4 100 000
16 000
2 400 000
6 600
1 000
5 700 000
25 000
1 500 000
3 600
5 900 000
15 000
97
1 200 000
5 700
870 000
3 800
66 000
9
840 000
1 100
6 800 000
25 000
20 000 000
88 000
180 000
570
18 000
1 200 000
280
140 000
78
310 000
160
6 500 000
8 400
2 800 000
8 800
96 000
240
3 700 000
3 500
980 000
2 800
22 000
5
3 100 000
4 800
4 800 000
18 000
44 000
280
7 600 000
17 000
45 000
5
2 400 000
9 100
<10
<10
5 400 000
22 000
3 400 000
8 600
2 300
<10
7 400 000
32 000
2 200 000
6 800
8 000 000
21 000
220
<10
1 900 000
7 400
2 200 000
7 400
110 000
280
1 200 000
2 400
9 600 000
32 000
29 000 000
110 000
250 000
790
28 000
<100
4 800 000
9 300
230 000
310
410 000
570
8 300 000
16 000
4 100 000
12 000
190 000
730
5 200 000
12 000
1 500 000
4 100
1 300 000
3 300
4 100 000
9 700
6 100 000
23 000
310 000
1 000
9 300 000
25 000
70 000
180
4 600 000
13 000
6 700 000
28 000
4 400 000
11 000
5 600
9 100 000
49 000
3 000 000
7 600
10 000 000
27 000
590
2 700 000
9 400
3 900 000
11 000
190 000
650
1 700 000
3 100
13 000 000
39 000
38 000 000
150 000
310 000
1 000
41 000
12 000 000
29 000
340 000
430
530 000
820
10 000 000
20 000
5 700 000
16 000
290 000
1 000
6 800 000
13 000
2 000 000
5 300
3 500 000
12 000
5 100 000
13 000
7 400 000
29 000
890 000
1 400
11 000 000
32 000
110 000
400
7 000 000
19 000
2010
Lower
1 700 000
8 800
2 300 000
5 100
1 700
<10
7 300 000
22 000
1 100 000
2 000
4 200 000
6 500
66
980 000
3 700
850 000
3 400
96 000
12
530 000
390
6 900 000
17 000
21 000 000
60 000
80 000
180
59 000
11
480 000
230
100 000
69
310 000
120
7 600 000
7 300
3 400 000
8 000
95 000
170
2 500 000
2 100
1 100 000
1 400
380 000
49
5 100 000
4 700
4 200 000
12 000
32 000
260
7 700 000
11 000
2 200
3 400 000
9 700
Point
<10
<10
2 400 000
14 000
3 200 000
6 800
3 400
9 400 000
29 000
1 900 000
5 300
5 700 000
11 000
140
<10
1 600 000
5 000
1 900 000
7 400
140 000
350
880 000
1 700
9 000 000
22 000
28 000 000
82 000
150 000
350
93 000
180
4 400 000
8 100
230 000
320
410 000
570
9 600 000
16 000
4 500 000
11 000
170 000
670
3 300 000
11 000
1 300 000
2 400
650 000
1 700
6 200 000
10 000
5 300 000
16 000
240 000
1 100
9 300 000
18 000
2 900
<10
6 000 000
14 000
2015
Upper
Lower
3 300 000
20 000
4 200 000
8 900
7 500
1 800 000
9 200
2 300 000
4 200
370
11 000 000
45 000
2 800 000
5 700
7 300 000
15 000
300
4 500 000
10 000
890 000
1 500
3 500 000
4 900
2 500 000
6 400
3 500 000
11 000
210 000
720
1 400 000
2 300
11 000 000
28 000
35 000 000
110 000
220 000
460
140 000
380
10 000 000
25 000
420 000
460
550 000
870
12 000 000
20 000
5 900 000
14 000
250 000
970
4 200 000
11 000
1 700 000
3 100
980 000
3 500
7 300 000
13 000
6 300 000
20 000
700 000
1 500
11 000 000
24 000
3 800
770 000
2 500
720 000
3 200
2 000
490 000
260
5 900 000
9 800
14 000 000
26 000
75 000
160
38 000
7
820 000
240
140 000
100
320 000
110
4 800 000
4 600
3 600 000
6 700
55 000
150
3 800 000
2 500
670 000
970
1 500 000
180
2 400 000
1 800
6 100 000
16 000
50 000
250
6 300 000
8 100
17 000
8 600 000
20 000
2 800 000
6 600
Point
0
0
3 100 000
14 000
3 200 000
6 000
710
<10
7 000 000
15 000
1 400 000
5 200
5 300 000
9 200
<50
<10
1 400 000
3 600
1 900 000
7 500
2 900
<10
800 000
1 600
7 900 000
14 000
19 000 000
42 000
180 000
340
65 000
130
2 800 000
4 900
400 000
390
420 000
630
7 300 000
13 000
4 600 000
9 900
160 000
680
6 500 000
12 000
1 100 000
2 000
2 400 000
6 000
3 300 000
7 200
7 500 000
21 000
260 000
1 200
8 300 000
15 000
22 000
<100
5 200 000
10 000
Method used
Upper
4 700 000
21 000
4 100 000
8 000
1 500
10 000 000
29 000
2 000 000
5 600
7 700 000
13 000
2 300 000
4 600
3 400 000
11 000
4 500
1 200 000
2 400
10 000 000
17 000
24 000 000
65 000
310 000
450
100 000
290
5 500 000
13 000
710 000
530
520 000
960
10 000 000
17 000
5 700 000
12 000
330 000
1 000
11 000 000
12 000
1 600 000
2 600
4 000 000
13 000
4 200 000
10 000
9 100 000
25 000
560 000
1 600
11 000 000
20 000
27 000
8 400 000
16 000
1
1b
2
2
2
2
1
1c
2
2
2
2
2
2
1
1a
2
2
2
2
1
1c
2
2
2
2
2
2
2
2
1
1c
1
1c
2
2
1
2
2
2
2
2
2
2
2
2
2
2
1
1c
2
2
2
2
1
2
2
2
1
2
2
2
119

WHO region
Country/area
2000
Lower
2005
Point
Upper
Lower
Point
Upper
AFRICAN
Nigeria
Rwanda
Senegal
Sierra Leone
South Africa
South Sudan1
Swaziland
Togo
Uganda
Zambia
Zimbabwe
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
41 000 000
160 000
950 000
3 400
40 000
110
1 100 000
4 600
1 200 000
10 000
23 000
66 000 000
260 000
8 700 000
7 200
55 000
110
3 800 000
8 400
2 800 000
17 000
65 000
46 000 000
140 000
550 000
1 000
24 000
2 900 000
9 600
3 900
1 900 000
5 500
9 300 000
39 000
54 000 000
200 000
3 400 000
5 200
47 000
110
2 300 000
6 500
2 000 000
12 000
39 000
530
2 000 000
6 100
1 900
<10
2 500 000
6 900
12 000 000
49 000
3 500 000
8 800
16 000 000
63 000
1 200 000
2 500
710
<10
2 100 000
5 200
10 000 000
24 000
cases
deaths
cases
deaths
cases
deaths
8 400 000
22 000
3 000 000
11 000
78 000
23
12 000 000
30 000
4 000 000
14 000
960 000
2 500
15 000 000
38 000
5 200 000
18 000
2 700 000
9 100
cases
deaths
1 600
1 700
0
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
33 000
49 000
<50
1 200 000
370
320 000
<50
1 600
<10
110 000
0
820
0
7 400
<50
98 000
<50
52 000
78
130 000
330
81 000
<50
8 100
0
49 000
<50
1 200
<10
140 000
<50
1 200 000
5 600
630
59 000 000
190 000
1 600 000
3 600
30 000
<100
1 300 000
4 600
2 400 000
12 000
17 000
<100
1 800 000
4 000
970
74 000 000
240 000
3 500 000
5 200
39 000
2 800 000
6 900
13 000 000
35 000
3 500 000
8 900
17 000 000
45 000
7 400 000
7 800
2 200 000
3 400
85 000
25
9 700 000
20 000
2 900 000
7 900
990 000
2 500
12 000 000
26 000
3 700 000
10 000
3 000 000
9 200
1 900
1 600
1 800
0
2 000
110 000
21 000
62 000
1 600 000
370
470 000
710 000
180
140 000
2 300
4 200
130 000
17 000
920
68
24 000
3 700
340 000
43 000
83 000
160
210 000
740
110 000
59 000
12
78 000
10
26 000
9 100
3 000
62 000
10 000
1 300
3 900
180 000
130 000
30 000
<50
820 000
180
190 000
<50
5 300
<50
19 000
0
73
0
6 000
<10
68 000
<50
89 000
120
140 000
370
37 000
<50
3 200
0
13 000
<10
4 300
<10
160 000
<10
640 000
1 400
1 400 000
9 000
13 000
2 200 000
6 400
3 400 000
16 000
21 000
2 600 000
7 400
1 300
AMERICAS
Belize
Brazil
Colombia
Dominican Republic
Ecuador
El Salvador
French Guiana
Guatemala
Guyana
Haiti
Honduras
Mexico
Nicaragua
Panama
Peru
120
950 000
370
200 000
1 300
110 000
770
4 200
56 000
35 000
7
72 000
9
56 000
7 500
38 000
1 100
99 000
930 000
180
240 000
6 500
21 000
82
16 000
190 000
140 000
240
220 000
780
52 000
3 600
17 000
4 600
200 000
2010
Lower
2015
Point
47 000 000
94 000
730 000
530
3 600
Upper
2 200 000
4 500
12 000 000
12 000
59 000 000
130 000
1 100 000
3 000
4 900
<100
1 800 000
4 100
2 800 000
11 000
17 000
<100
1 800 000
3 200
530
<10
2 900 000
6 300
14 000 000
20 000
5 300 000
3 800
1 700 000
1 700
450 000
58
Lower
Point
71 000 000
170 000
1 500 000
4 600
6 700
42 000 000
78 000
2 800 000
320
2 600
2 700 000
6 000
3 700 000
15 000
22 000
950 000
640
1 200 000
4 000
9 000
2 800 000
7 100
790
970 000
1 400
190
3 800 000
7 900
17 000 000
25 000
6 900 000
16 000
2 200 000
6 300
970 000
2 500
8 700 000
22 000
2 600 000
8 800
1 800 000
6 000
160
180
0
190
15 000
20 000
<50
440 000
98
180 000
<50
4 700
<50
2 100
0
<50
0
3 400
<10
12 000
<10
52 000
93
150 000
390
21 000
<50
1 300
0
1 400
<10
490
<10
63 000
<10
36 000
7 300
490 000
98
240 000
160 000
5 800
700
2 300
630
<50
<10
9 200
470
32 000
7 500
76 000
180
250 000
850
28 000
14 000
42 000
5
5 400
1 500
530
1 700
3 500
530
590
78 000
120 000
1 100 000
800
2 000 000
8 300
14 000
970 000
1 800
370
380 000
98
140 000
3 800
1 900
<50
2 200
7 800
38 000
6
87 000
11
16 000
1 200
1 100
440
50 000
Method used
Upper
82 000 000
150 000
4 600 000
4 600
4 500
2 000 000
2 700
4 500 000
4 300
61 000 000
110 000
3 500 000
3 000
3 400
<100
1 400 000
4 400
2 000 000
5 800
12 000
160
1 900 000
2 800
260
<10
2 500 000
4 200
8 500 000
12 000
3 000 000
5 300
13 000 000
17 000
2
2
1
1c
1
1a
1
2
2
2
1
1a
2
2
1
1c
2
2
2
2
3 900 000
3 100
2 200 000
1 900
610 000
69
5 300 000
17 000
2 800 000
7 100
960 000
2 400
6 900 000
24 000
3 600 000
9 900
1 500 000
5 200
2
2
2
2
1
1c
2 100 000
6 500
2 800 000
8 900
15 000
3 200 000
7 400
380
<50
0
58 000
9 900
<10
180 000
<50
79 000
<50
870
<10
680
0
<10
0
730
<10
11 000
<10
20 000
<50
69 000
180
7 200
<10
560
0
4 600
<10
660
0
150 000
<10
1
1a
20 000
210 000
100 000
1 100
760
<10
1 500
25 000
28 000
100 000
370
9 600
630
5 800
710
180 000
1
1c
1
1a
1
1c
1
1c
1
1b
1
1b
1
1c
1
1c
1
1c
1
1c
1
1c
1
1b
1
1c
1
1a
1
1a
121

