Roll Back Malaria Progress & Impact Series
Focus on Malawi
Progress and impact of malaria control in Malawi at a glance
Since the creation of the NMCP in 1984, malaria control activities in Malawi have benefited from strong leadership and coordination.
Malawi has successfully garnered the support of external donors and, since 2006, funding for malaria control has increased tremendously. From 2006 to 2010, external partners committed more than US$ 121 million in funding for Malawi's malaria control efforts. Funding for malaria control in Malawi has come mainly from four sources: the Government of Malawi, the Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund), the United States President's Malaria Initiative (US-PMI), and household level expenditures.
These financial contributions have supported critical malaria prevention and treatment activities, including:
- Distribution of more than 9 million ITNs over the period 2004–2010 through commercial outlets and public health facilities.
- Expansion of IRS from one district to seven districts over the period 2004–2010, protecting nearly 2 million residents.
- Distribution of more than 21 million doses of artemisinin-based combination therapy (ACT) over the period 2007–2010.
These activities have translated into gains in the coverage of malaria control interventions at the national level, notably:
- Household ownership of at least one ITN increased dramatically from less than 13% in 2000 to 55% in 2012.
- ITN use among vulnerable populations has increased remarkably between 2000 and 2012&,3151;from less than 3% among children under five years of age and pregnant women to 56% and 51%, respectively.
- The percentage of pregnant women receiving at least two doses of intermittent preventive treatment during pregnancy (IPTp2) in 2012 was 54%, nearly twice that recorded in 2000 and one of the highest coverage rates in sub-Saharan Africa.
- In 2012, half of all children under five years of age with fever sought treatment from a health facility, provider, or pharmacy—a significant increase from 35% in 2000.
Thanks to these improvements in national coverage, the burden of malaria has declined and children's lives have been saved.
- A significant reduction in malaria parasite prevalence among children (aged 6–35 months) occurred between 2001 and 2009 from 61% to 20%, as measured in surveys conducted during the low transmission season. Surveys conducted in the high transmission season in 2010 and 2012 also showed a decline in prevalence from 43% to 28%, respectively, among children aged 6–59 months.
- Severe anaemia (haemoglobin <8g/dL) among young children (aged 6–23 months), who are most vulnerable to malaria, declined from 20% (2004) to 13% (2010).
- Under-five mortality dropped 41% from 188 to 112 deaths per 1000 live births over the period 1996–2000 to 2006–2010.
- According to the Lives Saved Tool (LiST estimation model), approximately 21 600 deaths among children under five years of age were prevented by malaria vector control interventions and the prevention of malaria in pregnancy in Malawi between 2000 and 2010.
Malawi's improved malaria and health indicators are all signs that malaria control efforts are working and delivering results. The coverage of some non-malaria maternal and child survival interventions also improved over the decade, including increased women's literacy, women giving birth in a health facility, exclusive breastfeeding, care seeking for suspected acute respiratory infection (ARI) and diarrhea, and the introduction of the Haemophilus influenzae type b (Hib) vaccination. In addition to the impact on under-five mortality from these interventions, it is also plausible to conclude that reductions in all-cause under-five mortality in Malawi during the period 2000 to 2010 were in part due to reductions in malaria-specific mortality.
Investments in malaria control efforts in Malawi have paid off in terms of important reductions in malaria morbidity and mortality among children under five years of age. The support of the Government and the willingness of development partners to work together led to the substantial gains in malaria control during 2000–2010 as described in this report. It is paramount for these investments to continue to reach the ambitious goal of reducing malaria morbidity and mortality by half over the period 2010–2015.