Country profiles - World Health Organization

Country profiles Afghanistan 93 Algeria 94 Angola 95 Argentina 96 Azerbaijan 97 Bangladesh 98 Belize 99 Benin 100 Bhutan 101 Bolivia (Plurinational State of ) 102 Botswana 103 Brazil 104 105 Burkina Faso Burundi 106 Cambodia 107 Cameroon 108 Cape Verde 109 110 Central African Republic Chad 111 China 112 Colombia 113 Comoros 114 Congo 115 116 Costa Rica Côte d’Ivoire 117 Democratic People’s Republic of Korea 118 Democratic Republic of the Congo 119 Djibouti 120 Dominican Republic 121 Ecuador 122 El Salvador 123 Equatorial Guinea 124 Eritrea 125 Ethiopia 126 French Guiana, France 127 Gabon 128 Gambia 129 Georgia 130 Ghana 131 Guatemala 132 Guinea 133 Guinea-Bissau 134 Guyana 135 Haiti 136 Honduras 137 India 138 Indonesia 139 Iran (Islamic Republic of ) 140 Iraq 141 Kenya 142 Kyrgyzstan 143

144 Lao People’s Democratic Republic Liberia 145 Madagascar 146 Malawi 147 Malaysia 148 Mali 149 Mauritania 150 Mexico 151 Mozambique 152 Myanmar 153 Namibia 154 Nepal 155 Nicaragua 156 Niger 157 Nigeria 158 Pakistan 159 Panama 160 161 Papua New Guinea Paraguay 162 Peru 163 Philippines 164 165 Republic of Korea Rwanda 166 Sao Tome and Principe 167 168 Saudi Arabia Senegal 169 Sierra Leone 170 Solomon Islands 171 Somalia 172 173 South Africa Sri Lanka 174 South Sudan 175 Sudan 176 Suriname 177 Swaziland 178 Tajikistan 179 Thailand 180 181 Democratic Republic of Timor-Leste Togo 182 Turkey 183 Uganda 184 United Republic of Tanzania (Mainland) 185 United Republic of Tanzania (Zanzibar) 186 Uzbekistan 187 Vanuatu 188 189 Venezuela (Bolivarian Republic of ) Viet Nam 190 Yemen 191 Zambia 192 Zimbabwe 193

A.1 M ethods for preparing country profiles This section describes the methods used for preparing country profiles. The methods also apply to other sections of the report.

A.1.1 Epidemiological profile Populations at risk The total population of each country is taken from the World population prospects, 2010 revision (1). The country population is subdivided into three levels of malaria endemicity, as reported by the NMCP: 1. Areas of high transmission, where the reported incidence of confirmed malaria due to all species was ≥1 per 1000 population per year in 2011. 2. Areas of low transmission, where the reported malaria case incidence from all species was < 1 per 1000 population per year in 2011 but greater than 0. Transmission in these areas is generally highly seasonal, with or without epidemic peaks. 3. Malaria-free areas, where there is no continuing local mosquito-borne malaria transmission, and all reported malaria cases are imported. An area is designated malaria-free when no cases have occurred for several years. Areas may be naturally malaria-free due to altitude or other environmental factors that are unfavourable for malaria transmission; or areas may become malaria-free as a result of effective control efforts. In practice, malaria-free areas can be accurately designated by national programmes only after taking into account the local epidemiological situation and the results of entomological and biomarker investigations. If a national programme did not provide the number of people living in high- and lowrisk areas, the numbers were inferred from subnational case incidence data provided by the programme. The population at risk is the total population living in areas where malaria is endemic (low and high transmission), excluding the population living in malaria-free areas. The population at risk is used as the denominator in calculating the coverage of malaria interventions, and hence in assessing current and future needs for malaria control interventions, taking into account the population already covered. For countries in the pre-elimination and elimination stages, population at risk is defined by the countries based on the resident populations in foci where active malaria transmission occurs. Maps of malaria The epidemiological maps for each country shown in the country profiles are based on the number of confirmed cases per 1000 population in 2011. Seven levels of endemicity are shown: ■■ >100 cases per 1000 population per year; ■■ > 50 cases per 1000 population per year and < 100 cases; ■■ >10 cases per 1000 population per year but < 50 cases ■■ >1 cases per 1000 population per year but < 10 cases ■■ > 0.1 case per 1000 population per year but < 1 cases; ■■ > 0 case per 1000 population per year but < 0.1 cases; ■■ 0 recorded cases. 90 | world malaria report 2012

The first four categories correspond to the high-transmission category defined above. It should be noted that case incidence rates for 2011do not necessarily reflect the endemicity of areas in previous years. If subnational data on population or malaria cases were lacking, an administrative unit was labelled “no data” on the map. In some cases, the subnational data provided by a malaria control programme did not correspond to a mapping area known to WHO. This may be the result of modifications to administrative boundaries or the use of names not verifiable by WHO. The maps for countries in sub-Saharan Africa display a combination of: (i) cases per 1000 per year and, (ii) parasite prevalence in areas with > 10 cases per 1000 population per year. To obtain a measure of combined parasite prevalence for both P. falciparum and P. vivax, the sum of the two independent parasite rates (2, 3) was calculated at each point (~5km2). Data on environmental suitability for malaria transmission were used to identify areas that would be free of malaria. Vector and parasite species The species of mosquito responsible for malaria transmission in a country and the species of Plasmodium involved are listed according to information provided by WHO regional offices. The proportion of malaria cases due to P. falciparum is estimated from the number of P. falciparum and mixed infections detected by microscopy divided by the total number of microscopically confirmed malaria cases.

A.1.2 Intervention policies and targets Intervention policy The policies and strategies adopted by each country for malaria prevention, diagnosis and treatment may vary according to the epidemiological setting, socioeconomic factors and the capacity of the national malaria programme or country health system. Adoption of policies does not necessarily imply immediate implementation, nor does it indicate full, continuous implementation nationwide. Antimalarial treatment policy Antimalarial treatment policies are shown along with the results of recent therapeutic efficacy tests where these are available. Data on therapeutic efficacy were extracted from the WHO global database on antimalarial drug efficacy and originate from three main sources: published data, unpublished data, and regular monitoring data from surveillance studies conducted according to the WHO standard protocol. The percentage of treatment failures is equal to the total number of early treatment failures plus late clinical failures plus late parasitological failures, divided by the total number of patients who completed the study follow-up. The number of studies included in the analysis and the years during which the studies were conducted are shown for each antimalarial medicine. The median, minimum and maximum describe the range of treatment failures observed in the studies for each antimalarial medicine.

A.1.3 Financing Government and external financing The data shown are those reported by the programme. The first graph shows financial contributions by source or name of agency

by year. The government contribution is usually the declared government expenditure for the year. When government expenditure was not reported by the programme, the government budget was used. External contributions are contributions allocated to the programme by external agencies, which may or may not be disbursed. Additional information about contributions from specific donor agencies, as reported by these agencies, is given in Annex 2. All countries were requested to convert their local currencies to 2011 US$. Expenditure by intervention The pie chart shows the proportion of malaria funding from all sources, spent on different activities in 2011: ITNs, insecticides and spraying materials, IRS, diagnosis, antimalarial medicines, monitoring and evaluation; human resources, technical assistance; management. There may be differences in the completeness of data, and the expenditures on activities listed may not include all items of expenditure. Government expenditures usually only include expenditures specific to malaria control and do not take into account costs related to maintaining health systems, human resources, etc.

A.1.4 Coverage Coverage with ITNs Household surveys: The percentage of the population with access to an ITN in their household and the percentage of persons who sleep under an ITN are taken from nationally representative household surveys, such as multiple indicator cluster surveys (MICS), demographic and health surveys (DHS), and malaria indicator surveys (MIS). Other available national surveys were also included. The results of subnational surveys undertaken to support local project implementation are difficult to interpret nationwide and hence are not presented in the profiles, although they can be useful for assessing progress locally. It should be noted that many of these surveys are conducted during the dry season for logistical reasons, and the estimates may not reflect the use of nets during peak malaria transmission when the rate of ITN use may be higher. ■■

Proportion of population with access to an ITN within their household – an indicator to measure the proportion of households that have a sufficient number of ITNs to cover all individuals who spent the previous night in surveyed households, assuming each ITN is shared by two people. It is useful for determining what proportion of households has achieved universal access to ITNs. It is labeled as “With access to an ITN in household” in the graphs.

■■

Proportion of population potentially protected with ITNs – calculated as the number of ITNs distributed multiplied by 1.8 (a ratio of one ITN for every two persons but allowing for only one person sleeping under some ITNs in households with an odd number of inhabitants) divided by the population at high risk. It is labeled as “At high risk protected with ITNs” in the graphs.

As LLINs are considered to have an average useful lifespan of 3 years, the cumulative total of mosquito nets distributed over the past 3 years is taken as the number of ITNs distributed for any particular year. Other ITNs are considered to have an average lifespan of 1 year; some nets will be effective for longer if re-treated with insecticide. Therefore, the numerator for LLINs and ITNs is the sum of the cumulative LLINs distributed in the latest 3 years and the number of ITNs distributed and re-treated during the latest year. Outside Africa the population at high risk is used as the denominator for vector control coverage because the population at low risk is often at very low risk and it is not clear whether ITNs or IRS are needed by the entire population. For high-burden countries in the African Region a model was used to estimate the percentage of households owning at least one ITN: ■■

Proportion of households with at least one ITN – an indicator measuring the proportion of households that have acquired ITNs or have been reached by an ITN programme, or, conversely, the proportion that has no access to an ITN. It is labeled as “Modeled % of households with ≥ 1 ITN” in the graphs.

The model takes into account data from three sources: household surveys, the number of ITNs delivered by manufacturers to a country, and the number of ITNs distributed by NMCPs (Section 4.1) (4). For years where survey results are available, the estimates of the model are the same as those of the survey. Such operational estimates contain no information about the geographical distribution of ITNs or their distribution within households. ITNs may be clustered in certain subpopulations, thus depriving others at risk, and the number of ITNs delivered to a household may exceed or fall short of the recommended ratio of one net per two people. Coverage with IRS The following indicator is calculated:

Proportion of population who slept under an ITN the previous night – an indicator to provide a direct measure of ITN use by all age groups at the time a survey is conducted. It is labeled as “All ages who slept under an ITN” in the graphs.

Proportion of the population at risk protected by IRS – calculated as the number of people living in a household where IRS has been applied during the preceding 12 months, divided by the population at risk (the sum of populations living in lowand high-transmission areas), multiplied by 100 for countries in the African region including Djibouti, Somalia and South Sudan. For countries outside Africa, population at high risk only was considered.