WHO region
Country/area
2000
Lower
Point
2005
Upper
Lower
Point
Upper
AMERICAS
Suriname
cases
deaths
cases
deaths
12 000
40 000
11
18 000
<50
78 000
60
41 000
9 800
230 000
180
49 000
12
1 800 000
1 100
28 000
380 000
86
2 200
15 000
15 000
14 000 000
15 000
5 800
1 900 000
400
210
1 100 000
3 900
3 500 000
12 000
1 900 000
6 400
740 000
98
1 600 000
190
260 000
35
13 000
<10
78 000
52
28 000
210 000
140
Afghanistan
Djibouti
Pakistan
Saudi Arabia
Somalia
Sudan
Yemen
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
580 000
170
2 000
12 000
1 900 000
410
4 800
330 000
50
1 600 000
210
290 000
44
1 100 000
540
10 000
<50
13 000
<10
3 900 000
4 000
5 200
0
610 000
1 800
2 400 000
6 300
730 000
1 800
580 000
280
7 900
<50
16 000
<10
3 900 000
4 400
220
0
1 100 000
2 800
2 200 000
5 500
600 000
1 500
890 000
540
14 000
18 000
13 000 000
16 000
250
1 400 000
5 300
2 900 000
11 000
2 100 000
5 400
EUROPE
Tajikistan
cases
deaths
19 000
21 000
0
23 000
2 400
2 500
0
2 800
cases
deaths
cases
deaths
71 000
13
6 000
110 000
210
6 500
<50
150 000
430
7 300
76 000
11
1 900
120 000
250
2 000
<10
170 000
520
2 200
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
40 000
150 000
0
24 000 000
36 000
4 000 000
4 600
1 400 000
3 100
110 000
60
220 000
810
250 000
470
300 000
6 800
8 200
31 000 000
64 000
6 600 000
9 900
2 100 000
6 800
160 000
100
1 000 000
820
500 000
1 300
19 000 000
3 500
3 600 000
660
1 000 000
160
50 000
16
33 000
210
190 000
30
7 400
0
29 000 000
41 000
5 100 000
7 200
1 500 000
3 100
82 000
62
120 000
210
270 000
530
2 300 000
7 300
36 000
270 000
47
21 000
360 000
1 300
15 000
34 000
4
5 300
1 900 000
5 700
160 000
460
1 000 000
160
96 000
16
SOUTH-EAST ASIA
Bangladesh
Bhutan
Democratic Peoples Republic of
Korea
India
Indonesia
Myanmar
Nepal
Thailand
Timor-Leste
18 000 000
3 100
2 200 000
600
970 000
150
71 000
20
45 000
800
130 000
22
36 000 000
63 000
7 300 000
14 000
2 100 000
6 300
130 000
110
500 000
210
370 000
1 000
WESTERN PACIFIC
Cambodia
China
Lao Peoples Democratic Republic
Malaysia
Papua New Guinea
Philippines
122
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
950 000
130
23 000
180 000
21
12 000
1 000 000
150
79 000
13
1 500 000
3 600
29 000
<50
260 000
630
13 000
<50
1 400 000
3 100
110 000
230
390 000
710
23 000
<50
50 000
120
5 600
<50
1 400 000
2 800
140 000
300
530 000
1 400
25 000
71 000
250
6 300
1 800 000
5 300
210 000
590
2010
Lower
2015
Point
1 800
52 000
11
250 000
58
690
1 900
1 100 000
250
190 000
26
880 000
110
320 000
42
Upper
2 500
<10
78 000
72
340 000
200
1 600
<10
2 000
<10
1 500 000
1 700
<50
0
280 000
740
1 200 000
3 000
510 000
1 300
Lower
Method used
Point
4 500
110
210 000
210
150 000
27
480 000
340
3 100
300 000
66
1 100
2 300
170
2 100 000
3 200
730 000
170
84
390 000
1 400
1 600 000
5 700
810 000
2 800
310 000
52
970 000
130
200 000
24
Upper
150
0
230 000
220
390 000
190
5 600
<50
180
<10
1 000 000
740
91
0
700 000
2 100
1 400 000
3 500
310 000
770
270
490 000
500
510 000
330
18 000
200
1 500 000
1 300
100
1 300 000
4 800
1 900 000
6 800
460 000
1 600
1
1c
1
1c
1
1b
1
1c
1
1b
1
1c
1
1c
1
1c
110
120
0
140
69 000
8
440
84 000
200
480
<10
100 000
360
530
7 100
8 400
<50
<50
0
10 000
1
1c
1
1b
15 000
16 000
0
21 000 000
33 000
5 900 000
8 900
1 600 000
3 000
38 000
<50
120 000
100
110 000
220
18 000
7 200
8 600
31 000 000
63 000
7 700 000
17 000
2 200 000
6 100
58 000
9 900 000
1 500
990 000
160
170 000
27
17 000
370 000
100
150 000
420
16 000
7 700
0
13 000 000
24 000
1 300 000
1 900
240 000
490
24 000
<50
52 000
<50
120
<10
1
1b
1
1c
1
1c
1
1c
1
1c
1
1a
1
1c
220 000
560
6 300
95 000
17
97 000
350
7 100
68 000
1 600 000
5 100
75 000
240
650 000
140
9 200
16 000 000
2 800
4 600 000
830
1 100 000
180
25 000
36 000
100
90 000
14
140 000
22
5 200
48 000
6
5 900
890 000
130
35 000
5
180 000
320
5 900
<10
69 000
170
6 400
<50
1 200 000
2 600
53 000
110
0
0
1
1a
1
1c
97
1 900
120 000
120
<50
0
88 000
<50
2 000
<10
900 000
1 200
13 000
<50
1
1b
18 000 000
47 000
1 600 000
3 600
340 000
980
35 000
150 000
160
150 000
200
110 000
2 300
1 200 000
2 300
17 000
1
1c
1
1b
1
1c
1
1b
1
1c
1
1c
123

WHO region
Country/area
2000
Lower
Point
2005
Upper
Lower
Point
Upper
WESTERN PACIFIC
Republic of Korea
Solomon Islands
Vanuatu
Viet Nam
cases
deaths
cases
deaths
cases
deaths
cases
deaths
4 200
160 000
25
17 000
160 000
24
4 500
0
190 000
370
23 000
<50
210 000
430
5 100
1 300
230 000
650
31 000
180 000
28
19 000
250 000
780
32 000
5
308 872 300

1 064 830
3 605 520
1 450
22 348 800
38 400
23 000
154 924 807

458 152
1 309 268
214
4 897 410
809
2 400
41 817 300
83 350
5 287 100
16 190
381 954 020
1 204 220
23 957 700
4 587
1 658 600
260
186 750 185
464 022
1 400
0
220 000
420
26 000
<50
39 000
79
1 600
260 000
730
34 000
47 000
140
REGIONAL SUMMARY
African
Americas
European
South-East Asia
Western Pacific
Total
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
146 716 840

588 411
1 717 470
397
4 718 800
884
19 000
21 533 000
4 705
2 585 200
363
177 290 310
594 760
225 899 390

787 840
2 345 820
838
8 768 200
14 440
21 000
0
30 246 500
45 250
3 739 500
8 360
271 020 410
856 728
216 738 490

667 360
1 677 673
722
8 404 120
14 480
2 500
0
36 201 400
52 352
2 295 000
4 429
265 319 183
739 343
290 668 490

903 200
2 342 782
1 340
20 322 250
38 240
2 800
46 580 400
85 140
2 984 900
8 410
362 901 622
1 036 330
1 South Sudan became an independent State on 9 July 2011 and a Member State of WHO on 27 September 2011. South Sudan and Sudan have distinct epidemiological profiles
comprising high-transmission and low-transmission areas respectively. For this reason, data up to June 2011 from the high-transmission areas of Sudan (10 southern states,
which correspond to contemporary South Sudan) and low-transmission areas (15 northern states which correspond to contemporary Sudan) are reported separately.
Cases: (1) Estimated from reported confirmed cases, (2) Estimated from parasite prevalence surveys
Deaths: (1a) Reported deaths adjusted for completeness of death reporting, (1b) Reported deaths adjusted for case reporting completeness (1c) Estimated by applying case
fatality rate to estimated cases, (2) Modelled from verbal autopsy data
124
2010
Lower
2015
Point
1 300
58 000
10
14 000
21 000
3
156 963 936
313 679
798 400
126
2 742 590
486
110
21 935 440
3 932
1 218 400
176
183 658 876
318 399
1 400
<10
70 000
130
18 000
<50
25 000
50
209 461 870
498 340
1 032 070
653
3 833 600
6 940
120
0
28 868 480
45 420
1 628 700
3 380
244 824 840
554 733
Upper
Lower
Method used
Point
1 600
1 300
83 000
230
25 000
32 000
6
610
29 000
88
11 000
268 111 090

683 660
1 465 720
1 338
5 385 400
13 440
140
129 499 160

216 456
570 730
32
2 511 354
442
41 596 530
86 980
2 144 000
6 568
318 702 880
791 986
11 107 397
1 687
869 010
163
144 557 651
218 780
1 400
0
39 000
51
820
<10
13 000
<50
191 386 270
391 330
764 350
400
3 805 871
7 300
0
0
14 632 220
26 390
1 177 220
1 371
211 765 931
426 791
Upper
1 600
45 000
88
1 100
14 000
1
1b
1
1c
1
1c
1
1c
265 182 880

