Studies Show that Malaria Interventions Are Critical Investments for Saving Children’s Lives in Africa

Sep 27, 2017 |

WASHINGTON, D.C. – New studies released today in a special supplement of the American Journal of Tropical Medicine and Hygiene adds to the evidence that over the last decade, global malaria control efforts have saved millions of children’s lives in areas most affected by malaria.

Malaria remains a major cause of preventable death, killing an estimated 429,000 people and causing more than 212 million illnesses in 2015, according to the World Health Organization (WHO). With support from the U.S. President’s Malaria Initiative (PMI) and the Global Fund to Fight AIDS, Tuberculosis and Malaria – and commitments from bilateral and multilateral partners – hundreds of millions of people have benefited from protective measures, such as insecticide-treated nets and spraying of homes with insecticides, and have been appropriately diagnosed with rapid diagnostic tests and treated with effective anti-malarial drugs.

The September 2017 supplement includes nine novel contributions on evaluating the impact of malaria control interventions in sub-Saharan Africa, where most of malaria deaths are among children under the age of five years. Results from these rigorous impact evaluations highlight the successes of malaria control efforts, including reinforcing the link between malaria intervention scale-up and reductions in malaria morbidity and child mortality.

Together with other donor countries, the United States contributes to effective malaria prevention and control for more than half a billion people from the Sahel to the Horn to Southern Africa. Between 2000 and 2015, malaria deaths declined by 60 percent, and almost 7 million lives were saved. Many children are alive because of work to scale up proven malaria interventions. The reports presented in the supplement provide further evidence of the impact achieved in many African countries.

“This supplement is the first published collection of impact evaluation papers designed by the PMI interagency team and implemented in partnership with national malaria control programs and other partners,” said Irene Koek, Acting U.S. Global Malaria Coordinator. “The U.S. purposefully and systematically invested in rigorous, scientific country malaria program evaluations to document the impact of malaria control investments.” 

The authors present real-world evidence of declining trends in malaria infection and illness and improved child survival across sub-Saharan Africa. Further, the studies present new methods for evaluating the impact of large-scale malaria control programs in resource-poor settings with simultaneous scale-up of other maternal and child health interventions.

“The progress we’ve seen in malaria-endemic countries is inspiring and shows us the impact of our global malaria control programs and investments,” said U.S. Centers for Disease Control and Prevention Director Brenda Fitzgerald, M.D. “Conducting evaluations like these is critical to inform us of what is working and how we can save more lives from this preventable disease.”

Taken together, the articles in the supplement represent a conceptual and practical framework for planning and executing impact evaluations for malaria. The framework builds on previous impact evaluation models and offer lessons for evaluating the impact of control programs for other health conditions in challenging settings.

The papers in this supplement and the accompanying editorial and commentaries all indicate the need to strengthen national capacity for generating strategic information through improved routine health information systems for program monitoring and malaria surveillance.

The articles also identify critical considerations for ensuring strong, informative evaluations, including country ownership, engagement of stakeholders, tailoring evaluations to each setting, and using standard methodology. As comprehensive malaria control strategies continue to make inroads along the continuum from malaria control to elimination, approaches to pursuing impact evaluation will also need to evolve. Malaria deaths will not indefinitely decline in countries that have successfully controlled this disease, and a shift to tracking malaria infection and illness rates will be necessary to guide programs toward elimination.

From the tremendous accomplishments documented in these papers, global malaria partners are challenged to continue refining their approaches based on responding to the best possible data with minimal delay. Anticipating that, as Dr. Richard Cibulskis from WHO states, “… enhanced use of information can itself act as a powerful intervention and … further accelerate declines in malaria.”

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