Programme data: Nationally representative surveys are usually not undertaken frequently enough to allow assessment of trends in intervention coverage or to provide contemporary information. This is particularly true for WHO Regions other than the African Region. Therefore estimates of intervention coverage are made using routinely reported data. Data on the number of ITNs distributed by malaria programmes are supplied annually by ministries of health to WHO as part of reporting for the World Malaria Report. This information is used to estimate the following indicator:

Programme data are the most important source of information for estimating IRS coverage, as household surveys do not generally include questions on IRS. In addition, IRS is often focalized, carried out on a limited geographical scale, for which nationally representative household surveys may not provide an adequate sample size for coverage to be measured accurately. The percentage of people protected by IRS is a measure of the extent to which IRS is implemented and the extent to which the population at risk benefits from IRS nationwide. The data show

■■

■■

world malaria report 2012 | 91

neither the quality of spraying nor the geographical distribution of IRS coverage in a country. Cases tested and ACT delivered Household surveys frequently ask what treatment was received by febrile children, but in most cases it is not known whether the fever can be attributed to malaria (even if a finger or heel prick was done during a consultation at a health facility the result of the diagnostic test is seldom recorded in a household survey). Few countries have information systems that are able to record the treatments given to individual patients. Instead, programme data on the numbers of diagnostic tests performed and antimalarial medicines distributed by the programmes are used to calculate proxy indicators for access to diagnosis and treatment. The following indicator on access to diagnostic testing is calculated: ■■ The proportion of suspected cases attending public health facilities that receive a diagnostic test – the number of suspected cases examined by microscopy or by RDT divided by the total number of suspected malaria cases, multiplied by 100. This indicator reflects the extent to which a programme can provide diagnostic services to patients attending public health facilities. It does not consider patients attending privately run health facilities, and therefore does not reflect the experience of all patients seeking treatment. In many situations health facilities in the private sector are less likely to provide a diagnostic test than those in the public sector. The indicator may also be biased if health facilities that provide a diagnostic test, such as hospitals, are more likely to submit monthly reports. Aggregate information on numbers of treatment courses delivered to public health facilities is used to relate these to the number of patients treated. Two indicators can be calculated: ■■ Proportion of malaria cases potentially treated with any antimalarial in the public sector – the number of antimalarial treatment courses delivered divided by the number of estimated presumed and confirmed malaria cases in public health facilities, multiplied by 100. ■■ Proportion of P. falciparum malaria cases potentially treated with ACT in the public sector – the number of ACT courses delivered divided by the number of estimated presumed and confirmed P. falciparum malaria cases in the public sector, multiplied by 100. The first of these indicators can provide information on whether the malaria control programme delivers sufficient antimalarials to treat all malaria patients who seek treatment in the public sector. For high transmission countries in the African Region the estimated number of cases attending public sector health facilities is used as a denominator. For other countries, the denominator is the total number of confirmed cases, adjusted for reporting completeness. The second indicator can provide information on whether the malaria control programme delivers sufficient ACTs to treat the number of patients with P. falciparum malaria seeking treatment in the public sector. For high transmission countries in the African Region the estimated number of cases attending public sector health facilities is used as a denominator. For other countries, the denominator is the total number of reported confirmed cases, adjusted for reporting completeness. 92 | world malaria report 2012

A.1.5 Impact Confirmed cases, admissions and deaths Where available, the numbers of confirmed malaria cases, admissions and deaths are shown in order to provide information on trends in malaria. The numbers of confirmed cases, admissions and deaths are derived from case reports divided by the population at risk x 100 000. Values are plotted on a logarithmic scale, except for countries with low numbers of reported cases for which values are plotted on an arithmetic scale. These indicators help to asses changes in the incidence of malaria over the years, provided that there has been consistency in case reporting over time. For countries in the pre-elimination or elimination phases the total number of cases is plotted on an arithmetic scale along with those acquired within the country (indigenous cases). Malaria test positivity rate and ABER The following indicators are presented to help interpret observed trends: ■■ Annual blood examination rate (ABER) – the number of parasitological tests (by microscopy or RDT) undertaken per 100 people at risk per year ■■ Slide positivity rate (SPR) – the number of microscopically positive cases divided by the total number of slides examined, multiplied by 100 ■■ RDT positivity rate – the number of positive RDT tests divided by the total number of RDT tests carried out, multiplied by 100. These indicators help to ensure that potential differences in diagnostic effort or completeness of reporting are taken into account and allow proper interpretation of the trends on confirmed cases. To discern decreases in malaria incidence, the ABER should ideally remain constant or be increased. In countries progressively reducing their malaria endemicity, the population at risk also reduces, becoming limited to active and residual foci where malaria transmission is present, or where there is a potential high risk due to receptivity. In addition, it is useful to monitor the percentage of suspected malaria cases that were examined with a parasite-based test. When reviewing the number of malaria admissions and deaths, the health facility reporting rate (the proportion of health facilities that report) should remain constant and should be high, i.e. > 80%. RDT and slide positivity rates are derived from the number of parasitologically positive cases per 100 cases examined by RDT or microscopy. They measure the prevalence of malaria parasites among people who seek care and are examined in health facilities. These rates should be less distorted by variations in the ABER than trends in the number of confirmed cases.

References 1. World population prospects. New York, United Nations, United Nations Population Division, 2010. http://esa.un.org/wpp/unpp/ panel_population.htm 2. Gething PW et al. A new world malaria map: Plasmodium falciparum endemicity in 2010. Malaria Journal, 2011, 10: 378. 3. Gething PW et al. A long neglected world malaria map: Plasmodium vivax endemicity in 2010. PLoS Neglected Tropical Diseases, 2012, 6: e1814. 4. Flaxman AD et al. Rapid scaling up of insecticide-treated bed net coverage in Africa and its relationship with development assistance for health: a systematic synthesis of supply, distribution, and household survey data. PLoS Medicine, 2010, 7(8): e1000328

Afghanistan

Eastern Mediterranean Region

Phase: Control. Impact: >75% decrease in case incidence 2000–2011.

Tajikistan

Turkmenistan

I. Epidemiological profile 2011

%

9 920 000 14 900 000 7 490 000 32 310 000

31 46 23

Population (UN Population Division) High transmission (≥1 case per 1000 population) Low transmission (0-1 cases per 1000 population) Malaria-free (0 cases) Total

Pakistan

Parasites and vectors

India

Major plasmodium species: P. falciparum (7%), P. vivax (93%) Major anopheles species: An. superpictus, stephensi, pulcherrimus, subpictus, hyrcanus, culicifacies, fluviatilis

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100

Distribution of confirmed malaria cases (per 1 000 population)

II. Intervention policies and strategies Intervention WHO-recommended policies/strategies

Yes/ Year No adopted

ITN/LLIN

ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups

Yes Yes

2005 2010

IRS

IRS is recommended DDT is used for IRS

No No

– –

IPT

IPT used to prevent malaria during pregnancy

NA

–

Yes Yes Yes Yes Yes

2000 2009 2003 2003 2003

Case Patients of all ages should receive diagnostic test management RDTs used at community level ACT is free for all ages in public sector Pre-referral treatment with recommended medicines Oral artemisinin-based monotherapies are not registered

Financing

First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax

Medicine

Year

AS+SP

2005-2012

Government and external financing

No. of studies

Contribution (US$m)

0

0

Max

Follow-up

3.8

28 days

Expenditure by intervention in 2011 Insecticides & spray materials ITNs

6

Diagnostics

4

Antimalarial medicines

2

Monitoring and evaluation Human resources & technical assistance

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Management and other costs

Government* Global Fund World Bank USAID/PMI WHO/UNICEF Others * Expenditure: costs for sub-national level, health systems, human resources, etc not included. IV.

Coverage

Coverage of ITN and IRS

Cases tested and antimalarials delivered: Programme data (public sector) 100

100

Source: NMLCP, MIS 2009.

80

60

60

Cases (%)

80

40

2001 2002 2003 2004 2005 Population at high risk protected with IRS All ages who slept under an ITN

Impact

100 80 60 40 20

2006

0

2007 2008 2009 2010 2011 Population at high risk protected with ITNs Households with at least one ITN

Malaria test positivity rate and ABER

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Suspected cases tested Cases potentially treated with any antimalarial P. falciparum cases potentially treated with ACT

Microscopically confirmed cases, admissions (per 100 000) and deaths 2.0 1.5 1.0 0.5

0 0.0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 ABER (Micr. & RDT) RDT posivity rate Slide positivity rate

10 000

50

1 000

40

Cases and admissions rate (log)

0 2000

120

40 20

20

ABER(%)

Households or population (%)

– 2004 – – –

Min Median

8

8

0

Positivity rate (%)

CQ AS+SP QN AM ;QN CQ+PQ(14d)

Therapeutic efficacy tests (clinical and parasitological failure, %)

10

V.

Year adopted

30

100

20

10

10

Number of deaths

III.

Medicine

Antimalaria policy

1 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases


Algeria

African Region

Phase: Elimination. Impact: >75% decrease in case incidence 2000–2011.

Atlantic Ocean

Tunisia

Morocco


Population (UN Population Division) Number of active foci Number of people living within active foci Number of people living in malaria-free areas Total

Medit. Sea

%

Libya

0 – – 36 000 000

Mauritania

Parasites and vectors Major plasmodium species: P. falciparum (100%), P. vivax (0%) Major anopheles species: An.labranchiae, multicolor, hispaniola, claviger

Insufficient data

Chad

Mali

0

0–0.1

Niger 0.1–1.0

1.0–10

10–50

50–100

≥100




ITN/LLIN


No No

– –

IRS


Yes Yes

1980 –

Case Malaria diagnosis is free of charge in the public sector management Gametocidal treatment of P.falciparum cases Radical treatment of P. vivax cases

Yes No Yes

1968 – –

Surveillance Foci and case investigation undertaken Case reporting from private sector is mandatory

Yes Yes

1980 0

Contribution (US$m)

III. 35 30 25 20 15 10 5 0

Financing

Antimalaria policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax

Medicine


Year

No. of studies

Min Median

Max

Follow-up

ITNs Diagnostics Antimalarial medicines Monitoring and evaluation Human resources & technical assistance

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Coverage


Cases tested and antimalarials delivered: Programme data (public sector) 100 80

60

60

Cases (%)

80

40

40 20

20

Impact

0

2006 2007 2008 2009 2010 2011 Population at risk protected with IRS Households with at least one ITN



1.4 4.0 3.5 1.2 3.0 1.0 2.5 0.8 2.0 0.6 1.5 0.4 1.0 0.2 0.5 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 ABER (Micr. & RDT) RDT posivity rate Slide positivity rate

94 | world malaria report 2012

Microscopically confirmed malaria cases and indigenous cases 600

Total confirmed cases

0 2000 2001

ABER (%)


– – – – –

Insecticides & spray materials

2002 2003 2004 2005 Modelled % of households ≥1 ITN All ages who slept under an ITN

Positivity rate (%)

– – – – CQ

Expenditure by intervention in 2011

100

V.

Year adopted



Medicine

500 400 300 200 100 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Indigenous malaria cases

Confirmed malaria cases

Angola

African Region

Phase: Control. Impact: Insufficiently consistent data to assess trends.

Democratic Republic of the Congo


%

19 600 000 0 0 19 600 000

100 0 0


Atlantic Ocean Zambia

Parasites and vectors Major plasmodium species: P. falciparum (100%), P. vivax (0%) Major anopheles species: An. gambiae, funestus, nili

Namibia Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR


II. Intervention policies and strategies Yes/ Year No adopted

Intervention WHO-recommended policies/strategies ITN/LLIN


Yes Yes

2001 2010

IRS


Yes No

2003 –

IPT


N/A

–

Yes No Yes Yes

2010 – 2005 2003

No

–

Case Patients of all ages should receive diagnostic test management RDTs used at community level ACT is free for all ages in public sector Pre-referral treatment with recommended medicines Marketing authorization for all oral artemisinin-based monotherapies withdrawn III.