560 830
1 173 370
870
5 688 300
14 830
20 143 760
51 580
1 541 000
2 588
293 729 310
630 698
125
Annex 4 G. Population at risk and reported malaria cases

by place of care, 2015
WHO region
Country/area
Population
UN population
At risk
(low + high)
At risk
(high)
Number of people living

in active foci
AFRICAN
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cabo Verde
Cameroon
Chad
Comoros
Congo
Cte d'Ivoire
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Guinea
Guinea-Bissau
Kenya
Liberia
Madagascar
Malawi
Mali
Mauritania
Mayotte
Mozambique
Namibia
Niger
Nigeria
Rwanda
Senegal
Sierra Leone
South Africa
South Sudan1
Swaziland
Togo
Uganda
Mainland
Zanzibar
Zambia
Zimbabwe
39666519
25021974
10879829
2262485
18105570
11178921
520502
23344179
4900274
14037472
788474
4620330
22701556
77266814
845060
5227791
99390750
1725292
1990924
27409893
12608590
1844325
46050302
4503438
24235390
17215232
17599694
4067564
233993
27977863
2458830
19899120
182201962
11609666
190344
15129273
6453184
54490406
12339812
1286970
7304578
39032383
53470420
51957514
1512906
16211767
15602751
25021974
10879829
1499989
18105570
11178921
23344179
4900274
13883825
788474
4620330
22701556
77266814
845060
5227791
67585709
1725292
1990924
27409893
12608590
1844325
46050302
4503438
24235390
17215232
17599694
4067564
27977863
1951686
18705173
182201962
11609666
190344
15129273
6453184
5449041
12339812
360352
7304578
39032383
53470420
51957514
1512906
16211767
12286025
25021974
10879829
95305
18105570
11178921
16574367
4900274
9454923
375159
4620330
22701556
74948810
845060
3711732
27034284
1725292
1990924
27409893
12608590
1844325
32324967
4503438
21271015
17215232
15839725
2847295
27977863
1135022
10546534
139161989
11609666
190344
14524102
6453184
2179616
12339812
0
7304578
39032383
52884689
51957514
927175
16211767
4464890
308626
-
359287
10724705
207847528
48228704
10528391
16144363
6126583
268606
16342897
4865489
42193048
10182444
5072515
268606
12539759
267944
4780493
4875710
97337
229658
4069177
23917
251369
22000
-
AMERICAS
Belize
Brazil
Colombia
Dominican Republic
Ecuador
El Salvador
French Guiana
Guatemala
126
Public sector
P
Private sector
Community level
0
6839963
2009959
1298
9783385
8414481
3117
3312273
1218246
1641285
101330
300592
5216344
16452476
68058
111950
5987580
285489
891511
13368757
1251096
15915943
2306116
1536344
8518905
4410839
219184
14241392
207612
4497920
17388046
6093114
84348
1421221
2337297
35982
651
1756701
22095860
20797048
20451119
345929
8116962
1384893
747
3254270
1495375
340
8286453
5243410
28
2321933
953535
1490556
1517
264574
3606725
11627473
15142
24310
2174707
217287
249437
10186510
891175
7676980
1781092
752176
4933416
3317001
181562
7718782
12050
3817634
14732621
2505794
2058
502084
1569606
8976
651
1113928
13421804
7746258
7741816
4442
5094123
391651
0
15848
0
3966
2145778
39254
208556
16084
494445
3338
0
161371
83613
83613
-
6
584
73800
913
1337177
23898
460109
2416
968551
10541
300
275085
659921
658721
1200
-
94030
0
29162
0
0
0
0
154619
40118
0
43521
418475
1165029
67678
84172
0
259
93231
467748
110
0
0
256392
269004
30497
94078
911332
8664
5053
0
80196
82141
10625
193138
197354
158897
504032
120108
188772
74580
0
602
394088
90728
26367
159167
1502840
332706
367167
261824
89267
11558
301746
13
6907
143162
55866
661
686
9
434
6836
5
0
-
0
129
-
277
-
0
-
127
Annex 4 G. P
opulation at risk and reported malaria cases
by place of care, 2015
WHO region
Country/area
Population
UN population
At risk
(low + high)
At risk
(high)
Number of people living

in active foci
Americas
Guyana
Haiti
Honduras
Mexico
Nicaragua
Panama
Peru
Suriname
767085
10711067
8075060
127017224
6082032
3929141
31376670
542975
31108083
713389
10711067
5117453
3428487
184172
4437249
85247
6193641
268480
5676866
376477
270047
172882
3414952
85247
4977960
4466571
-
32526562
887861
79109272
188924874
31540372
10787104
40234882
26832215
24582076
443931
185733706
10787104
40234882
20899635
8753666
0
54631264
5490347
34964112
6724424
692020
42995
-
8481855
160995642
774830
25155317
1311050527
257563815
53897154
28513700
67959359
1184765
16679149
1193055980
67296487
32078320
13672319
33979680
1062868
4282484
183547074
30311412
8521440
1035047
5436749
398960
36042
-
15577899
1383924532
6802023
30331007
7619321
100699395
50293439
11016604
6299338
7619321
61409115
-
7497002
2125078
7162162
6637429
-
33340
-
583591
264652
93447601
577755
264652
68869834
577755
230048
6352108
985902466
536180401
410843142
8481855
1907095109
1689543460
5538046433
857774467
105992566
282681334
0
1357824801
156056619
2760329787
716045227
29563231
110563812
0
233533166
30581582
1120287018
308626
4763857
735015
0
36042
33340
5876880
Afghanistan
Djibouti
Pakistan
Saudi Arabia
Somalia
Sudan
Yemen
EUROPEAN
Tajikistan
South-East Asia
Bangladesh
Bhutan
India
Indonesia
Myanmar
Nepal
Thailand
Timor-Leste
Western Pacific
Cambodia
China
Malaysia
Papua New Guinea
Philippines
Republic of Korea
Western Pacific
Solomon Islands
Vanuatu
Viet Nam
Regional Summary
African
Americas
European
South-East Asia
Western Pacific
Total
C = Confirmed
P = Presumed
128
Public sector
P
Private sector
C
Community level
C
132941
302740
153906
867853
604418
64511
865980
15236
625174
9984
17583
3564
551
2307
562
66609
376
136402
0
0
0
0
-
58
7
3
463
-
0
-
343
-
801938
630886
8885456
1306700
119008
1102186
668024
350044
1378
3776244
2620
39169
1102186
95287
610337
-
0
-
16482
-
122806
74087
91007
140841230
1599427
714075
225353
1370461
121110
6608
104
7409
1169261
217025
77842
113595
14755
80
0
0
-
119
21
-
0
0
0
0
32992
104925
725
9405
21
163680
4052616
284003
1066470
909940
260645
699
33930
3116
36056
2311
553103
5135
699
0
0
0
22
0
17809
5561
48
716
662
0
0
19038
0
-
16370
9107
48644
2428
-
192044
14938
2673662
50916
697
19252
0
-
148
-
210625568
6685401
13514198
0
145159556
9618697
385603420
129585751
452512
5366928
5
1606679
705215
137717090
3172253
5
0
0
0
22
3172280
3813301
660
610337
0
140
24796
4449234
2658152
277
0
0
0
19038
2677467
3670281
343
16482
0
148068
76697
3911871
129
Annex 4 H. Reported malaria cases by method of confirmation,

20002015
WHO region
Country/area
2000
2005
2010
2011
2012
2013
2014
2015
AFRICAN
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cabo Verde
Cameroon
Central African
Republic
Chad
130
Presumed and confirmed

Microscopy examined
Confirmed with microscopy
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
541
27 733
541
506
2 080 348
71 555
3 252 692
484 249
308 095
144
6 843
144
89 614
437 041
45 283
40 078
-
299
18 392
299
297
2 329 316
889 572
803 462
11 242
1 615 695
73 262
21 335
2 334 067
903 942
327 464
68
7 902
68
277 413
131 856
501 846
37 439
31 668
-
408
12 224
408
396
3 687 574
1 947 349
1 324 264
639 476
358 606
1 432 095
12 196
1 046
5 723 481
177 879
88 540
940 985
715 999
4 255 301
2 825 558
1 599 908
273 324
163 539
47
47
1 845 691
66 484
544 243
89 749
75 342
309 927
125 106
-
191
11 974
191
187
3 501 953
1 765 933
1 147 473
833 753
484 809
1 424 335
88 134
68 745
475 986
354 223
1 141
432
5 024 697
400 005
83 857
450 281
344 256
3 298 979
2 859 720
1 485 332
181 489
86 542
36
26 508
36
29
1 829 266
1 110 308
120 466
221 980
528 454
86 348
114 122
94 778
-
887
15 790
887
828
3 031 546
2 245 223
1 056 563
1 069 483
440 271
1 513 212
243 008
825 005
705 839
308
193
6 970 700
223 372
90 089
4 516 273
3 767 957
2 570 754
2 659 372
1 484 676
1 148 965
666 400
36
8 715
36
35
1 589 317
1 182 610
93 392
459 999
55 746
46 759
660 575
69 789
-
603
12 762
603
587
3 144 100
3 025 258
1 462 941
1 103 815
536 927
1 670 273
291 479
99 368
1 158 526
979 466
506
456
7 146 026
183 971
82 875
4 296 350
3 686 176
4 469 007
4 123 012
2 366 134
2 933 869
1 775 253
46
10 621
46
24
1 824 633
1 236 306
591 670
407 131
63 695
36 943
136 548
79 357
1 272 841
206 082
621 469
548 483
-
266
8 690
266
260
3 180 021
3 398 029
1 431 313
1 855 400
867 666
1 509 221
155 205
108 714
1 335 582
935 521
1 485
1 346
8 280 183
198 947
83 259
6 224 055
5 345 396
4 831 758
4 471 998
2 718 391
2 903 679
1 866 882
46
6 894
46
20
1 369 518
1 086 095
1 254 293
495 238
55 943
41 436
369 208
253 652
1 513 772
160 260
1 137 455
753 772
-
747
8 000
747
0
0
727
3 254 270
3 345 693
1 396 773
3 009 305
1 372 532
1 495 375
296 264
108 061
1 486 667
1 160 286
340
1 284
326
48
8 286 453
222 190
92 589
8 290 188
6 922 857
5 243 410
3 254 670
1 964 862
5 076 107
3 194 844
28
3 117
28
21
2 321 933
1 024 306
592 351
1 128 818
570 433
953 535
139 241
106 524
724 303
492 309
1 490 556
149 574
937 775
637 472
-
WHO region
Country/area
2000
2005
2010
2011
2012
2013
2014
2015
AFRICAN
Comoros
Congo
Cte d'Ivoire
Democratic
Republic of the
Congo
Equatorial
Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana

Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
801 784
15 751
964 623
3 758
897
127 024
50 810
3 349 528
-
29 554
6 086
67
1 280 914
6 334 608
5 531
2 971
24 192
48 937
9 073
3 901 957
1 364 194
538 942
235 479
129 513
70 644
329 426
3 452 969
655 093
0
-
103 670
87 595
35 199
5 249
1 339
446 656
1 721 461
62 726
9 252 959
3 678 849
2 374 930
54 728
42 850
78 095
42 585
39 636
16 772
14 177
53 750
79 024
13 894
22 088
4 068 764
2 509 543
1 158 197
185 105
54 714
12 816
7 887
1 120
194 009
290 842
52 245
123 564
64 108
3 849 536
2 031 674
1 029 384
247 278
42 253
-
76 661
63 217
22 278
20 226
2 578
277 263
37 744
2 588 004
49 828
29 976
9 442 144
4 226 533
2 700 818
2 912 088
1 861 163
37 267
23 004
20 601
2 899
1 865
39 567
67 190
15 308
25 570
19 540
3 549 559
3 418 719
1 480 306
178 822
261 967
172 241
71 588
190 379
4 154 261
1 172 838
624 756
781 892
416 504
-
65 139
125 030
45 507
27 714
4 333
120 319
120 319
2 795 919
195 546
107 563
1 572 785
1 033 064
9 128 398
4 329 318
2 656 864
3 327 071
2 134 734
20 890
33 245
13 196
6 826
1 973
42 178
84 861
11 557
33 758
10 258
3 876 745
3 778 479
1 692 578
188 089
66 018
18 694
4 129
1 059
300 363
156 580
29 325
705 862
271 038
10 676 731
4 219 097
2 971 699
1 438 284
783 467
-
62 565
154 824
46 130
21 546
7 026
183 026
69 375
43 232
0
0
4 708 425
395 914
215 104
3 384 765
2 291 849
11 363 817
4 126 129
2 611 478
6 096 993
4 103 745
25 162
27 039
11 235
5 489
1 894
34 678
81 541
10 890
39 281
10 427
3 316 013
8 573 335
2 645 454
185 196
90 185
26 432
10 132
2 550
279 829
236 329
65 666
614 128
175 126
7 200 797
1 394 249
721 898
1 488 822
917 553
-
2 465
93 444
1 987
9 839
216
248 159
88 764
54 523
19 746
11 800
4 658 774
568 562
306 926
4 904 066
3 405 905
9 968 983
3 533 165
2 126 554
11 114 215
7 842 429
20 417
47 322
17 685
9 807
2 732
35 725
63 766
10 993
53 032
19 775
2 513 863
7 062 717
2 118 815
185 996
90 275
27 687
11 812
4 213
166 229
286 111
66 253
317 313
99 976
8 453 557
1 987 959
970 448
3 610 453
2 445 464
-
1 517
89 634
963
11 479
337
264 574
87 547
51 529
0
0
3 606 725
811 426
478 870
4 174 097
2 897 034
11 627 473
2 877 585
1 902 640
13 574 891
9 724 833
15 142
21 831
8 564
46 227
6 578
24 310
59 268
8 332
47 744
11 040
2 174 707
5 679 932
1 867 059
217 287
79 308
20 390
12 761
3 477
249 437
272 604
49 649
609 852
190 733
10 186 510
2 023 581
934 304
5 478 585
3 385 615
-
131

20002015
WHO region
Country/area
2000
2005
2010
2011
2012
2013
2014
2015
AFRICAN
Guinea
Guinea-Bissau
Kenya
Liberia
Madagascar
Malawi
Mali
Mauritania
Mayotte
Mozambique
132

Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
816 539
4 800
246 316
4 216 531
1 392 483
31 575
6 946
3 646 212
546 634
-
850 309
50 452
185 493
33 721
14 659
9 181 224
44 875
8 718
5 025
57 325
39 850
1 229 385
37 943
6 753
3 688 389
962 706
223 472
500
500
-
1 092 554
20 936
140 143
48 799
30 239
56 455
20 152
6 071 583
2 384 402
898 531
2 675 816
335 973
212 927
998 043
709 246
293 910
24 393
2 173
604 114
200 277
6 851 108
2 171 542
1 380 178
227 482
244 319
5 449
909
2 299
1 085
396
2 023
396
236
3 381 371
1 950 933
644 568
2 287 536
878 009
-
1 189 016
43 549
5 450
139 066
90 124
174 986
57 698
21 320
139 531
50 662
11 120 812
3 009 051
1 002 805
2 480 748
728 443
577 641
1 593 676
1 338 121
255 814
34 813
3 447
739 572
221 051
5 338 701
119 996
50 526
580 708
253 973
1 961 070
974 558
307 035
154 003
3 752
1 130
7 991
1 796
92
1 214
92
51
3 344 413
2 504 720
1 093 742
2 966 853
663 132
-
1 220 574
191 421
125 779
129 684
61 048
23 547
97 047
26 834
9 335 951
4 836 617
1 426 719
164 424
26 752
1 800 372
772 362
507 967
1 276 521
899 488
395 149
38 453
3 667
906 080
355 753
4 922 596
406 907
283 138
2 763 986
1 281 846
2 171 739
97 995
788 487
169 104
1 865
255
3 293
1 633
72
1 463
72
47
3 203 338
2 546 213
886 143
2 234 994
927 841
-
775 341
63 353
147 904
132 176
58 909
17 733
102 079
36 851
9 750 953
6 606 885
2 060 608
655 285
274 678
1 483 676
818 352
496 269
1 144 405
747 951
387 045
42 573
4 947
1 026 110
380 651
3 906 838
132 475
44 501
3 029 020
1 236 391
2 327 385
190 337
1 889 286
1 176 881
128 486
5 510
957
3 576
630
82
82
71
3 924 832
2 058 998
774 891
5 215 893
2 223 983
-
1 595 828
116 767
82 818
577 389
98 952
106 882
35 546
197 536
57 885
9 655 905
7 444 865
2 415 950
850 884
392 981
1 066 107
1 318 801
302 708
912 382
561 496
433 101
37 362
3 853
926 998
374 110
5 065 703
198 534
77 635
5 344 724
2 827 675
2 590 643
219 637
1 820 216
156 529
47 500
15 835
15
15
14
7 117 648
2 295 823
1 009 496
9 944 222
6 108 152
-
891 175
78 377
52 211
1 092 523
758 768
7 676 980
7 772 329
1 025 508
1 965 661
473 519
1 781 092
509 062
305 981
947 048
625 105
752 176
39 604
4 748
1 488 667
739 355
1 167
4 933 416
216 643
75 923
7 030 084
3 585 315
3 317 001
243 151
3 389 449
2 052 460
181 562
60 253
22 631
7 718 782
2 313 129
735 750
11 928 263
6 983 032
-
WHO region
Country/area
2000
2005
2010
2011
2012
2013
2014
2015
AFRICAN
Namibia
Niger
Nigeria
Rwanda
Sao Tome and

Principe
Senegal
Sierra Leone
South Africa
South Sudan1
Swaziland

Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
2 476 608
32 149
66 076
31 975
1 123 377
56 169
44 959
460 881
64 624
29 374
-
339 204
23 339
817 707
107 092
46 170
21 230
9 873
3 532 108
1 654 246
1 438 603
683 769
22 370
68 819
18 139
1 346 158
105 093
33 160
233 833
10 605
3 702
3 452
1 106
7 755
7 755
337 582
6 066
4 587
279
-
25 889
14 522
556
3 643 803
165 514
49 285
7 426 774
570 773
3 873 463
523 513
45 924
27 674
638 669
2 708 973
638 669
3 346
48 366
2 233
9 989
507
707 772
27 793
17 750
651 737
325 920
934 028
718 473
218 473
1 609 455
715 555
8 060
3 787
276 669
4 273
900 283
900 283
1 722
87
181
-
14 406
13 262
335
48 599
1 525
3 157 482
130 658
68 529
1 130 514
712 347
4 306 945
672 185
242 526
208 858
1 602 271
208 858
8 442
83 355
6 373
33 924
2 069
604 290
18 325
14 142
555 614
263 184
856 332
46 280
25 511
886 994
613 348
9 866
178 387
5 986
204 047
3 880
795 784
112 024
797
130
419
170
3 163
7 875
194
4 592 519
1 781 505
1 119 929
1 781 505
1 119 929
6 938 519
1 953 399
2 898 052
483 470
2 904 793
422 224
190 593
61 246
12 550
103 773
10 706
23 124
1 844
634 106
19 946
15 612
524 971
265 468
1 945 859
194 787
104 533
1 975 972
1 432 789
6 846
121 291
1 632
30 053
3 997
1 125 039
225 371
626
345
217
153
4 911
1 507
136
32 495
4 775
4 288 425
1 799 299
1 176 711
1 799 299
1 176 711
12 830 911
1 633 960
7 194 960
962 618
2 862 877
879 316
201 708
83 302
9 243
73 866
6 352
34 768
2 891
772 222
24 205
20 801
668 562
325 088
1 715 851
185 403
76 077
2 377 254
1 625 881
8 851
364 021
2 572
239 705
6 073
1 855 501
262 520
962
488
474
234
15 914
1 894
222
185 078
15 692
3 222 613
2 872 710
0
2 872 710
1 953 309
16 512 127
1 681 469
1 233 654
9 188 933
6 593 300
1 610 812
4 010 202
1 528 825
168 004
81 987
1 754
33 355
569
58 090
1 185
628 642
19 343
12 636
697 175
252 988
1 898 852
66 277
39 414
2 056 722
1 335 062
13 988
300 291
4 101
240 622
7 604
711
711
322
12 050
207 612
12 050
2 888
3 817 634
295 229
206 660
2 657 057
2 065 340
14 732 621
851 183
569 036
8 655 024
6 281 746
2 505 794
5 811 267
2 354 400
281 847
151 394
2 058
11 941
140
72 407
1 918
2
502 084
26 556
17 846
1 384 834
474 407
352
1 569 606
75 025
37 820
2 176 042
1 445 556
8 976
13 917
785
17 446
3 572
3 568
651
43
152
282
133

20002015
WHO region
Country/area
2000
2005
2010
2011
2012
2013
2014
2015
AFRICAN
Togo
Uganda
United Republic
of Tanzania
Mainland
Zanzibar
Zambia
Zimbabwe

Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
3 552 859
45 643
53 533
17 734
45 643
53 533
17 734
3 337 796
-
437 662
9 867 174
2 107 011
1 104 310
11 466 713
8 037 619
2 764 049
11 441 681
7 993 977
2 756 421
25 032
43 642
7 628
4 121 356
1 494 518
-
983 430
478 354
224 087
575 245
393 014
13 208 169
3 705 284
1 581 160
12 893 535
3 637 659
1 277 024
136 123
1 974
12 819 192
3 573 710
1 276 660
74 343
63 949
364
136 123
1 974
4 229 839
648 965
513 032
249 379
-
519 450
502 977
237 305
390 611
282 145
12 173 358
385 928
134 726
194 819
97 147
10 164 967
5 656 907
1 813 179
1 628 092
337 582
10 160 478
5 513 619
1 812 704
1 315 662
333 568
4 489
143 288
475
312 430
4 014
4 607 908
10 004
470 007
319 935
-
768 287
579 507
260 535
660 627
436 839
13 591 932
3 466 571
1 413 149
2 449 526
1 249 109
8 477 435
6 931 025
1 772 062
1 091 615
214 893
8 474 278
6 784 639
1 771 388
701 477
212 636
3 157
146 386
674
390 138
2 257
4 695 400
727 174
276 963
-
882 430
560 096
272 855
882 475
609 575
16 541 563
3 718 588
1 502 362
7 387 826
8 585 482
6 804 085
1 481 275
813 103
71 169
8 582 934
6 720 141
1 480 791
369 444
69 459
2 548
83 944
484
443 659
1 710
5 465 122
1 115 005
422 633
-
1 130 251
621 119
310 207
1 135 581
820 044
13 724 345
2 048 185
578 289
7 060 545
3 053 650
7 403 562
727 130
572 289
17 740 207
107 728
7 399 316
592 320
571 598
17 566 750
106 609
4 246
134 810
691
173 457
1 119
5 972 933
5 964 354
4 077 547
535 983
1 420 894
535 931
-
1 113 928
621 119
305 727
1 135 581
808 200
13 421 804
3 684 722
1 248 576
12 126 996
5 889 086
7 746 258
673 223
412 702
16 620 299
3 830 030
2 550
7 741 816
532 118
411 741
16 416 675
3 827 749
4 442
141 105
961
203 624
2 281
2 550
5 094 123
7 207 500
4 184 661
391 651
1 384 893
391 651
180

Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
1 486
18 559
1 486
31 469
143 990
31 469
613 241
2 562 576
613 241
-
1 549
25 119
1 549
21 442
202 021
20 142
6 000
1 300
606 067
2 660 539
606 067
-
150
27 366
150
13 769
133 463
12 252
7 394
1 517
334 668
2 711 432
334 667
-
79
22 996
79
7
7 143
143 272
6 108
7 390
1 035
267 146
2 476 335
266 713
1 486
433
-
37
20 789
37
4
7 415
121 944
6 293
10 960
1 122
242 758
2 325 775
237 978
23 566
4 780
-
26
25 351
26
4
7 342
133 260
6 272
10 789
1 070
178 546
1 873 518
174 048
19 500
3 719
-
19
24 122
19
0
7 401
124 900
7 401
143 415
1 658 976
142 031
11 043
1 384
-
13
26 367
13
4
6 907
159 167
6 907
143 162
1 488 072
139 844
14 655
3 205
4 949
AMERICAS
Belize
Bolivia
(Plurinational
State of)
Brazil
134
WHO region
Country/area
2000
2005
2010
2011
2012
2013
2014
2015
40 768
325 713
36 166
77 819
4 602
496
362 304
496
54 425
241
370 825
241
8
106 915
8
2
448
14 651
187
261
4 931
264 269
4 931
50 025
754
12 354
142 843
12 354
0
0
17 696
134 766
10 893
126 637
6 803
3 380
151 420
3 380
1 427
102
664
900 578
664
0
0
8
55 866
316 451
48 059
11 983
3 535
7 785
661
316 947
661
50 220
30
686
261 824
686
68
9
89 267
9
0
0
6
434
11 558
272
162
6 836
295 246
5 538
6 500
1 298
2
9 984
132 941
9 984
0
0
17 583
69 659
5 224
233 081
12 359
3 564
150 854
3 555
3 052
20
0
551
867 853
551
0
0
34
AMERICAS
Colombia
Dominican
Republic
Ecuador
El Salvador
French Guiana
Guatemala
Guyana
Haiti
Honduras
Mexico

Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
144 432
478 820
144 432
1 233
427 297
1 233
104 528
544 646
104 528
753
279 072
753
3 708
48 162
3 708
53 311
246 642
53 311
24 018
209 197
24 018
16 897
21 190
16 897
35 125
175 577
35 125
7 390
2 003 569
7 390
-
121 629
493 562
121 629
3 837
397 108
3 837
17 050
358 361
17 050
67
102 479
67
3 414
32 402
3 414
39 571
178 726
39 571
38 984
210 429
38 984
21 778
3 541 506
21 778
15 943
153 474
15 943
2 500
2 967
1 559 076
2 967
-
117 650
521 342
117 637
13
3 414
469 052
2 482
26 585
932
1 888
481 030
1 888
7 800
24
115 256
24
7
1 632
14 373
688
944
7 384
235 075
7 384
2 000
0
22 935
212 863
22 935
84 153
270 427
84 153
9 685
152 961
9 685
4 000
1 226
1 192 081
1 226
7
64 436
396 861
60 121
21 171
4 188
1 616
421 405
1 616
56 150
1 233
460 785
1 233
14
16
100 883
15
1
1
6
1 209
14 429
505
704
6 817
195 080
6 817
29 506
201 693
29 471
0
35
32 969
184 934
32 969
7 618
152 451
7 465
4 000
45
1 130
1 035 424
1 130
6
60 179
346 599
50 938
70 168
9 241
952
415 808
952
90 775
558
459 157
558
14
19
124 885
19
6
900
13 638
401
499
5 346
186 645
5 346
0
0
31 656
196 622
31 601
55
25 423
167 726
25 423
46
6 439
155 165
6 439
4 000
10
842
1 025 659
842
9
51 722
284 332
44 293
42 723
7 403
579
431 683
579
71 000
378
397 628
378
10
7
103 748
7
1
875
22 327
324
551
6 214
153 731
6 214
0
0
31 479
205 903
31 479
0
0
26 543
165 823
20 957
5 586
5 428
144 436
5 364
237
64
499
1 017 508
499
0
0
4
135

20002015
WHO region
Country/area
2000
2005
2010
2011
2012
2013
2014
2015
AMERICAS
Nicaragua
Panama
Peru
Suriname
Venezuela
(Bolivarian
Republic of)

Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
23 878
509 443
23 878
1 036
149 702
1 036
68 321
1 483 816
68 321
11 361
63 377
11 361
29 736
261 866
29 736
-
6 642
516 313
6 642
3 667
208 582
3 667
87 699
1 438 925
87 699
9 131
59 855
9 131
45 049
420 165
45 049
-
692
535 914
692
18 500
0
418
141 038
418
31 546
744 627
31 545
23
1
1 771
16 533
1 574
541
138
45 155
400 495
45 155
-
925
521 904
925
14 201
354
116 588
354
0
0
25 039
702 894
25 005
58
34
795
15 135
751
1 025
20
45 824
382 303
45 824
-
1 235
536 278
1 235
16 444
0
844
107 711
844
0
0
31 570
758 723
31 436
562
569
17 464
306
4 008
50
52 803
410 663
52 803
-
1 194
519 993
1 196
19 029
705
93 624
705
0
0
43 139
863 790
48 719
858
729
13 693
530
6 043
199
78 643
476 764
78 643
-
1 163
605 357
1 163
15 620
0
874
80 701
874
0
0
65 252
864 413
65 252
1 634
400
17 608
98
15 489
303
90 708
522 617
90 708
-
2 307
604 418
2 307
29
562
64 511
562
0
0
16
66 609
865 980
66 609
0
376
15 083
345
153
31
274
136 402
625 174
136 402
1 594
203 911
257 429
94 475
4 667
19 716
1 732 778
19 716
7 422
3 337 054
82 526
6 608
6 608
1 872
326 694
338 253
116 444
2 469
1 913
413
18 966
1 674 895
18 966
4 570
4 022 823
4 776 274
127 826
290
1 059
715 878
1 059
855
392 463
524 523
69 397
1 010
1 010
3 031
614 817
3 031
1 184
4 281 356
4 281 346
220 870
279 724
19 721
1 941
944 723
1 941
1 912
482 748
531 053
77 549
0
0
230
124
3 239
530 470
3 239
1 529
4 065 802
4 168 648
287 592
518 709
46 997
2 788
1 062 827
2 788
2 719
391 365
511 408
54 840
0
0
27
1 410
22
3
1 629
479 655
1 629
0
0
842
4 285 449
4 497 330
250 526
410 949
40 255
3 406
1 186 179
3 406
0
0
3 324
319 742
507 145
39 263
0
0
1 684
7 189
1 684
1 373
385 172
1 373
853
3 472 727
3 933 321
196 078
628 504
85 677
2 513
1 309 783
2 513
2 479
290 079
1 028 932
122 724
155 919
22 558
9 439
39 284
9 439
1 243
468 513
1 243
867
3 666 257
4 343 418
193 952
779 815
81 197
2 305
1 249 752
2 305
2 254
350 044
538 789
86 895
1 378
610 337
799
20 549
579
632
3 776 244
4 619 980
137 401
691 245
64 612
2 620
1 306 700
2 620
2 537
Afghanistan
Djibouti
Iran (Islamic
Republic of)
Pakistan
Saudi Arabia
136

Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
WHO region
Country/area
2000
2005
2010
2011
2012
2013
2014
2015
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
10 364
4 332 827
368 557
1 394 495
1 394 495
-
28 404
47 882
12 516
2 515 693
628 417
200 560
472 970
44 150
-
24 553
20 593
5 629
200 105
18 924
1 465 496
625 365
1 653 300
95 192
198 963
645 463
78 269
97 289
28 428
-
41 167
26 351
1 627
35 236
1 724
1 214 004
506 806
2 222 380
142 147
645 093
60 207
108 110
30 203
-
35 712
37 273
6 817
964 698
526 931
2 000 700
165 678
685 406
68 849
150 218
41 059
-
9 135
67 464
7 407
989 946
592 383
1 800 000
149 451
723 691
63 484
157 457
39 294
-
26 174
64 480
11 001
1 207 771
579 038
788 281
489 468
97 089
643 994
51 768
141 519
34 939
-
39 169
100 792
20 953
1 102 186
586 827
95 287
529 932
38 254
111 787
30 728
-

Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
233785
233785
19064
-
216197
216197
2309
-
112
173523
112
1
78
173367
78
13
33
209239
33
15
14
213916
14
7
7
200241
7
5
5
5

Microscopy examined
Bangladesh
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
Bhutan
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
Democratic
People's Republic
RDT examined
of Korea
Confirmed with RDT
Imported cases
437 838
360 300
55 599
5 935
76 445
5 935
204 428
90 582
2 031 790
290 418
220 025
48 121
1 825
60 152
1 825
11 507
11 315
1 816 569
91 227
308 326
20 519
152 936
35 354
487
54 709
436
13 520
25 147
13 520
1 599 986
Somalia
Sudan
Yemen
EUROPEAN
Tajikistan
SOUTH-EAST ASIA
Microscopy examined
India
Indonesia

RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
86 790 375 104 120 792 108 679 429