Financing

Antimalaria policy

Medicine

Year

AL

2004–2004


No. of studies

Contribution (US$m)

2006 2006 2006 2006 –

Min Median

2

0

1.15

Max

Follow-up

2.3

28 days

Expenditure by intervention in 2011 Insecticides & spray materials

80

ITNs

60

Diagnostics

40


20


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage



100

Source: MIS 2007, MIS 2011

80

60

60

Cases (%)

80

40

Impact

Malaria test positivity rate and ABER 20

80

15

40 20


Microscopically confirmed cases, admissions and deaths (per 100 000)

100

60

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 At risk protected with IRS Modelled % of households ≥1 ITN With access to an ITN in household All ages who slept under an ITN

10 5

0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 ABER (Micr. & RDT) RDT posivity rate Slide positivity rate

10 000

Cases and deaths rates (log)

0

40 20

20

ABER (%)

Population (%)

AL AL QN QN –


100

0

Positivity rate (%)

Year adopted


120

V.

Medicine

1 000 100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases


Argentina

Region of the Americas

Phase: Pre-elimination. Impact: >75% decrease in case incidence 2000–2011.

Brazil


%

0 204 000 40 600 000 40 804 000

0 0 100


Atlantic Ocean

Pacific Ocean

Parasites and vectors Major plasmodium species: P. vivax (100%) Major anopheles species: An. pseudopunctipennis, darlingi

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100





No No

– –

IRS


Yes No

– –

IPT


N/A

–

Case Patients of all ages should receive diagnostic test Yes management RDTs used at community level No ACT is free for all ages in public sector Yes Pre-referral treatment with recommended medicines – Oral artemisinin-based monotherapies are not registered –

– – – – –

III.

Financing


Medicine


– – – – –

Year

No. of studies

Min Median

Max


2.0

ITNs

1.5

Diagnostics

1.0


0.5

Monitoring and evaluation

Coverage

WHO/UNICEF


Others



100

80

60

60

Cases (%)

80

40

20

20 0 2000 2001 2002 2003 2004 2005 Population at high risk protected with IRS All ages who slept under an ITN

Impact

2006

0


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Suspected cases tested Cases potentially treated with any antimalarial


Microscopically confirmed cases and deaths 5

500

8

4

400

6

3

4

2

2

1

10



ABER(%)

V.

40

1

Number of deaths

IV.

Human resources & technical assistance

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Government* Global Fund World Bank USAID/PMI * Expenditure: costs for local level, health systems, etc. not included.

Follow-up


Cases and deaths

Contribution (US$m)

– – – – CQ+PQ

2.5

0


Year adopted


3.0

Positivity rate (%)

Medicine

300 200 100 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Deaths

Confirmed cases

Azerbaijan

European Region

Phase: Elimination. Impact: >75% decrease in case incidence 2000–2011. Application of elimination measures contributed to improvement of malaria situation in Azerbaijan - 4 indigenous cases reported in 2011. Malaria elimination strategy 2008-2013 is supported by the government, WHO and the Global Fund.

Georgia

I. Epidemiological profile Population (UN Population Division) Number of active foci Number of people living within active foci Number of people living in malaria-free areas Total

2011

%

22 254 000 9 050 000 9 304 000

3 97

Armenia Caspian Sea Islamic Republic of Iran

Parasites and vectors Major plasmodium species: P. vivax (100%) Major anopheles species: An.sacharovi, maculipennis

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100




ITN/LLIN


Yes No

2009 –

IRS


Yes No

1930 –


Yes – Yes

1930 – 1956


Yes –

1930 –

III.

Financing


Medicine


Contribution (US$m)

2008 2008 2008 2008 –

Year

No. of studies

Min Median

Max


4

ITNs

3

Diagnostics

2


1


IV.


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Coverage




100

80

60

60

Cases (%)

80

40

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Population at high risk protected with ITNs Population at high risk protected with IRS All ages who slept under an ITN Households with at least one ITN



Microscopically confirmed malaria cases and indigenous cases 2 000

300 200 150 100 50


ABER (%)

250


Impact

0.5

40 20

20 0

Follow-up


Government* Global Fund World Bank USAID/PMI WHO/UNICEF Others * Expenditure: costs for sub-national level, health systems, human resources, etc not included.


AS+SP AS+SP QN+CL AS ;QN CQ+PQ(14d)

5

0

Positivity rate (%)

Year adopted


6

V.

Medicine

Antimalaria policy

1 500 1 000 500 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011




Bangladesh

South-East Asia Region

Phase: Control. Impact: >75% decrease in case incidence projected 2000–2015.


%

3 860 000 11 200 000 135 000 000 150 060 000

3 7 90


India Myanmar


Bay of Bengal

Major plasmodium species: P. falciparum (87%), P. vivax (13%) Major anopheles species: An. dirus, minimus, philippinensis, sundaicus

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100




ITN/LLIN


Yes Yes

2008 2008

IRS


No No

– –

IPT


NA

–

Yes Yes Yes Yes Yes

2000 2007 2007 2004 –


Financing


Contribution (US$m)

– 2004 2004 2004 2004

Medicine

Year

No. of studies

Min Median

2008-2009

7

0

0

2

28 days

2008-2009

1

0

0

0

42 days



10

Diagnostics Antimalarial medicines

5


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage



100

80

60

60

Cases (%)

80

40

0 2000 2001 2002 2003 2004 2005 Population at high risk protected with IRS All ages who slept under an ITN

2006

0


40 1.4 35 1.2 30 1.0 25 0.8 20 0.6 15 0.4 10 0.2 5 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 ABER (Micr. & RDT) RDT posivity rate Slide positivity rate



Microscopically confirmed cases, admissions (per 100 000) and deaths Cases and admissions rate (log)


ABER (%)

Impact

40 20

20

V.

Follow-up

AL

ITNs

IV.

Max

QN+D

15

0


AL QN+D ;QN+TAM ;QN CQ+PQ(14d)


20

Positivity rate (%)

Year adopted

100

700 600 500 400 10 300 200 100 1 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases

Number of deaths

III.

Medicine

Antimalaria policy

Belize


Phase: Control. Impact: >75% decrease in case incidence 2000–2011. Mexico


%

0 219 000 98 600 317 600

0 69 31


Caribbean Sea

Guatemala

Parasites and vectors Major plasmodium species: P. falciparum (1%), P. vivax (99%) Major anopheles species: An. albimanus, darlingi

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

100





Yes Yes

2009 2009

IRS


Yes No

– –

IPT


N/A

–

Yes No Yes No No

– – 2010 – –


Financing

0.8 0.7 0.6 0.5 0.4 0.3 0.2 0.1 0

– – – – –

Year

No. of studies

Min Median

Max

Follow-up

Insecticides & spray materials ITNs No data reported for 2011

Coverage

WHO/UNICEF

Antimalarial medicines Monitoring and evaluation Management and other costs

Others



80

80

60

60

40

40 20


Impact

Diagnostics


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Cases (%)


Medicine

2006

0



14 12 8 10 6 8 6 4 4 2 2 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 ABER (Micr. & RDT) RDT posivity rate Slide positivity rate


Microscopically confirmed cases and deaths

Cases and deaths

ABER(%)

10

Positivity rate (%)

– CQ+PQ – – CQ+PQ


100

V.

Year adopted



Government* Global Fund World Bank USAID/PMI * Expenditure: costs for local level, health systems, etc. not included. IV.


Medicine

1 800 10 9 1 600 8 1 400 7 1 200 6 1 000 5 800 4 600 3 400 2 200 1 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Deaths

Number of deaths

Contribution (US$m)

III.

Antimalaria policy

Confirmed cases


Benin

African Region


Burkina Faso

I. Epidemiological profile Population (UN Population Division) High transmission (≥1 case per 1000 population) Low transmission (0-1 cases per 1000 population) Malaria-free (0 cases) Total

2011

Nigeria

%

9 100 000 0 0 9 100 000

Togo

Ghana

100 0 0

Parasites and vectors Major plasmodium species: P. falciparum (100%), P. vivax (0%) Major anopheles species: An. gambiae, funestus, nili

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR




ITN/LLIN


Yes No

2007 –

IRS


Yes No

2006 –

IPT


Yes

2005

Yes Yes No Yes

2011 2012 – 2008

Yes

2008


Financing

Antimalaria policy

Contribution (US$m)

2004 2004 2004 2004 –

Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine

Year

AL

2005-2009


No. of studies

Min Median

5

0

0

Max

Follow-up

6.5

28 days


20

ITNs

15

Diagnostics

10

Antimalarial medicines Monitoring and evaluation

5


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage


100


Source: DHS 2006

80

60

60

Cases (%)

80

40

0

40 20

20

0


Impact



10 000

79

ABER (%)

78



Microscopically confirmed cases, admissions and deaths (per 100 000) Cases and deaths rate (log)

Population (%)

AL AL QN QN –

25

0

Positivity rate (%)

Year adopted


30

V.

Medicine

1 000 100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases

Bhutan


>75% decrease in case incidence 2000–2011

China


%

96 000 450 000 192 000 738 000

13 61 26

Population (UN Population Division) High transmission (≥1 case per 1000 population) Low transmission (0-1 cases per 1000 population) Malaria-free (0 cases) Total Parasites and vectors

India

Major plasmodium species: P. falciparum (53%), P. vivax (47%) Major anopheles species: An. culicifacies, maculatus

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100




ITN/LLIN


Yes Yes

2006 2006

IRS


Yes No

1964 –

IPT


NA

–

Yes No Yes No Yes

1964 – 2006 – –


Financing


Contribution (US$m)

– 2006 2006 2006 2006

Medicine

Year

AL

2005-2011


No. of studies

Min Median

22

0

1.0

Diagnostics

0

28 days


0.5


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage



100

80

60

60

Cases (%)

80

40

40 20

20 0 2000


Impact

0

2006 2007 2008 2009 2010 2011 Population at high risk protected with ITNs Households with at least one ITN



Microscopically confirmed cases and deaths 10 000

8

8

8 000

6

6

4

4

2

2

2 000


0

Cases and deaths

10

10

ABER (%)

V.

Follow-up

Insecticides & spray materials ITNs

IV.

0

Max


1.5

0


AL QN AM ;QN CQ+PQ(14d)


2.0

Positivity rate (%)

Year adopted

6 000 4 000

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Deaths

16 14 12 10 8 6 4 2 0

Number of deaths

III.

Medicine

Antimalaria policy

Confirmed cases


Bolivia (Plurinational State of )



Peru

I. Epidemiological profile

Brazil 2011

%

484 000 3 080 000 6 530 000 10 094 000

5 31 65


Pacific Ocean


Paraguay

Chile

Major plasmodium species: P. falciparum (4%), P. vivax (96%) Major anopheles species: An. darlingi

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

100





Yes Yes

2008 2005

IRS


Yes No

1959 –

IPT


N/A

–

Yes Yes Yes No No

2000 2005 2003 – –


Financing


Medicine


Contribution (US$m)

– 2001 – 2001 2001

Year

No. of studies

Min Median

Max

ITNs

3

Diagnostics

2


1


IV.

Follow-up



2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Coverage

WHO/UNICEF


Others



100 80

80

60

60

Cases (%)


AS+MQ QN+CL QN CQ+PQ


4

0

40


Impact

40 20

20

2006

0



8 7 6 40 5 30 4 3 20 2 10 1 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 ABER (Micr. & RDT) RDT posivity rate Slide positivity rate

Cases and deaths

ABER(%)

50


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Suspected cases tested Cases potentially treated with any antimalarial P. falciparum cases potentially treated with ACT Microscopically confirmed cases and deaths

60

Positivity rate (%)

Year adopted


5

V.

Medicine

35 000 12 30 000 10 25 000 8 20 000 6 15 000 4 10 000 2 5 000 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Deaths

Confirmed cases

Number of deaths

III.