2 031 790
256 993
1 752 763
245 612
-
1 816 569
1 599 986
- 10 600 000
315 394
465 764
1 178 457
1 335 445
315 394
465 764
255 734
-
51 773
29 518
3 864
10 216
6 608
270 253
253 887
74 755
78 719
69 093
20 232
4 016
1 866
3 249
1 612
119 849
35 675
19 171
46 482
53 713
31 541
5 885
1 998
6 967
4 996
129
207
82
45
48
104
44 481
42 512
31 632
33 586
26 149
194
82
45
48
84
47 938
20
0
23
29
70
16 760
23 537
15 673
11 212
7 409
26 513
39 238
71 453
38 201
29 272
16 760
21 850
14 407
10 535
7 010
0
0
0
61 348
0
0
0
12
205
0
0
0
1 310 656
1 067 824
881 730
1 102 205
1 169 261
108 969
109 033 790 113 109 094 124 066 331 121 141 970
660
1 310 656
1 067 824
881 730
1 102 205
1 169 261
10 500 384 13 125 480 14 782 104 14 562 000 19 699 260
422 447
417 819
1 833 256
252 027
217 025
962 090
1 429 139
1 447 980
1 300 835
1 224 504
422 447
417 819
343 527
252 027
217 025
250 709
471 586
260 181
249 461
342 946
-
137

20002015
WHO region
Country/area
2000
2005
2010
2011
2012
2013
2014
2015
SOUTH-EAST ASIA
Myanmar
Nepal
Thailand
Timor-Leste

Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
581 560
381 610
120 083
48 686
100 063
7 981
78 561
4 403 739
78 561
15 212
15 212
-
516 041
437 387
165 737
178 056
188 930
5 050
29 782
2 524 788
29 782
130 679
97 781
43 093
-
693 124
275 374
103 285
729 878
317 523
96 383
102 977
3 115
17 887
779
32 480
1 695 980
22 969
81 997
9 511
119 072
109 806
40 250
85 643
7 887
-
567 452
312 689
91 752
795 618
373 542
71 752
95 011
1 910
25 353
1 504
24 897
1 354 215
14 478
96 670
10 419
36 064
82 175
19 739
127 272
-
480 586
265 135
75 220
1 158 831
405 366
70 272
152 780
1 659
22 472
433
32 569
1 130 757
32 569
6 148
64 318
5 211
117 599
-
315 509
138 473
25 215
1 162 083
226 058
38 113
100 336
1 197
32 989
777
41 362
1 830 090
33 302
1 042
56 192
1 025
121 991
-
152 195
93 842
11 952
797 071
140 243
122 874
127 130
1 469
48 444
37 921
1 756 528
37 921
342
30 515
342
86 592
0
-
77 842
52 076
6 569
661 999
71 273
345
113 595
63 946
1 112
49 649
725
517
14 755
1 358 953
14 135
10 888
0
9 890
80
30 275
80
90 835
0
-

Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
RDT examined
Confirmed with RDT
Imported cases
203 164
122 555
51 320
18 167
11 122
279 903
256 273
40 106
874 894
1 832 802
12 705
1 751 883
225 535
79 839
36 596
-
67 036
88 991
26 914
58 791
22 522
100 106
3 814 715
21 936
2 632
30 359
156 954
13 615
573 788
1 425 997
5 569
1 788 318
267 132
92 957
46 342
581 871
12 125
-
49 356
90 175
14 277
103 035
35 079
7 855
7 115 784
4 990
23 047
150 512
4 524
127 790
16 276
6 650
1 619 074
6 650
831
1 379 787
198 742
75 985
20 820
17 971
19 106
301 031
18 560
-
57 423
86 526
13 792
130 186
43 631
4 498
9 189 270
3 367
17 904
213 578
6 226
7 743
11 609
5 306
1 600 439
5 306
1 142
1 151 343
184 466
70 603
27 391
13 457
9 617
327 060
9 552
-
45 553
80 212
10 124
108 974
30 352
2 678
6 918 657
2 603
2 399
46 819
223 934
13 232
145 425
32 970
4 725
1 566 872
4 725
924
878 371
156 495
67 202
228 857
82 993
8 154
332 063
7 133
-
24 130
54 716
4 598
94 600
16 711
4 121
5 554 960
4 086
4 007
41 385
202 422
10 036
133 337
28 095
3 850
1 576 012
3 850
865
1 125 808
139 972
70 658
468 380
209 336
7 720
317 360
5 826
1 523
688
-
26 278
48 591
5 288
92 525
19 864
2 921
4 403 633
2 921
2 864
48 071
133 916
8 018
160 626
40 053
3 923
1 443 958
3 923
766
644 688
83 257
68 114
475 654
213 068
4 903
286 222
3 618
28 598
1 285
-
33 930
49 357
7 423
114 323
26 507
3 116
4 052 588
3 088
3 055
36 056
110 084
4 167
173 919
31 889
0
2 311
1 066 470
2 311
435
553 103
112 864
64 719
541 760
233 068
5 135
224 843
4 988
35 789
134
18
WESTERN PACIFIC
Cambodia
China
Lao People's
Democratic
Republic
Malaysia
Papua New
Guinea
Philippines
138
WHO region
Country/area
2000
2005
2010
2011
2012
2013
2014
2015
Western pACIFIC
Microscopy examined
Republic of
Korea
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
Solomon Islands
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
Vanuatu
RDT examined
Confirmed with RDT
Imported cases
Microscopy examined
Viet Nam
RDT examined
Confirmed with RDT
Imported cases
4 183
368 913
300 806
68 107
33 779
31 668
6 768
274 910
2 682 862
74 316
-
1 369
393 288
316 898
76 390
34 912
61 092
9 834
84 473
2 728 481
19 496
-
1 772
1 772
56
95 006
212 329
35 373
17 300
4 331
16 831
29 180
4 013
10 246
4 156
54 297
2 760 119
17 515
7 017
-
838
838
64
80 859
182 847
23 202
17 457
3 455
5 764
19 183
2 077
12 529
2 743
45 588
2 791 917
16 612
491 373
-
555
555
47
57 296
202 620
21 904
13 987
2 479
3 435
16 981
733
16 292
2 702
43 717
2 897 730
19 638
514 725
-
443
443
50
53 270
191 137
21 540
26 216
4 069
2 381
15 219
767
13 724
1 614
35 406
2 684 996
17 128
412 530
-
638
638
78
51 649
173 900
13 865
26 658
4 539
982
18 135
190
17 435
792
27 868
2 357 536
15 752
416 483
-
699
699
65
50 916
124 376
14 793
40 750
9 205
697
4 870
15
9 794
408
0
19 252
2 204 409
9 331
459 332
-
RDT, rapid diagnostic test

Cases reported before 2000 can be presumed and confirmed cases, or only confirmed cases, depending on the country.
139
Annex 4 I. Reported malaria cases by species, 20002015

WHO region
Country/area
2000
2005
27733
261
277
2080348
71555
3428846
6843
144
0
0
89614
442246
20977
19101
967484
889
0
-
18392
242
57
2329316
803462
11242
1667622
0
0
0
2910545
7902
68
0
0
277413
131856
507617
14770
16898
29554
1280914
6337168
2844
110
64056
7506
1567
5
2010
2011
2012
2013
15790
48
11
0
4849418
1875386
0
0
0
308
193
7852299
4228015
8715
1
0
0
2865319
468986
730364
168043
43681
637
1189
117640
120319
0
0
3423623
11993189
0
0
0
45792
15169
0
138982
12121
9204
346
12762
14
2
0
5273305
2041444
506
456
7857296
7384501
10621
22
0
0
3652609
491074
1272841
185779
45669
72
363
209169
43232
0
0
5982151
14871716
0
0
0
44561
13129
0
134183
12482
7361
1350
2014
2015
AFRICAN
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cabo Verde
Cameroon
Central African
Republic
Chad
Comoros
Congo
Cte d'Ivoire
Democratic
Republic of the
Congo
Equatorial
Guinea
Eritrea
140
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
12224
7
4
1
4591529
1432095
12196
1046
0
6037806
5590736
47
47
0
0
1845691
66484
743471
159976
33791
528
880
446656
1721461
10568756
0
0
0
83639
53813
0
96792
9785
3989
57
11974
4
0
0
4469357
1565487
68745
0
0
1141
432
0
5446870
4768314
26508
7
0
0
3060040
221980
528454
135248
21387
334
557
277263
37744
0
0
2607856
12018784
0
0
0
40704
22466
0
97479
10263
4932
19
8690
5
0
0
6134471
1955773
1485
1346
0
9274530
7622162
6894
26
0
0
3709906
625301
295088
0
0
1737195
103545
2203
0
0
290346
66323
0
0
6418571
3712831
0
0
14647380
57129
17452
0
121755
23787
6780
94
8000
0
0
0
6839963
2009959
1298
326
0
9783385
8414481
3117
7
0
0
3312273
592351
0
1218246
598833
0
1641285
101330
1300
0
0
300592
51529
0
0
5216344
3375904
0
0
16452476
68058
111950
14510
4780
21
WHO region
Country/area
2000
2005
2010
2011
127024
50810
0
3349528
816539
4800
0
246316
4216531
1417112
3646212
546634
-
4727209
374335
158658
5949
294348
70644
0
329426
3452969
850309
50452
0
204555
9181224
66043
44875
0
1260575
3688389
962706
223472
500
339204
889986
74129
0
1878
5420110
732776
390252
0
233770
2157
720
2015
492062
64108
0
5056851
926447
0
102937
1092554
20936
0
195006
7557454
898531
0
3087659
212927
0
0
719967
6851108
3324238
250073
2023
138
3
19
6097263
878009
0
39855
556
0
0
10616033
601455
0
17123
5487972
814547
665813
178822
261967
190379
0
5067731
593518
0
31238
1276057
5450
0
300233
13127058
1002805
0
2887105
577641
0
805701
5734906
2628593
162820
1214
38
2
0
7059112
663132
0
74407
335
0
0
3637778
757449
0
21370
2012
2013
2014
2015
AFRICAN
Ethiopia
Gabon
Gambia
Ghana
Guinea
Guinea-Bissau
Kenya
Liberia
Madagascar
Malawi
Mali
Mauritania
Mayotte
Mozambique
Namibia
Niger
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
5962646
946595
745983
238483
862442
271038
0
12578946
3755166
0
0
1220574
191421
0
237398
12883521
1453471
0
2441800
1407455
0
980262
6528505
2171739
172374
1463
21
2
2
6170561
927841
0
10844
194
0
0
5915671
817072
0
25270
9243894
1687163
958291
256531
26432
0
0
889494
175126
0
8444417
1629198
0
0
775341
63353
0
0
238580
14677837
2335286
0
2202213
1244220
0
0
1071310
5787441
2849453
135985
82
9
0
8200849
2998874
0
34002
136
0
0
5533601
1426696
0
5102
7457765
1250110
868705
256183
26117
0
603424
99976
0
10636057
3415912
0
0
1595828
660207
0
309939
15142723
2808931
0
2433086
864204
0
0
977228
7703651
2905310
0
2590643
188194
15
1
0
0
12240045
7117648
0
186972
15914
0
0
7014724
3828486
0
39066
5987580
1188627
678432
285489
891511
240382
0
13368757
4319919
0
0
1251096
810979
0
15915943
1499027
0
2306116
931086
0
0
1536344
8518905
3585315
0
4410839
219184
14241392
7718782
0
207612
12050
0
0
4497920
2267867
0
0
141

WHO region
Country/area
2000
2005
2010
2011
2012
2013
2014
2015
AFRICAN
Nigeria
Rwanda
Sao Tome and

Principe
Senegal
Sierra Leone
South Africa
South Sudan1
Swaziland
Togo
Uganda
United Republic
of Tanzania
Mainland
Zanzibar
Zambia
Zimbabwe
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
2476608
66250
1134587
44959
0
460881
64624
29374
0
0
0
3552859
81442
17734
0
81442
17734
0
3337796
-
3532108
2409080
73050
1418091
38746
0
243082
3702
0
0
7755
337582
10374
279
0
0
437662
10869875
1082223
0
22086
16740283
7628
0
16679237
61046
7628
0
4121356
1494518
-
3873463
523513
0
2708973
638669
0
58961
2219
14
0
1043632
343670
0
2327928
218473
0
276669
2181
0
5
900283
1722
87
0
0
1419928
224080
0
7
15332293
1565348
15812
0
15388319
2338
0
0
15116242
272077
2338
0
0
4229839
912618
249379
0
-
5221656
1602271
208858
0
117279
6363
4
6
900903
277326
0
1150747
25511
0
382434
6906
14
0
795784
112024
0
797
0
0
893588
237282
0
23
12522232
231873
0
0
15299205
4489
0
0
14843487
455718
4489
0
0
4607908
480011
319935
0
0
11789970
3095386
483470
126897
10700
1
0
897943
281080
1
2579296
1537322
0
152561
3109
5
7
1125039
626
0
0
1311047
260526
0
9
16845771
2662258
0
0
14513120
2730
0
201
13976370
536750
2730
0
201
4695400
727174
276963
0
-
21659831
3064585
962618
108634
9242
1
0
1119100
345889
0
0
2576550
1701958
0
603932
8645
0
0
1855501
669
0
1
1442571
272847
0
8
26145615
1502362
14650226
1673
0
52
14122269
527957
1673
0
52
5465122
1115005
422633
0
-
19555575
4178206
1623176
0
0
91445
1754
0
0
1079536
265624
0
0
2647375
1374476
0
0
543196
11563
0
0
711
389
0
0
1756700
1130234
0
0
19201136
3631939
0
0
25190092
2235
0
106764
24880179
0
0
106609
309913
2235
0
155
7859740
1420946
535931
0
-
17388046
6093114
84348
2055
0
0
1421221
491901
0
0
2337297
1483376
0
0
35982
554
0
1
651
157
0
0
1756701
1113910
0
0
22095860
7137662
0
0
20797048
413615
0
175
20451119
411741
0
345929
1874
0
175
8116962
1384893
391651
0
0
Suspected
No Pf
No Pv
No Other
18559
20
1466
-
25119
32
1517
0
27366
0
149
0
22996
0
72
0
20789
0
33
0
25351
0
22
0
24122
0
18
0
26367
0
9
0
AMERICAS
Belize
142
WHO region
Country/area
2000
2005
2010
2011
2012
2013
2014
2015
143990
2437
28932
0
2562576
124939
478212
932
478820
50476
92702
0
427297
1225
7
0
544646
48974
55624
0
279072
9
744
0
48162
3051
657
214
246642
1474
50171
36
209197
12188
11694
0
21190
16897
0
0
175577
1425
33679
0
2003569
131
7259
0
509443
1369
22645
0
149702
45
991
0
1483816
20618
47690
13
63377
10608
1673
811
208021
1031
19062
0
2660539
147150
450687
211
493562
41781
78157
0
397108
3829
8
0
358361
2212
14836
0
102479
2
65
0
32402
1649
1637
71
178726
1017
38641
48
210429
15558
21255
1291
3541506
21778
0
0
153474
976
15011
0
1559076
22
2945
0
516313
1114
5498
0
208582
764
2901
0
1438925
14954
72611
59855
6877
1611
589
140857
1557
13694
0
2711433
47406
283435
183
521342
32900
83255
48
495637
2480
2
0
488830
258
1630
0
115256
0
17
0
14373
987
476
548
237075
30
7163
0
212863
11244
8402
132
270427
84153
0
0
152961
866
8759
0
1192081
0
1226
0
554414
154
538
0
141038
20
398
0
744650
2291
29169
3
17133
638
817
36
150662
526
7635
0
2477821
32100
231368
362
418159
14650
44701
16
477555
1614
2
0
460785
290
929
0
100884
1
8
0
14429
584
339
489
195080
64
6707
0
201693
15945
9066
96
184934
32969
0
0
152604
585
7044
10
1035424
0
1124
0
536105
150
775
0
116588
1
353
0
702952
2929
21984
3
16184
310
382
17
132904
385
8141
0
2349341
31913
203018
4361
416767
17612
44283
175
506583
950
2
0
459157
78
466
0
124885
0
15
0
13638
382
257
377
186645
54
5278
0
196622
16722
11244
9
167772
25423
0
0
155165
560
5865
0
1025659
0
833
0
552722
236
999
0
107711
1
843
0
759285
3399
28030
7
21685
115
167
2
144049
975
7398
2
1893797
29201
143050
3235
327081
17110
33345
177
502683
576
3
0
397628
160
208
0
103748
0
6
0
22327
744
337
345
153731
101
6062
0
205903
13655
13953
101
20586
20378
0
0
144673
1153
4293
0
1017508
0
495
0
536170
220
974
0
93624
6
699
0
864648
6630
36285
0
19736
420
359
64
124900
325
7060
0
1670019
21105
115299
1245
403532
20067
20129
130
416729
491
5
0
370825
49
199
106915
0
6
0
14651
137
98
200
314294
24
5593
0
142843
3943
7173
258817
17662
0
0
151420
564
2881
0
900578
0
656
0
620977
161
1000
0
80701
8
866
0
866047
10282
54394
26964
177
158
35
159167
84
6811
0
1502840
14764
122615
46
332706
25322
21987
739
367167
631
0
0
261824
184
434
0
89267
0
3
0
11558
85
227
116
301746
43
5487
0
132941
3219
6002
32
302740
17583
0
0
153906
904
2631
2
867853
0
517
0
604418
338
1937
4
64511
0
546
0
865980
13618
52919
8
15236
17
61
21
AMERICAS
Bolivia
(Plurinational
State of)
Brazil
Colombia
Dominican
Republic
Ecuador
El Salvador
French Guiana
Guatemala
Guyana
Haiti
Honduras
Mexico
Nicaragua
Panama
Peru
Suriname
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
143

WHO region
Country/area
2000
2005
2010
2011
261866
5491
24829
1
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
2012
2013
2014
2015
420165
5725
38985
38
400495
10629
32710
60
382303
9724
34651
6
410663
10978
39478
23
476764
22777
50938
4882
522617
21074
62850
6769
625174
24018
100880
11491
366865
5115
89240
2546
0
-
548503
5917
110527
0
3969
413
0
0
2219
16747
0
8671271
42056
85748
0
1
63770
12516
0
0
629380
42627
1442
27
847589
6142
63255
0
1010
0
0
166
1656
0
8601835
73857
143136
0
29
0
0
220698
5629
0
0
835018
77271
966
2
936252
5581
71968
0
354
152
1502
0
8418570
73925
205879
0
69
0
0
99403
804940
59689
478
33
847933
1231
53609
0
1412
20
0
0
44
711
0
8902947
95095
228215
2901
82
0
0
70459
891394
109504
398
4
787624
1877
43369
0
939
0
0
72
426
0
7752797
46067
283661
10506
34
0
0
85174
927821
102369
408
0
743183
3000
58362
39276
21
351
8514341
33391
232332
8870
51
0
6
79653
1207771
725169
67261
239
0
801938
4004
82891
84
632
4
8885456
30075
163872
7178
83
0
0
119008
1102186
668024
68655
300
-
Suspected
No Pf
No Pv
No Other
233785
831
18233
0
216197
81
2228
0
173523
0
111
0
173367
0
65
0
209239
0
18
0
213916
0
7
0
200241
0
2
0
0
0
0
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
Bhutan
No Pv
No Other
Suspected
Democratic
No Pf
People's Republic
No Pv
of Korea
No Other
Suspected
No Pf
India
No Pv
No Other
Suspected
No Pf
Indonesia
No Pv
No Other
742539
39475
16124
76445
2738
3197
241
204428
86790375
1047218
984572
2048
3178212
89289
156323
-
462322
37679
10442
60152
853
871
101
11507
0
6728
104120792
805077
1011492
4680
2113265
127594
147543
-
496616
52012
3824
0
54760
140
261
0
25147
0
13520
0
119279429
830779
765622
3585
2205293
220077
221176
2547
390102
49084
2579
0
44494
87
92
0
26513
0
16760
0
119470044
662748
645652
2256
2092187
200662
187989
2261
309179
9428
396
36
42512
33
47
0
40925
0
21850
0
122159270
524370
534129
9325
2051425
199977
187583
981
93926
3597
262
2
31632
14
9
72719
0
14407
0
127891198
462079
417884
1767
1833256
170848
150985
1342
125201
8981
489
727
28716
17
31
38878
0
10535
0
138628331
720795
379659
1575907
124051
107260
-
122806
5279
477
748
74087
14
20
0
91007
0
6817
0
140841230
774627
390440
0
1599427
103315
94267
8
AMERICAS
Venezuela
(Bolivarian
Republic of)
Suspected
No Pf
No Pv
No Other
Afghanistan
Djibouti
Iran (Islamic
Republic of)
Pakistan
Saudi Arabia
Somalia
Sudan
Yemen
EUROPEAN
Tajikistan
SOUTH-EAST ASIA
Bangladesh
144
WHO region
Country/area
2000
2005
2010
2011
2012
2013
2014
2015
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
No Pv
No Other
843087
95499
21802
252
140768
560
7056
4403739
43717
37975
47
15212
-
787691
124644
37014
638
361936
1181
5691
2524788
14670
14921
59
185367
43093
15523
266
1277568
70941
29944
346
213353
550
2349
0
1777977
9401
13401
20
266384
28350
11432
0
1210465
59604
28966
162
188702
0
908
0
1450885
5710
8608
13
225772
14261
3758
0
1423966
314676
135388
27917
243432
108
1480
0
1130757
11553
17506
3172
182854
1962
2288
0
1364792
222770
98860
11548
169464
273
1659
22
1838150
14449
15573
3084
178200
373
512
0
890913
104863
41866
5087
296979
195
1154
1756528
13743
20513
117107
118
139
0
714075
49311
26316
1689
225353
103
504
40
1370461
3291
4655
57
121110
33
24
0
Suspected
No Pf
No Pv
No Other
Suspected
No Pf
China
No Pv
No Other
Suspected
Lao People's
No Pf
Democratic
No Pv
Republic
No Other
Suspected
No Pf
Malaysia
No Pv
No Other
Suspected
No Pf
Papua New
Guinea
No Pv
No Other
Suspected
No Pf
Philippines
No Pv
No Other
Suspected
No Pf
Republic of
Korea
No Pv
No Other
Suspected
No Pf
Solomon Islands
No Pv
No Other
Suspected
No Pf
Vanuatu
No Pv
No Other
Suspected
No Pf
Viet Nam
No Pv
No Other
281444
46150
4505
665
496070
38271
1689
146
2694991
6000
5953
287
1897579
63591
14721
729
36596
25912
0
4183
601612
46703
21322
82
58679
3226
2972
10
2883456
57605
15935
772
165382
17482
9004
428
3892885
3588
18187
161
173698
13106
473
36
1994216
2222
2729
212
1962493
62926
22833
2632
593996
20033
6482
213
1369
633796
54001
22515
126
86170
3817
4453
64
2793458
14231
5102
163
193210
8213
4794
0
7118649
1269
3675
20
280549
4393
122
1
1619074
1344
3387
943
1505393
56735
13171
1990
301577
11824
2885
175
1772
27
1691
0
284931
22892
12281
200
48088
1545
2265
10
2803918
12763
4466
0
216712
7054
5155
0
9190401
1370
1907
50
221390
5770
442
14
1600439
634
1750
1660
1279140
59153
9654
632
327125
6877
2380
127
838
20
754
0
254506
14454
8665
0
32656
770
1224
2
3312266
10101
5602
0
194263
14896
19575
4971
6918732
16
179
60
369976
37692
7634
769
1566872
651
915
2187
1113528
58747
7108
609
333084
4774
2189
57
555
36
473
0
249520
14748
9339
232
33273
1257
1680
470
3436534
11448
7220
0
152137
7092
11267
2418
5554995
8
71
0
339013
24538
12537
955
1576012
422
385
2136
1454166
119469
7579
1279
320089
4968
1357
16
443
0
383
0
245014
13194
11628
446
28943
1039
1342
0
3115804
9532
6901
0
142242
8332
10356
5582
4403633
6
50
1
294542
23928
22625
1341
1443958
177
241
2706
922417
120641
78846
77759
314820
3760
834
196
638
0
557
0
233803
9835
7845
593
35570
279
703
0
2786135
8245
7220
0
163680
17830
13146
2498
4052616
1
26
0
284003
14430
20804
735
1066470
110
84
22
909940
118452
62228
114320
260645
4145
694
66
699
0
627
0
192044
10478
12150
1141
14938
150
273
0
2673662
4327
4756
0
SOUTH-EAST ASIA
Myanmar
Nepal
Thailand
Timor-Leste
WESTERN PACIFIC
Cambodia
Pf, Plasmodium falciparum ; Pv, Plasmodium vivax