Antimalaria policy

Botswana

African Region


Zimbabwe


2011

%

366 000 954 000 711 000 2 031 000

18 47 35

Namibia

South Africa

Parasites and vectors Major plasmodium species: P. falciparum (100%), P. vivax (0%) Major anopheles species: An. gambiae, arabiensis

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR




ITN/LLIN


Yes Yes

2009 1997

IRS


Yes Yes

1950 1950

IPT


No

–

Yes No Yes Yes

2010 – 2007 2007

No

–


Financing

Antimalaria policy

Medicine


Year

No. of studies

Contribution (US$m)

Antimalarial medicines Monitoring and evaluation Human resources & technical assistance

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Coverage



60

60

40

40 20

20

0


Impact




10

2.0

8

1.5 1.0 0.5


1 000

Cases and deaths rate (log)

Positivity rate (%)

Cases (%)

80

ABER (%)


80

2

Follow-up

Diagnostics

No data reported for 2011

100

4

Max

ITNs


6

Min Median


0.5

V.

2007 2007 2007 2007 –


1.0

0

AL AL QN QN –


1.5

IV.

Year adopted


2.0

0

Medicine

100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases


Brazil


Phase: Control. Impact: 50%–75% decrease in case incidence projected 2000–2015.

Colombia


%

4 520 000 35 400 000 157 000 000 196 920 000

2 18 80


Peru Atlantic Ocean

Bolivia (Plurinational State of)

Pacific Ocean

Argentina

Parasites and vectors Major plasmodium species: P. falciparum (13%), P. vivax (87%) Major anopheles species: An. darlingi, albitarsis, aquasalis

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

100





Yes Yes

2007 2007

IRS


Yes No

1945 –

IPT


N/A

–

Yes Yes Yes Yes Yes

1972 2007 2006 2006 2010


Financing

– 2006 – 2006 2006


No. of studies

Min Median

Max

Follow-up

AS+MQ

2005–2007

3

0

0

0

42 days

AL

2005–2007

2

0

0

0

28 days

ITNs Diagnostics



2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Coverage

WHO/UNICEF


Others



60

60

Cases (%)

80

40

40 20

20

V.

Year



Impact

0

2006




Microscopically confirmed cases, admissions (per 100 000) and deaths

30

10

25

8

20 15 10 5

6 4 2



ABER(%)


AL ;AS+MQ AM ;AS ;QN CQ+PQ


100

Positivity rate (%)




Year adopted

1 000

250 200

100

150 100

10

50 1 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases

Number of deaths

140 120 100 80 60 40 20 0

Medicine

Cases and admission rate (log)

Contribution (US$m)

III.

Antimalaria policy

Burkina Faso

African Region


Niger

Mali


%

17 000 000 0 0 17 000 000

100 0 0


Benin Ghana


Togo

Côte d'Ivoire

Major plasmodium species: P. falciparum (100%), P. vivax (0%) Major anopheles species: An. gambiae, arabiensis

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR





Yes Yes

2007 1998

IRS


Yes No

2006 –

IPT


Yes

2005

Yes No Yes Yes

2009 – – 2005


Financing

Contribution (US$m)

80 70 60 50 40 30 20 10 0

Yes

2009

Antimalaria policy

Medicine

Year adopted


AL ;AS+AQ AL ;AS+AQ QN QN –

2005 2005 – – –


Year

No. of studies

2005-2009

6

1.9

7

12.5

28 days

AS+AQ

2006-2009

3

3.2

15.3

21.5

28 days




2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Cases tested and antimalarials delivered: Programme data (public sector) Source: DHS 2003, DHS 2010

80

60

60

Cases (%)

80

40

40 20

20

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 At risk protected with IRS Modelled % of households ≥1 ITN With access to an ITN in household All ages who slept under an ITN Malaria test positivity rate and ABER



2.5

25

2.0

20

1.5

15

1.0

10

0.5

5


10 000


Impact

ABER (%)

Population (%) Positivity rate (%)


100

100

V.

Follow-up


Coverage

0

Max

AL


Min Median

1 000 100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases


Burundi

African Region


Rwanda


2011

%

2 060 000 4 630 000 1 890 000 8 580 000

24 54 22


United Republic of Tanzania

Parasites and vectors Major plasmodium species: P. falciparum (100%), P. vivax (0%) Major anopheles species: An. gambiae, funestus

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR




ITN/LLIN


Yes Yes

2004 2009

IRS


Yes No

2009 –

IPT


No

–

Yes Yes Yes No

2007 – 2009 –

No

–


Financing


Medicine

Year

AS+AQ

2005-2006


No. of studies 2

Contribution (US$m)

Follow-up

2.9

7.5

28 days

5.2


5


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Coverage



100 Source: DHS 2010

80

Cases (%)

80 60 40

60 40 20

20

0





Microscopically confirmed cases, admissions and deaths (per 100 000) 100 000


Impact

ABER (%)

Population (%)

Max

Diagnostics


Positivity rate (%)

Min Median

ITNs

10

V.

2003 2003 2003 2003 –


15

0

AS+AQ AS+AQ QN QN –


20

IV.

Year adopted


25

0

Medicine

10 000 1 000 100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases

Cambodia

Western Pacific Region

Phase: Control. Impact: >75% decrease in case incidence 2000–2011. Thailand


%

6 290 000 1 290 000 6 720 000 14 300 000

44 9 47


Viet Nam

Parasites and vectors Major plasmodium species: P. falciparum (63%), P. vivax (37%) Major anopheles species: An. minimus, dirus, maculatus, sundaicus

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

100





Yes Yes

2000 2000

IRS


No No

– –

IPT


NA

–

Yes Yes Yes No Yes

2000 2000 2000 – 2009


Financing

First-line treatment of unconfirmed malaria First-line treatment of P. falciparum AS+MQ ;DHA-PPQ+PQ For treatment failure of P. falciparum QN+T Treatment of severe malaria AM;QN Treatment of P. vivax DHA-PPQ

Medicine

Year

No. of studies

DHA-PPQ 2008-2011


Contribution (US$m)

0

3.6

Max

Follow-up

25

42 days


30

Diagnostics

20


10


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage



100

Source: DHS 2005, Other Nat. 2010

80

60

60

Cases (%)

80

40


Impact

2006

0



70 3.5 60 3.0 50 2.5 40 2.0 30 1.5 20 1.0 10 0.5 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 ABER (Micr. & RDT) RDT posivity rate Slide positivity rate



0 2000

V.

40 20

20

ABER (%)


Min Median

11

40

0

– 2000 2000 2000 2011


50

Positivity rate (%)

Year adopted

Medicine

1 000

700 600 500 100 400 300 10 200 100 1 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Number of deaths

III.

Antimalaria policy

Confirmed cases


Cameroon

African Region


Chad Nigeria


%

14 200 000 5 810 000 0 20 010 000

71 29 0


Central African Republic Atlantic Ocean

Parasites and vectors Major plasmodium species: P. falciparum (100%), P. vivax (0%) Major anopheles species: An. gambiae, arabiensis, funestus, moucheti

Congo

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR




ITN/LLIN


Yes Yes

2004 2010

IRS


Yes No

2007 –

IPT


Yes

2004

Yes Yes No Yes

2010 2009 – 2004

Yes

2006


Financing

Contribution (US$m)

70 60 50 40 30 20 10 0


Medicine

Year

AS+AQ

2005–2009


No. of studies 9

0

3.7

Max

Follow-up

8.7

28 days

Diagnostics Antimalarial medicines Monitoring and evaluation Human resources & technical assistance

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Cases tested and antimalarials delivered: Programme data (public sector)

80

60

60

Cases (%)

80

40

40 20

20

0


2.5

25

2.0

20

1.5

15

1.0

10

0.5

5






Impact

ABER (%)

Population (%)

Min Median

ITNs

100

Positivity rate (%)

2004 2004 2004 2004 –


100

V.

AS+AQ AS+AQ QN AM ;QN –


Coverage

0

Year adopted



Medicine

1 000 100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases

Cape Verde

African Region



2011

%

0 130 000 370 000 500 000

0 26 74

Atlantic Ocean

Parasites and vectors Major plasmodium species: P. falciparum (100%), P. vivax (0%) Major anopheles species: An. gambiae, arabiensis

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100




ITN/LLIN


No No

– –

IRS


Yes No

1998 –

IPT


NO

–

Yes Yes Yes No

1998 2008 2008 –

No

–


Financing

Antimalaria policy

Contribution (US$m)

2007 2007 – – –



Year

No. of studies

Min Median

Max


20

ITNs Diagnostics

15

Data not reported for 2011

10 5

IV.

Follow-up



2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage



80

80

60

60

Cases (%)

100

Population (%)

AL AL QN QN –

25

0

40

40 20

20 0 2000

2001 2002 2003 2004 2005 Modelled % of households ≥1 ITN With access to an ITN in household

Impact

2006

2007

0

2008 2009 2010 2011 At risk protected with IRS All ages who slept under an ITN




Microscopically confirmed cases, admissions and deaths (per 100 000) 100


ABER (%)

100

Positivity rate (%)

Year adopted


30

V.

Medicine

10

1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases


Central African Republic

African Region


Chad


South Sudan 2011

%

4 490 000 0 0 4 490 000

100 0 0

Cameroon


Congo

Major plasmodium species: P. falciparum (100%), P. vivax (0%) Major anopheles species: An. gambiae, arabiensis, funestus

Insufficient data

0

Democratic Republic of the Congo 0–0.1

0.1–1.0

1.0–10

>75 0

PR




ITN/LLIN


Yes No

2006 –

IRS


No No

– –

IPT


Yes

2004

No Yes No Yes

– 2008 – 2008

Yes

2010

III.

Financing

Contribution (US$m)

Case Patients of all ages should receive diagnostic test management RDTs used at community level ACT is free for all ages in public sector Pre-referral treatment with recommended medicines Marketing authorization for all oral artemisinin-based monotherapies withdrawn

8 7 6 5 4 3 2 1 0


Medicine


Year

No. of studies

Max

Follow-up

Diagnostics Data not reported for 2011


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011




80

60

60

Cases (%)

80

Population (%)

Min Median

ITNs

100

40

40 20

20

0


Impact







ABER (%)

100

Positivity rate (%)

2005 – – 2005 –


100

V.

AL AL QN AM ;QN –


Coverage

0

Year adopted


Others Government* Global Fund World Bank USAID/PMI WHO/UNICEF * Expenditure: costs for sub-national level, health systems, human resources, etc not included. IV.

Medicine

100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases

Chad

African Region


Algeria

Niger


%

9 220 000 2 190 000 115 000 11 525 000

80 19 1


Egypt

Libya

Sudan

Nigeria

Parasites and vectors Major plasmodium species: P. falciparum (100%), P. vivax (0%) Major anopheles species: An. gambiae, arabiensis, funestus, nili

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR




ITN/LLIN


Yes Yes

2003 2011

IRS


Yes No

– –

IPT


Yes

2004

Yes No Yes Yes

– – – –

No

–


Financing

Antimalaria policy

Medicine

Year adopted


AL ;AS+AQ AL ;AS+AQ QN AM ;QN –

– – – – –


Year

AS+AQ

2009-2009


No. of studies 2

Contribution (US$m)

0

28 days

800

ITNs

600

Diagnostics

400


200


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage



80

80

60

60

Cases (%)

100

Population (%)

0

Follow-up


1 000

0

40

40 20

20 0

0


Impact


4.0 3.5 3.0 80 2.5 2.0 60 1.5 40 1.0 20 0.5 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 ABER (Micr. & RDT) RDT posivity rate Slide positivity rate



ABER (%)

100


120

Positivity rate (%)

0

Max


1 200

V.

Min Median

100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases


China

Western Pacific Region Russian Federation


Kazakhstan

Mongolia


%

13 500 000 674 000 000 660 000 000 1 347 500 000

1 50 49


India

Parasites and vectors Major plasmodium species: P. falciparum (43%), P. vivax (57%) Major anopheles species: An. minimus, sinensis, anthropophagus, dirus

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

100




Antimalaria policy

ITN/LLIN


Yes Yes

2003 2000

First-line treatment of unconfirmed malaria First-line treatment of P. falciparum

IRS


Yes No

2000 –

IPT


NA

–

For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax

Yes No Yes No Yes

2000 – 2006 – 2006

Case Patients of all ages should receive diagnostic test management RDTs used at community level ACT is free for all ages in public sector Pre-referral treatment with recommended medicines Oral artemisinin-based monotherapies are not registered III.

Financing

Medicine

No. of studies

DHA-PPQ 2009–2011


Min Median

4

0

0

Follow-up

0

28 days


40

ITNs

30

Diagnostics

20


10


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage



100

80

60

60

Cases (%)

80

40

40 20

20 0 2000


Impact

2005

2006

0

2007 2008 2009 2010 2011 Population at high risk protected with IRS Households with at least one ITN




40 000

4

4

30 000

3

3

2

2

1

1



Cases and deaths

5

ABER (%)

V.

2000 2000 2000

Max


IV.

– 2000

60 50

Number of deaths

Contribution (US$m)

Year

50

0


ART+NQ ;ART-PPQ ;AS+AQ ;DHA-PPQ – AM ;AS ;PYR CQ+PQ(8d)


60

Positivity rate (%)

Year adopted

Medicine

40 30

20 000

20

10 000

10

0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Deaths

Confirmed cases

Colombia



Venezuela

Panama

(Bolivarian Republic of)


%

6 950 000 3 610 000 36 400 000 46 960 000

15 8 78


Pacific Ocean

Brazil

Ecuador


Peru

Major plasmodium species: P. falciparum (26%), P. vivax (74%) Major anopheles species: An. albimanus, darlingi, nunestovari, neivai, pseudopunctipenis

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

100





Yes Yes

2005 2005

IRS


Yes No

1958 –

IPT


N/A

–

Yes Yes Yes Yes No

1984 2007 2008 – –


Financing

Contribution (US$m)

35 30 25 20 15 10 5 0

Medicine

Year

No. of studies

Min Median

Max

Follow-up

AS+MQ

2006-2008

4

0

0

1.9

42 days

AL

2007-2010

3

0

0

1.3

28 days


ITNs Diagnostics



2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Coverage

WHO/UNICEF


Others


Cases tested and antimalarials delivered: Programme data (public sector) 100 Source: DHS 2000, Other Nat.

60

60

Cases (%)

80

40

40 20

20


Impact

2006

0





Microscopically confirmed cases, admissions (per 100 000) and deaths 1 000


0 2000

ABER(%)


– 2006 2004 2004 1960s


80

V.

– AS+MQ QN(3d)+CL(5d) QN CQ+PQ


100

Positivity rate (%)




Year adopted

70 60 100 50 40 10 30 20 1 10 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Number of deaths

III.

Medicine

Antimalaria policy

Confirmed cases


Comoros

African Region


Indian Ocean


2011

%

709 000 45 200 0 754 200

94 6 0


Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100




ITN/LLIN


Yes Yes

2005 2010

IRS


Yes No

– –

IPT


Yes

2004

Yes No Yes Yes

1997 – – 1997

Yes

2005


Financing

Antimalaria policy

Medicine

Year

AL

2006-2011


No. of studies

Contribution (US$m)

0

Follow-up

3.2

28 days

Expenditure by intervention in 2011 Insecticides & spray materials ITNs Diagnostics Antimalarial medicines

1


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Others Government* Global Fund World Bank USAID/PMI WHO/UNICEF * Expenditure: costs for sub-national level, health systems, human resources, etc not included.

Coverage



80

80

60

60

Cases (%)

100

Population (%)

0

Max

2

0

40

40 20

20

0


Impact







ABER (%)

50

Positivity rate (%)

– – – – –

Min Median

12

3

V.

AL AL QN QN –


4

0

Year adopted


5

IV.

Medicine

1 000 100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases

Congo

African Region


Cameroon


2011

%

4 140 000 0 0 4 140 000

100 0 0

Gabon


Parasites and vectors Major plasmodium species: P. falciparum (100%), P. vivax (0%) Major anopheles species: An. gambiae, arabiensis, funestus, brochieri, coustani, hancocki, hargreavesi, melas, moucheti, moucheti, nili, paludis

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR


II. Intervention policies and strategies




Yes No

2007 –

IRS


Yes No

– –

IPT


Yes

2006

Yes No No No

– – – –


Financing

No

–


Medicine

Year

No. of studies

Contribution (US$m)

Follow-up

1

5.6

5.6

5.6

28 days

1

2.8

2.8

2.8

28 days


Expenditure by intervention in 2011 Insecticides & spray materials ITNs Diagnostics


1


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Coverage




100

Source: DHS 2005, Other Nat.

80

60

60

Cases (%)

80

40

40 20

20

0


70 6 60 5 50 4 40 3 30 2 20 1 10 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 ABER (Micr. & RDT) RDT posivity rate Slide positivity rate




Impact

ABER (%)

Population (%)

Max

2005-2005


Positivity rate (%)

Min Median

2006-2006

2

V.

– – – – –

AL

3

0

AS+AQ AS+AQ AL QN –

AS+AQ

4

IV.

Year adopted


5

0

Medicine

1 000 100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases


Costa Rica


Nicaragua Phase: Control. Impact: >75% decrease in case incidence 2000–2011.

Caribbean Sea


%

47 300 1 610 000 3 070 000 4 727 300

1 34 65


Panama Pacific Ocean

Parasites and vectors Major plasmodium species: P. falciparum (24%), P. vivax (76%) Major anopheles species: An. albimanus

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

100





Yes Yes

2009 2009

IRS


Yes No

1957 –

IPT


N/A

–

No No No – No

– – – – –

III.

Financing

Contribution (US$m)


8 7 6 5 4 3 2 1 0


– – – – –

Medicine

Year

No. of studies

Min Median

Max

Follow-up

Insecticides & spray materials ITNs No data reported for 2011


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Coverage

WHO/UNICEF


Others



60

60

Cases (%)

80

40

40 20

20

Impact

2006

0




30

5

25

4

20 15 10 5

3 2 1




4 000 10 9 3 500 8 3 000 7 2 500 6 5 2 000 4 1 500 3 1 000 2 500 1 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Deaths

Confirmed cases

Number of deaths


Cases

0 2000

ABER(%)


Year adopted


80

V.

Medicine


100

Positivity rate (%)




Antimalaria policy

Côte d’Ivoire

African Region Mali


Burkina Faso

Guinea


%

20 200 000 0 0 20 200 000

100 0 0


Ghana Liberia


Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR




ITN/LLIN


Yes No

2006 –

IRS


No No

– –

IPT


Yes

2005

Yes Yes Yes No

– – – –

III.

Financing

Contribution (US$m)


70 60 50 40 30 20 10 0

No

–


Medicine

Year

No. of studies

Max

Follow-up

2005–2009

4

0

2.1

7.4

28 days

2

0

0

0

28 days





2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Coverage



60

60

Cases (%)

80

40

40 20

20

0






Impact

ABER (%)

Population (%)

Min Median

2008–2009

80

Positivity rate (%)

2003 2003 2003 2003 –

AS+AQ

100

V.


AL

100

0

Year adopted



Medicine

100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases


Democratic People’s Republic of KoreaSouth-East Asia Region Phase: Pre-elimination. Impact: >75% decrease in case incidence 2000–2011.

China


%

123 15 200 000 9 270 000 24 470 000

62 38

Population (UN Population Division) Number of active foci Number of people living within active foci Number of people living in malaria-free areas Total Parasites and vectors Major plasmodium species: P. vivax (100%) Major anopheles species: An.sinensis

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100




ITN/LLIN


Yes Yes

2002 2002

IRS


Yes No

2007 –


Yes No Yes

1953 – 2000


No No

– –

III.

Financing


Medicine


Contribution (US$m)

– – – – –

Year

No. of studies

Min Median

Max

Follow-up


8

ITNs

6

Diagnostics

4


2


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage



100

80

60

60

Cases (%)

80

40

40 20

20

0


Impact

2006



100

5

80

4

60

3

40

2

20

1



2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Suspected cases tested Cases potentially treated with any antimalarial P. falciparum cases potentially treated with ACT Microscopically confirmed malaria cases and indigenous cases


0 2000

ABER (%)


– – – CQ+PQ(14d)


10

0

Positivity rate (%)

Year adopted


12

V.

Medicine

Antimalaria policy

160 000 140 000 120 000 100 000 80 000 60 000 40 000 20 000 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Confirmed cases


South Sudan


Cameroon

2011

%

65 700 000 2 030 000 0 67 730 000

97 3 0

Population (UN Population Division)

Kenya

Uganda

Gabon Congo

I. Epidemiological profile High transmission (≥1 case per 1000 population) Low transmission (0-1 cases per 1000 population) Malaria-free (0 cases) Total

African Region


Atlantic Ocean

Angola

Zambia

Parasites and vectors Major plasmodium species: P. falciparum (100%), P. vivax (0%) Major anopheles species: An. gambiae, funestus, nili, moucheti

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR




ITN/LLIN


Yes Yes

2006 2008

IRS


Yes Yes

2007 2008

IPT


Yes

2005

Yes Yes Yes No

2007 2008 2006 –

No

–


Financing


Medicine

Year

AS+AQ

2005-2009


No. of studies

Contribution (US$m)

2005 2005 2005 2005 –

Min Median

7

0

3.7

Max

Follow-up

6.9

28 days


200

ITNs

150

Diagnostics

100


50


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage



100

Source: DHS 2007

80

60

60

Cases (%)

80

40

Impact


80

10

40 20



100

60

0


8 6 4 2


10 000


0

40 20

20

ABER (%)

Population (%)


250

0

Positivity rate (%)

Year adopted


300

V.

Medicine

1 000 100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases


Djibouti


Eritrea Phase: Control. Impact: Insufficiently consistent data to assess trends.


%

0 453 000 453 000 906 000

0 50 50


Gulf of Aden

Ethiopia


Somalia

Major plasmodium species: P. falciparum (100%), P. vivax (0%) Major anopheles species: An. arabiensis

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

100





Yes No

2008 –

IRS


Yes No

2006 –

IPT


NA

–

Yes No Yes No No

2007 – 2007 – –


Financing


Medicine


Year

No. of studies

Contribution (US$m)

2008 2008 2008 – –

Min Median

Max


0.6

Diagnostics

0.4


0.2


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage



100

Source: MICS 2006, MIS 2009.

80

60

60

Cases (%)

80

40

2006

0


25

1.0

20

0.8

15 10

0.6 0.4 0.2





ABER (%)




Impact

40 20

20

V.

Follow-up


0.8

0


AS+SP AS+SP AL QN CQ+PQ(14d)


1.0

Positivity rate (%)

Year adopted

1 000

35 30 25 100 20 15 10 10 5 1 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases

Number of deaths

III.

Medicine

Antimalaria policy

Dominican Republic


Phase: Control. Impact: Increase in case incidence 2000–2015.