145
Annex 4 J. Reported malaria deaths, 20002015

WHO region
Country/area
2000
2005
2010
2011
2
9510
0
0
0
691
0
0
439
712
0
0
0
3856
0
0
0
2016
0
6108
626
0
48767
0
591
0
748
0
0
0
0
1244
0
0
254
1275
0
424
0
0
0
0
379
0
379
0
0
0
13768
322
11
5224
776
2
836
668
558
92
0
0
15322
0
49
1086
353
426
2037
490
565
44328
41
699
5070
1285
0
0
0
1325
2060
6494
2581
85
1587
50
63
0
17
1024
0
18322
18075
247
7737
1916
1
8114
964
8
9024
2677
1
4536
526
886
53
0
1023
23476
30
27
1581
182
151
3859
735
296
26017
1422
427
8206
3006
211
0
3354
63
3929
4238
670
14
553
8188
83
1053
8
1507
8431
15867
15819
48
4834
255
0
6909
1753
8
7001
2233
1
3808
858
1220
19
892
1389
23748
52
12
936
74
440
3259
743
472
713
0
398
6674
2128
77
0
3086
36
2802
3353
380
19
472
3573
54
406
1
1314
5958
11806
11799
7
4540
451
0
11
245
124
6
66
0
0
0
29
16
0
0
4
0
0
123
87
16
22
0
2
4
33
29
1
0
6
0
0
76
42
15
0
0
1
0
24
8
3
0
1
0
0
70
23
10
0
0
2
0
36
5
2
0
1
2012
2013
2014
2015
0
5736
2261
3
7963
2263
0
3209
1442
1359
17
623
1534
21601
77
30
1621
134
289
2855
979
370
785
1725
552
5516
1894
106
0
2818
4
2825
7734
459
7
649
3611
72
1321
3
1197
6585
7820
7812
8
3705
351
0
7300
2288
7
6294
3411
0
4349
1026
1881
15
2870
3261
30918
66
6
358
273
262
2506
108
418
360
1191
641
3723
1680
25
0
2941
21
2209
7878
409
11
815
4326
105
1311
4
1361
7277
8528
8526
2
3548
352
0
5714
1869
22
5632
2974
2
4398
635
1720
0
271
4069
25502
0
15
213
159
170
2200
1067
357
472
2288
551
4490
2309
19
0
3245
61
2691
6082
496
0
500
2848
174
0
4
1205
5921
5373
5368
5
3257
406
1
7832
1416
5
5379
3799
0
3440
1763
1572
1
435
2604
39054
28
12
662
309
167
2137
846
0
15061
1379
841
3799
1544
39
0
2467
45
2778
0
516
0
526
1107
110
0
5
1205
6100
6313
6311
2
2389
200
0
0
60
24
8
0
0
2
0
35
6
1
0
2
0
0
40
10
5
0
0
3
1
14
10
1
0
0
0
1
36
17
4
0
0
0
1
11
9
2
0
0
0
0
37
18
3
0
0
0
1
12
15
0
0
1
AFRICAN
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cabo Verde
Cameroon
Chad
Comoros
Congo
Cte d'Ivoire
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Guinea
Guinea-Bissau
Kenya
Liberia
Madagascar
Malawi
Mali
Mauritania
Mayotte
Mozambique
Namibia
Niger
Nigeria
Rwanda
Senegal
Sierra Leone
South Africa
South Sudan1
Swaziland
Togo
Uganda
Mainland
Zanzibar
Zambia
Zimbabwe
AMERICAS
Belize
Brazil
Colombia
Dominican Republic
Ecuador
El Salvador
French Guiana
Guatemala
Guyana
Haiti
Honduras
Mexico
Nicaragua
146
WHO region
Country/area
2000
2005
2010
2011
2012
2013
2014
2015
AMERICAS
Panama
Peru
Suriname
1
20
24
24
1
4
1
17
1
0
1
18
0
1
1
16
1
7
0
10
0
4
1
6
0
5
0
5
0
3
0
8
0
0
4
0
0
0
2162
0
0
0
1
52
0
15
1789
0
22
0
0
0
0
6
1023
92
40
0
0
4
0
5
612
75
36
0
0
260
0
10
618
72
24
17
0
244
0
23
685
55
64
28
0
56
0
14
823
23
49
0
1
34
0
27
868
12
484
15
501
5
37
2
36
1
11
1
15
0
45
0
9
0
892
833
963
88
1018
432
754
388
519
252
440
385
562
217
384
157
2556
0
625
0
1707
10
161
71
788
6
80
58
581
2
43
16
403
0
37
3
236
0
47
3
92
0
38
1
37
0
33
0
608
31
350
35
617
536
0
38
3
142
296
48
77
33
725
145
0
38
5
18
151
19
24
13
616
30
1
34
1
21
94
33
17
12
523
12
2
19
1
14
45
0
44
12
381
16
0
18
0
8
12
0
28
10
307
12
0
18
0
6
18
0
4
4
203
10
0
23
0
6
10
20
2
8
163
20
0
13
0
3
77642
570
2166
0
5405
2360
88143
137269
346
1857
0
3506
1385
144363
150486
190
1143
0
2421
910
155150
104068
167
736
0
1821
727
107519
104105
156
996
0
1226
524
107007
116333
95
1048
0
1126
393
118995
99381
91
1008
0
955
268
101703
117886
98
991
0
620
239
119834
Afghanistan
Djibouti
Pakistan
Saudi Arabia
Somalia
Sudan
Yemen
EUROPEAN
Tajikistan
SOUTH-EAST ASIA
Bangladesh
Bhutan
Korea
India
Indonesia
SOUTH-EAST ASIA
Myanmar
Nepal
Thailand
Timor-Leste
WESTERN PACIFIC
Cambodia
China
Malaysia
Papua New Guinea
Philippines
Republic of Korea
Solomon Islands
Vanuatu
Viet Nam
REGIONAL SUMMARY
African
Americas
European
South-East Asia
Western Pacific
Total
Deaths reported before 2000 can be presumed and confirmed or only confirmed deaths depending on the country.
147
Notes
148
2016
WORLD MALARIA REPORT

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ISBN 978 92 4 151171 1

Who - World Malaria Report 2016

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Who - World Malaria Report 2016

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2016

WORLD MALARIA REPORT

WORLD MALARIA REPORT 2016

The mark CDC is owned by the US Dept. of Health and

For further information please contact:

ISBN 978 92 4 151171 1

World malaria report 2016.

1. Global targets, milestones and indicators

2.1 Total expenditure for malaria control and elimination

3.1 Population at risk sleeping under an insecticide-treated mosquito net

4. Diagnostic testing and treatment

5. Malaria surveillance systems

5.1 Health facility reports received at national level

WORLD MALARIA REPORT 2016

WORLD MALARIA REPORT 2016

WORLD MALARIA REPORT 2016

WORLD MALARIA REPORT 2016

WORLD MALARIA REPORT 2016

Melanie Renshaw (African Leaders Malaria Alliance [ALMA]), Trenton Ruebush

Claudia Nannini (WHO) for legal review;

Paprika (Annecy, France) for generating Annex 4;

Alex Williamson for the report cover; and

WORLD MALARIA REPORT 2016

Presidents Malaria Initiative

purchasing power parity

rapid diagnostic test

Sustainable Development Goal

Action and investment to defeat

Affordable Medicine Facility

Centers for Disease Control and

United Nations Childrens Fund

United States of America

conventional insecticide-treated net

United States Agency for

creditor reporting system

value of a statistical life

Development Assistance Committee

World Health Organization

gross domestic product

Global Fund to Fight AIDS,

Global Technical Strategy for

Abbreviations of WHO regions andoffices

WHO African Region

human immunodeficiency virus

WHO Regional Office for Africa

histidine rich protein 2

WHO Region of the Americas

intermittent preventive treatment in

WHO Regional Office for the

intermittent preventive treatment in

WHO Eastern Mediterranean Region

WHO Regional Office for the Eastern

indoor residual spraying

WHO European Region

insecticide-treated mosquito net

WHO Regional Office for Europe

long-lasting insecticidal net

WHO South-East Asia Region

monitoring and evaluation

national malaria control

WHO Regional Office for South-East

WHO Western Pacific Region

Organisation for Economic

1. Cibles, objectifs intermdiaires et indicateurs au niveau

2. Investissements dans les programmes et la recherche