Atlantic Ocean


Haiti 2010

%

432 000 8 180 000 1 450 000 10 062 000

4 81 14


Caribbean Sea

Parasites and vectors Major plasmodium species: P. falciparum (100%), P. vivax (0%) Major anopheles species: An. albimanus

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

100





Yes Yes

2008 2008

IRS


Yes No

1946 –

IPT


NA

–

Yes No No No No

1964 – – – –


Financing

Medicine

Year adopted


CQ+PQ CQ+PQ(3d) AS+D CQ ;QN CQ+PQ

– – – – –



Contribution (US$m)

Max

Diagnostics

4


2


IV.

Follow-up

ITNs

6


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Coverage

WHO/UNICEF


Others



100

80

60

60

Cases (%)

80

40


2006

0




4.0 7 3.5 6 3.0 5 2.5 4 2.0 3 1.5 2 1.0 1 0.5 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 ABER (Micr. & RDT) RDT posivity rate Slide positivity rate


Cases

Impact

40 20

20

ABER (%)


Min Median


8

0

Positivity rate (%)

No. of studies


10

V.

Year

4 500 4 000 3 500 3 000 2 500 2 000 1 500 1 000 500 0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Deaths

18 16 14 12 10 8 6 4 2 0

Number of deaths

III.

Antimalaria policy

Confirmed cases


Ecuador



Colombia


%

220 000 8 650 000 5 790 000 14 660 000

2 59 39


Pacific Ocean

Peru

Parasites and vectors Major plasmodium species: P. falciparum (24%), P. vivax (76%) Major anopheles species: An. albimanus, punctimacula, pseudopunctipennis, neivai

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

100





Yes No

2004 –

IRS


Yes No

2005 –

IPT


N/A

–

Yes Yes Yes No Yes

1956 2006 2006 – –


Financing


Medicine

Year

AS+SP

2005–2006


Contribution (US$m)

– 2004 2004 2004 2004

No. of studies

Min Median

1

0

0

Max

Follow-up

0

28 days


8

ITNs

6

Diagnostics

4


2


IV.


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Coverage

WHO/UNICEF


Others



100 80

80

60

60

Cases (%)


AS+SP AL QN CQ+PQ


10

0

40

40 20

20 0 2000


Impact

2005

2006

0

2007 2008 2009 2010 2011 Population at high risk protected with IRS Households with at least one ITN





25


10 000

Cases

8 000

ABER (%)

Positivity rate (%)

Year adopted


12

V.

Medicine

6 000 4 000 2 000 0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Deaths Confirmed cases

18 16 14 12 10 8 6 4 2 0

Number of deaths

III.

Antimalaria policy

El Salvador



Guatemala

Honduras


%

0 1 260 000 4 960 000 6 220 000

0 20 80


Pacific Ocean

Parasites and vectors Major plasmodium species: Major anopheles species:

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

100





Yes Yes

– –

IRS


Yes No

– –

IPT


N/A

–

Yes No No No No

2010 – – – –


Financing

4.0 3.5 3.0 2.5 2.0 1.5 1.0 0.5 0

– – – – –

Medicine

Year

No. of studies

Min Median

Max

Follow-up


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Coverage

WHO/UNICEF


Others



60

60

Cases (%)

80

40

Impact

2006


100

20

40 20



120

60

0


15 10 5


800 10 700 8 600 500 6 400 4 300 200 2 100 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Deaths Confirmed cases

Number of deaths

0 2000

80

40 20

20

ABER (%)





Positivity rate (%)

Year adopted


100

V.

Medicine





Cases

Contribution (US$m)

III.

Antimalaria policy


Equatorial Guinea

African Region


Cameroon


2011

%

720 000 0 0 720 000

100 0 0

Atlantic Ocean

Gabon

Parasites and vectors Major plasmodium species: P. falciparum (100%), P. vivax (0%) Major anopheles species: An. gambiae, cinctus, melas

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR




ITN/LLIN


Yes No

2007 –

IRS


Yes No

2005 –

IPT


Yes

–

Yes No Yes Yes

2005 – 2008 2008

No

–


Financing


Medicine

Year

AS+AQ

2006-2006


No. of studies 1

Contribution (US$m)

3.3

28 days

3.3

10


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Coverage



80

80

60

60

Cases (%)

100

40

40 20

20

0


100

10

80

8

60

6

40

4

20

2






Impact

ABER (%)

Population (%)

3.3



Positivity rate (%)

Follow-up


5

V.

2004 2004 2004 2004 –

Max

ITNs

0


Min Median

15

IV.

Year adopted


20

0

Medicine

1 000 100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases

Eritrea

African Region

Phase: Control. Impact: >75% decrease in admission rates projected 2000–2015.

Saudi Arabia Red Sea


Sudan 2011

%

3 840 000 1 570 000 0 5 410 000

71 29 0

Yemen

Ethiopia

Parasites and vectors Major plasmodium species: P. falciparum (68%), P. vivax (32%) Major anopheles species: An. arabiensis

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100




ITN/LLIN


Yes Yes

2002 2000

IRS


Yes No

1995 –

IPT


No

–

Yes Yes Yes Yes

1997 2008 2007 2002

Yes

–


Financing


Medicine

Year

AS+AQ

2006-2010


No. of studies

Contribution (US$m)

Antimalarial medicines Human resources & technical assistance

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011




80

80

60

60

Cases (%)

100

40

40 20

20

0




100

2.0

80

1.5 1.0 0.5


1 000


Impact

ABER (%)

Population (%)

100

Positivity rate (%)

28 days


Coverage

20

7.9

Diagnostics



40

4.6

Follow-up

ITNs

5

60

0

Max


10

V.

2007 2007 2007 2007 –


15

0

CQ+SP AS+AQ QN QN CQ+PQ

Min Median

8

20

IV.

Year adopted


25

0

Medicine

100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases


Ethiopia

African Region


Yemen Sudan Gulf of Aden


%

847 000 55 900 000 28 000 000 84 747 000

1 66 33


Somalia South Sudan


Kenya

Major plasmodium species: P. falciparum (55%), P. vivax (45%) Major anopheles species: An. arabiensis, funestus, pharoensis, nili

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR




ITN/LLIN


Yes Yes

2004 2004

IRS


Yes No

1960 –

IPT


No

–

Yes Yes Yes Yes

1960 2004 2004 1997

No

–


Financing

Antimalaria policy

Year

Max

Follow-up

AL

2003–2009

9

0

0

7.5

28 days

QN

2006–2006

1

10

10

10

28 days


No. of studies


Contribution (US$m)

Insecticides & spray materials Diagnostics Antimalarial medicines

50


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage



100

Cases (%)

80

40

60 40 20

20

0


7 70 6 60 5 50 4 40 3 30 2 20 1 10 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 ABER (Micr. & RDT) RDT posivity rate Slide positivity rate





Impact

ABER (%)


Source: DHS 2005

60

V.

Min Median

100

0

2004 2004 2004 2004 2004

Medicine

ITNs

80

AL AL QN QN CQ


150

IV.

Year adopted


200

0

Medicine

1 000 100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases

French Guiana, France



Atlantic Ocean


%

203 000 34 400 0 237 400

86 14 0


Suriname

Brazil

Parasites and vectors Major plasmodium species: P. falciparum (32%), P. vivax (68%) Major anopheles species: An. darlingi

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100





No Yes

– 2005

IRS


Yes No

– –

IPT


N/A

–

Case Patients of all ages should receive diagnostic test Yes management RDTs used at community level No ACT is free for all ages in public sector – Pre-referral treatment with recommended medicines No Oral artemisinin-based monotherapies are not registered –

– – – – –

Financing


Medicine


Year

No. of studies


4

Max

Follow-up

Diagnostics Antimalarial medicines Monitoring and evaluation

2


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Coverage

WHO/UNICEF


Others



60

60

Cases (%)

80

40


2006

0




2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Suspected cases tested Cases potntially treated with any antimalarial


ABER (%)

Impact

40 20

20

Cases

Contribution (US$m)

6

100


Min Median

ITNs


Positivity rate (%)

– – – – –


8

V.

AL QN+D – CQ+PQ


10

IV.

Year adopted


12

0

Medicine

4 500 10 4 000 8 3 500 3 000 6 2 500 2 000 4 1 500 1 000 2 500 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Deaths

Number of deaths

III.

Antimalaria policy

Confirmed cases


Gabon

African Region



2011

%

1 530 000 0 0 1 530 000

100 0 0

Congo

South Atlantic Ocean

Parasites and vectors Major plasmodium species: P. falciparum (100%), P. vivax (0%) Major anopheles species: An. gambiae, funestus, melas

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR




ITN/LLIN


Yes Yes

2003 2007

IRS


No No

– –

IPT


Yes

2003

Yes Yes Yes Yes

2009 2010 2003 2003

Yes

2003

III.

Financing

Contribution (US$m)


7 6 5 4 3 2 1 0


Medicine

Year

AS+AQ

2004–2005


No. of studies 1

Max

Follow-up

13.8

13.8

28 days

13.8

Diagnostics



2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Coverage



60

60

Cases (%)

80

40

40 20

20

0







Impact

ABER (%)

Population (%)

Min Median

ITNs

80

Positivity rate (%)

2003 2003 2003 2003 –


100

V.



100

0

Year adopted



Medicine

1 000 100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases

Gambia

African Region


Senegal


2011

%

1 780 000 0 0 1 780 000

100 0 0


Guinea-Bissau

Major plasmodium species: P. falciparum (100%), P. vivax (0%) Major anopheles species: An. gambiae, arabiensis, funestus, melas, pharoensis, nili

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100




ITN/LLIN


Yes Yes

2000 1998

IRS


Yes Yes

2008 2008

IPT


Yes

2002

Yes No Yes Yes

2009 – 2008 1998

No

–


Financing

Antimalaria policy

Medicine

Year

AL

2007-2010


No. of studies

Contribution (US$m)

0

2.5

Max

Follow-up

11.9

28 days


6

Diagnostics

4


2


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Coverage



80

80

60

60

Cases (%)

100

Population (%)

Min Median

4


40

40 20

20

0


Impact





ABER (%)

50


60

Positivity rate (%)

2005 2005 2005 2005 –

8

0

V.

AL AL QN QN –


10

0

Year adopted


12

IV.

Medicine

1 000 100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases


Georgia

European Region

Phase: Elimination. Impact: >75% decrease in case incidence 2000–2011. Since 2003 malaria cases have been on the decline. In 2011 only 1 indigenous case (1st generation local transmission) was reported. The goal of national malaria elimination strategy is to eliminate P. vivax malaria by.

Russian Federation

I. Epidemiological profile Population (UN Population Division) Number of active foci Number of people living within active foci Number of people living in malaria-free areas Total

2011

%

0 45 000 4 280 000 4 325 000

1 99

Black Sea

Turkey

Parasites and vectors Major plasmodium species: P. vivax (0%) Major anopheles species: An.sacharovi

Insufficient data

0

Azerbaijan

Armenia

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100




ITN/LLIN


No No

– –

IRS


Yes No

2000 –


Yes Yes Yes

2000 – 2000


Yes Yes

2000 2000

III.

Financing


Contribution (US$m)

– – – – CQ+PQ(14d)

– – – – –

Medicine

Year


No. of studies

Min Median

Max


0,8

ITNs

0,6

Diagnostics

0,4


0,2


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage



100

80

60

60

Cases (%)

80

40

0






Microscopically confirmed malaria cases and indigenous cases 500


Impact

ABER (%)

V.

40 20

20 0

Follow-up


1,0

0


Year adopted


1,2

Positivity rate (%)

Medicine

Antimalaria policy

400 300 200 100 0 2000 2001

2002 2003

2004 2005 2006 2007 Indigenous malaria cases

2008 2009 2010 2011 Confirmed malaria cases

Ghana

African Region Mali


Burkina Faso Benin


Togo 2011

%

25 000 000 0 0 25 000 000

100 0 0


Nigeria

Côte d'Ivoire

Gulf of Guinea

Parasites and vectors Major plasmodium species: P. falciparum (100%), P. vivax (0%) Major anopheles species: An. gambiae, arabiensis, funestus

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR





Yes Yes

2004 2004

IRS


Yes No

2005 –

IPT


Yes

2003

Yes Yes No Yes

2008 2009 – 2009


Financing

Yes

2010

Antimalaria policy

Medicine

Year adopted


AS+AQ AL ;AS+AQ QN QN –

2004 2004 2004 2004 –


Year

No. of studies

2003–2006

4

0

4.3

14

28 days

2003–2007

5

1.7

4

13.8

28 days



Contribution (US$m)

80

ITNs

60

Diagnostics

40


20


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage



100

Source: DHS 2003, DHS 2008

80

80

60

60

Cases (%)

Population (%)

Follow-up

AL

100

0

40

40 20

20 0

0


Impact





ABER (%)

100


120

Positivity rate (%)

Max

AS+AQ

120

V.

Min Median

1 000 100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases


Guatemala



Caribbean Sea

Belize Mexico


%

2 210 000 4 500 000 8 040 000 14 750 000

15 31 55


Honduras Pacific Ocean

Parasites and vectors Major plasmodium species: P. falciparum (1%), P. vivax (99%) Major anopheles species: An. albimanus, pseudopunctipennis, darlingi

El Salvador

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100





Yes Yes

2006 2006

IRS


No No

– –

IPT


N/A

–

Yes Yes No No No

– 2006 – – –


Financing

16 14 12 10 8 6 4 2 0

CQ+PQ – CQ CQ+PQ

– – – – –

Medicine

Year

No. of studies

Min Median

Max

Follow-up

Insecticides & spray materials ITNs Diagnostics Antimalarial medicines Monitoring and evaluation Human resources & technical assistance

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Others



60

60

Cases (%)

80

40

20


Impact

40

2006

0





25

6

20

5

15 10 5

4 3 2

10 8

40 000

6 4

20 000

2

1



60 000

0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Deaths

Confirmed cases

Number of deaths

Coverage

WHO/UNICEF

ABER (%)

Households or population (%) Positivity rate (%)

Year adopted


100

V.

Medicine





Cases

Contribution (US$m)

III.

Antimalaria policy

Guinea

African Region



%

10 200 000 0 0 10 200 000

100 0 0

Population (UN Population Division) High transmission (≥1 case per 1000 population) Low transmission (0-1 cases per 1000 population) Malaria-free (0 cases) Total Parasites and vectors Major plasmodium species: P. falciparum (100%), P. vivax (0%) Major anopheles species: An. gambiae, funestus, melas

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR




ITN/LLIN


Yes Yes

2007 2009

IRS


No No

– –

IPT


Yes

2008

Yes Yes Yes Yes

2010 2010 2009 2010

No

–


Financing


Medicine

Year

AS+AQ

2004–2004


No. of studies

Contribution (US$m)


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Coverage of ITN and IRS Source: DHS 2005

80

60

60

Cases (%)

80

40

0




2.0 1.5 1.0 0.5



Impact

20

40 20

20

ABER (%)



100

40

28 days


Coverage

60

1

Diagnostics


80

1

Follow-up

ITNs

5

100

1

Max


10

V.

– – – – –


15

0


Min Median

1

20

IV.

Year adopted


25

0

Medicine

1 000 100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases


Guinea-Bissau

African Region Senegal



2011

%

1 550 000 0 0 1 550 000

100 0 0

Guinea Atlantic Ocean


Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR




ITN/LLIN


Yes No

2005 –

IRS


Yes No

2006 –

IPT


Yes

2005

Yes No No Yes

2008 – – 2003

No

–


Financing

Antimalaria policy

Medicine

Year

AL

2006-2008


No. of studies 1

Contribution (US$m)

– – – – –

Min Median

Max

Follow-up

3.6

3.6

28 days

3.6


80

ITNs

60

Diagnostics

40


20


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage



80

80

60

60

Cases (%)

100

40

0


Impact







0

40 20

20

ABER (%)

Population (%)

AL AL QN QN –


100

0

Positivity rate (%)

Year adopted


120

V.

Medicine

1 000 100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases

Guyana



Atlantic Ocean Venezuela (Bolivarian Republic of)


%

265 000 439 000 52 900 756 900

35 58 7



Suriname

Brazil


Brazil

Major plasmodium species: P. falciparum (69%), P. vivax (31%) Major anopheles species: An. darlingi, aquasalis

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100





Yes Yes

2005 2005

IRS


No No

– –

IPT


N/A

–

Yes No Yes Yes Yes

1946 – 2005 2005 2004


Financing

Medicine

Year

AL

2004–2008


No. of studies

0

1.6

Max

Follow-up

3.2

28 days


ITNs Diagnostics


1.0 0.5


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Coverage

WHO/UNICEF


Others



100

Source: DHS 2009.

80

60

60

Cases (%)

80

40


Impact

40 20

20

2006

0

2007 2008 2009 2010 2011 Population at high risk protected with ITNs With access to an ITN in household


35 30 15 25 20 10 15 10 5 5 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 ABER (Micr. & RDT) RDT posivity rate Slide positivity rate



ABER (%)

20

10 000

25

1 000

20


Contribution (US$m)

Min Median

2

1.5



– 2004 2004 – 2004


0

Positivity rate (%)

– AL+PQ QN+T – CQ+PQ


2.0

V.

Year adopted


2.5

IV.

Medicine

15

100

10

10

5

Number of deaths

III.

Antimalaria policy

0 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases


Haiti

Region of the Americas Cuba



%

5 370 000 4 760 000 0 10 130 000

53 47 0


Caribbean Sea Dominican Republic

Parasites and vectors Major plasmodium species: P. falciparum (100%), P. vivax (0%) Major anopheles species:

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100





Yes Yes

2011 2005

IRS


Yes No

– –

IPT


N/A

–

Yes No Yes No No

1988 – – – –


Financing


Medicine


Year

No. of studies

Contribution (US$m)

Min Median

Max

Follow-up

ITNs

6

Diagnostics


4 2


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Coverage

WHO/UNICEF


Others



100

80

60

60

Cases (%)

80

40

40 20

20 0 2000


Impact

2006

0




ABER (%)

100





– – – – –


0

Positivity rate (%)

– CQ+PQ – – –


8

V.

Year adopted


10

IV.

Medicine

1 000

35 30 25 100 20 15 10 10 5 1 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases

Number of deaths

III.

Antimalaria policy

Honduras



Belize

Caribbean Sea


%

1 090 000 4 560 000 2 110 000 7 760 000

14 59 27


Guatemala

El Salvador

Parasites and vectors Major plasmodium species: P. falciparum (8%), P. vivax (92%) Major anopheles species: An. albimanus, darlingi, pseudopunctipennis, aquasalis

Insufficient data

0

Nicaragua

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100





Yes Yes

2009 2009

IRS


Yes No

– –

IPT


N/A

–

Yes No Yes No No

– – – – –


Financing


Medicine

Year

CQ

2008–2009


– – 2011 – –

No. of studies

Min Median

1

0

0

Max

Follow-up

0

28 days


2.0

ITNs

1.5

Diagnostics

1.0


0.5




2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Coverage

WHO/UNICEF


Others



100

Source: Other Nat.

80

60

60

Cases (%)

80

40


V.

Impact

40 20

20

2006

0





40 000

10

20

4

30 000

8

15

3

10

2

5

1


Cases

25

ABER (%)

Contribution (US$m)

– CQ+PQ SP QN CQ+PQ

2.5

0


Year adopted


3.0

Positivity rate (%)

Medicine

6

20 000

4

10 000

2

Number of deaths

III.

Antimalaria policy

0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Deaths

Confirmed cases


India


Phase: Control. Impact: 50%–75% decrease in case incidence projected 2000–2015. Afghanistan China

Pakistan Bhutan


Bangladesh

2010

%

273 000 000 832 000 000 137 000 000 1 242 000 000

22 67 11


Myanmar Arabian Sea

Thailand

Bay of Bengal

Parasites and vectors Major plasmodium species: P. falciparum (51%), P. vivax (49%) Major anopheles species: An. stephensi, culicifacies, fluviatilis, minimus, dirus, annularis

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100




ITN/LLIN


Yes Yes

2001 2001

IRS


Yes Yes

1953 1953

IPT


NA

–

Yes Yes Yes Yes Yes

1958 2006 2006 1977 2009


Financing

160 140 120 100 80 60 40 20 0


Medicine

Year

AS+SP

2005–2007


No. of studies 9

0

0

Max

Follow-up

4

28 days


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Coverage



60

60

Cases (%)

80

40

0

2006



1 000

10

8 6 4

9

2 8 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 ABER (Micr. & RDT) RDT posivity rate Slide positivity rate



Microscopically confirmed cases, admissions (per 100 000) and deaths Cases and admissions rate (log.)


Impact

40 20

20

ABER (%)


Min Median


10

Positivity rate (%)

2007 2007 – 2007 2007


100

V.

AS+SP ;PQ AS+SP ;PQ QN+D ;QN+T AM ;AS ;QN CQ+PQ(14d)



Year adopted

1 800 1 600 1 400 100 1 200 1 000 800 10 600 400 200 1 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Total microscopically confirmed cases

Number of deaths

Contribution (US$m)

III.

Medicine

Antimalaria policy

Indonesia



Malaysia


%

41 200 000 107 000 000 94 500 000 242 700 000

17 44 39


Indian Ocean


Australia

Major plasmodium species: P. falciparum (55%), P. vivax (45%) Major anopheles species: An. sundaicus, balabacensis, maculatus, farauti, subpictus

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100





Yes Yes

2006 –

IRS


Yes No

1959 –

IPT


NA

–

Yes Yes Yes Yes Yes

2007 2005 2004 2004 –

Case Patients of all ages should receive diagnostic test management RDTs used at community level ACT is free for all ages in public sector Pre-referral treatment with recommended medicines Oral artemisinin-based monotherapies are not registered III.

Financing

Antimalaria policy

First-line treatment of unconfirmed malaria First-line treatment of P. falciparum AS-AQ/DHA-PP+PQ For treatment failure of P. falciparum QN+D+PQ Treatment of severe malaria AM ;AS ;QN Treatment of P. vivax AS-AQ/DHA-PP+PQ(14d)

Medicine

Year

AS+AQ

2003–2006

8

0

DHA+PPQ 2004–2008

3

2.7


No. of studies

Contribution (US$m)

Follow-up

8.8

24.1

28 days

4.1

4.8

42 days

ITNs

30

Diagnostics

20


10


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Coverage



100

Source: DHS 2007, Other Nat.

80

60

60

Cases (%)

80

40

20

20

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Population at high risk protected with ITNs Population at high risk protected with IRS All ages who slept under an ITN Households with at least one ITN Malaria test positivity rate and ABER

40 2.5 35 2.0 30 25 1.5 20 1.0 15 10 0.5 5 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 ABER (Micr. & RDT) RDT posivity rate Slide positivity rate




Impact

ABER (%)

0

40

1 000 900 800 100 700 600 500 10 400 300 200 1 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Number of deaths

IV. Households or population (%)

Max



Positivity rate (%)

Min Median


40

0

– 2008 2004 2004 2004


50

V.

Year adopted

Medicine

Admissions

Deaths

Confirmed cases


Iran (Islamic Republic of )



Caspian Sea

Turkey

Uzbekistan

Turkmenistan



Iraq

%

694 999 000 73 000 000 74 000 000

Afghanistan

84

Pakistan

Saudi Arabia

Parasites and vectors Major plasmodium species: P. falciparum (12%), P. vivax (88%) Major anopheles species: An.stephensi, culicifacies, fluviatilis, Superpictus

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100




ITN/LLIN


Yes No

2005 2005

IRS


Yes No

– –


Yes Yes Yes

– 1948 1948


Yes Yes

2010 1981

Contribution (US$m)

III.

Financing

16 14 12 10 8 6 4 2 0


Medicine

Year

AS+SP

2005-2010


No. of studies

Min Median

8

0

0

Max

Follow-up

0.5

28 days


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Coverage



80

80

60

60

Cases (%)


– 2006 2006 2006 2005


40

0

40 20

20

0


Impact





25 000


ABER (%)

10

Positivity rate (%)

AS+SP AL AS ;QN CQ+PQ(14d)


100

V.

Year adopted



Medicine

Antimalaria policy

20 000 15 000 10 000 5 000 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Indigenous malaria cases Confirmed cases

Iraq

Eastern Mediterranean Region Turkey

Phase: Prevention of re-introduction. Impact: >75% decrease in case incidence 2000–2011.

Syrian Arab Republic



Islamic Republic of Iran

%

0 0 27 600 000 27 600 000

Jordan 100

Saudi Arabia

Parasites and vectors Major plasmodium species: P. vivax (0%) Major anopheles species: An.stephensi, superpictus, pulcherrimus

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100




ITN/LLIN


No No

– –

IRS


– No

– –


Yes Yes Yes

1957 1957 1957


Yes Yes

1957 1961

Contribution (US$m)

III.

Financing

1.6 1.4 1.2 1.0 0.8 0.6 0.4 0.2 0


Medicine


No. of studies

Min Median

Max

Follow-up


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011




80

80

60

60

Cases (%)


Year


40

40 20

20

0


Impact




0.5

0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 RDT posivity rate Slide positivity rate


1.0

Positivity rate (%)

– 2006 2006 – –

ITNs

100

V.

AL QN+D QN CQ+PQ(14d)


Coverage

0

Year adopted



Medicine

Antimalaria policy

1 500 1 000 500 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Confirmed cases


Kenya

African Region South Sudan


Ethiopia Somalia


Uganda 2011

%

15 000 000 16 600 000 9 990 000 41 590 000

36 40 24


Indian Ocean



Major plasmodium species: P. falciparum (100%), P. vivax (0%) Major anopheles species: An. gambiae, arabiensis, funestus, merus

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR




ITN/LLIN


Yes Yes

2006 2010

IRS


Yes No

2003 –

IPT


Yes

2001

Yes No Yes Yes

2009 – 2006 2006

No

–


Financing

Antimalaria policy

Medicine

Year

AL

2002–2008


No. of studies

Contribution (US$m)

28 days

Diagnostics



2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Coverage




Source: DHS 2003, MIS 2007, DHS 2008, Other Nat.

80

60

60

Cases (%)

80

40

40 20

20

0


50

10

40

8

30

6

20

4

10

2






Impact

ABER (%)

Population (%)

6.6

ITNs


Positivity rate (%)

2.7

Follow-up


20

V.

0

Max


40

0

2004 2004 2004 2004 –

Min Median

12

60

100

AL AL QN QN –


80

IV.

Year adopted


100

0

Medicine

1 000 100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases

Kyrgyzstan

European Region

Phase: Elimination. Impact: >75% decrease in case incidence 2000–2011. Zero indigenous malaria cases were reported in the country in 2011. Kyrgyzstan shows strong political commitment to the Tashkent Declaration. Malaria control is supported by the government, WHO and the Global Fund.

Kazakhstan



%

2 22 900 5 370 000 5 392 900

100

China Tajikistan

Parasites and vectors Major plasmodium species: P. vivax (0%) Major anopheles species: An.superpictus, pulcherrimus, claviger

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100





Yes yes

2003 2006

IRS


– No

– –


Yes Yes Yes

2002 2002 2002


Yes No

2002 –

III.

Financing

Contribution (US$m)

ITN/LLIN

2 1 1 1 1 0 0 0


Medicine


No. of studies

Min Median

Max

Follow-up


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Coverage



60

60

Cases (%)


Year

ITNs

40

40 20

20

0


Impact



4 000 3 500 4 3 000 2 500 3 2 000 2 1 500 1 000 1 500 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 ABER (Micr. & RDT) RDT posivity rate Slide positivity rate


ABER (%)


5

Positivity rate (%)

– – – – –


80

V.

– – – – CQ+PQ(14d)


100

0

Year adopted


Global Fund World Bank USAID/PMI WHO/UNICEF Others Government* * Expenditure: costs for sub-national level, health systems, human resources, etc not included. IV.

Medicine

Antimalaria policy

2 500 2 000 1 500 1 000 500 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011




Lao People’s Democratic Republic

Western Pacific Region China


Viet Nam

Myanmar


%

2 260 000 1 450 000 2 580 000 6 290 000

36 23 41


South China Sea

Thailand

Parasites and vectors Major plasmodium species: P. falciparum (93%), P. vivax (7%) Major anopheles species: An. minimus, dirus, maculatus, jeyporiensis

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100




ITN/LLIN


Yes Yes

2003 2000

IRS


Yes No

2010 –

IPT


NA

–

Yes Yes Yes Yes Yes

2003 2005 2005 2005 2008


Financing


Medicine

Year

AL

2007–2012


No. of studies

Contribution (US$m)

0

1.5

Max

Follow-up

8.3

28 days


6

Diagnostics

4


2


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage



100

80

60

60

Cases (%)

80

40


2006

0



20

10

15

8

10 5

6 4 2



2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Suspected cases tested Cases potentially treated with any antimalarial P. falciparum cases potentially treated with ACT Microscopically confirmed cases and deaths

Cases

Impact

40 20

20

ABER (%)


– 2000 2000 2000 2000

Min Median

8

8

0

Positivity rate (%)

AL QN+D AS+AL CQ+PQ(14d)


10

V.

Year adopted

45 000 400 40 000 350 35 000 300 30 000 250 25 000 200 20 000 150 15 000 100 10 000 50 5 000 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases

Number of deaths

III.

Medicine

Antimalaria policy

Liberia

African Region


Guinea

Sierra Leone


2011

%

4 130 000 0 0 4 130 000

100 0 0

Côte d'Ivoire

Atlantic Ocean

Parasites and vectors Major plasmodium species: P. falciparum (100%), P. vivax (0%) Major anopheles species: An. gambiae

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR





Yes Yes

2005 2008

IRS


Yes No

2009 –

IPT


Yes

2001

Yes Yes Yes No

2005 – 2005 –

Yes

–

III.

Financing

Contribution (US$m)


35 30 25 20 15 10 5 0


Medicine

Year

AS+AQ

2007-2007


No. of studies 2

0

28 days

Monitoring and evaluation Human resources & technical assistance Management and other costs


Cases tested and antimalarials delivered: Programme data (public sector) 100 Source: MIS 2009, MIS 2011

Cases (%)

60

40

40 20

20

0




100

60

80

50 40 30 20 10


100 000


Impact

ABER (%)


0

Follow-up


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

60

20

0

Max

Diagnostics


80

40

Min Median


80

60

2004 2004 2004 2004 –

ITNs

100

V.



Coverage

0

Year adopted



Medicine

10 000 1 000 100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases


Madagascar

African Region

Phase: Control. Impact: 50%–75% decrease in admission rates projected 2000–2015.

Mozambique


%

6 390 000 14 900 000 0 21 290 000

30 70 0


Indian Ocean


Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100





Yes Yes

2004 2009

IRS


Yes No

1993 –

IPT


Yes

2006

Yes Yes Yes No

2006 2010 2006 –

No

–

III.

Financing

Contribution (US$m)


80 70 60 50 40 30 20 10 0


Medicine

Year

AS+AQ

2006–2007


No. of studies

Min Median

10

0

0

Max

Follow-up

8.7

28 days


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Coverage



Cases tested and antimalarials delivered: Programme data (public sector) 100 Source: DHS 2009, MIS 2011

60

60

Cases (%)

80

40

40 20

20

0







Impact

ABER (%)


2006 2006 2006 2006 –


80

V.



100

0

Year adopted



Medicine

10

1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases

Malawi

African Region




%

15 400 000 0 0 15 400 000

100 0 0


Zambia Mozambique

Zimbabwe


Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR





Yes Yes

2006 2010

IRS


Yes No

2007 –

IPT


Yes

1993

Yes No Yes Yes

2011 – 2007 2007


Financing

Yes

2009


Medicine

Year

No. of studies

Contribution (US$m)

2007 2007 2007 2007 –

Min Median

Max

Follow-up

AS+AQ

2005–2005

2

0

1.8

3.6

28 days

AL

2005–2005

1

7.1

7.1

7.1

28 days



40

ITNs

30

Diagnostics


20


10


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage



100

Source: DHS 2004, MICS 2006, Other Nat.

80

60

60

Cases (%)

80

40

0


Impact


4 40 4 35 3 30 3 25 2 20 2 15 1 10 1 5 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 ABER (Micr. & RDT) RDT posivity rate Slide positivity rate




0

40 20

20

ABER (%)

Population (%)

AL AL AS+AQ QN –

50

0

Positivity rate (%)

Year adopted


60

V.

Medicine

1 000 100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases


Malaysia


Phase: Pre-elimination. Impact: >75% decrease in case incidence projected 2000–2015

South China Sea

Thailand


%

3 134 1 190 000 27 300 000 28 490 000

4 96


Indonesia

Parasites and vectors Major plasmodium species: P. falcipari (30%), P. vivax (70%) Major anopheles species: An.donaldi, balabacensis, maculatus

Insufficient data

Indonesia 0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100




ITN/LLIN


Yes Yes

1995 1995

IRS


– No

– –


Yes No Yes

1967 – –


Yes Yes

1995 1988

III.

Financing

Contribution (US$m)

40 35 30 25 20 15 10 5 0


Medicine


Year

No. of studies

Min Median

Max

Follow-up


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Coverage



60

60

Cases (%)

80

40


2006

0


Malaria test positivity rate and ABER 250 200

0.5

150 100 50





Impact

40 20

20

ABER (%)


– – – – –


1.0

Positivity rate (%)

– –AS+MQ QN+T QN+T CQ+PQ(14d)


100

V.

Year adopted



Medicine

Antimalaria policy

14 000 12 000 10 000 8 000 6 000 4 000 2 000 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Confirmed cases

Mali

African Region


Algeria


Mauritania 2011

%

14 300 000 1 580 000 0 15 880 000

90 10 0


Niger Senegal Burkina Faso

Nigeria

Guinea


Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR





Yes No

2005 –

IRS


Yes No

2007 –

IPT


Yes

2003

Yes Yes No Yes

2008 2005 – 2009


Financing

No

–

Antimalaria policy

Medicine

Year adopted


AS+AQ AL ;AS+AQ AL QN –

2007 2007 2007 – –


Year

No. of studies

2002–2006

4

0

2

7.6

28 days

AL

2004–2008

6

0

3

6

28 days



Contribution (US$m)


20

ITNs

15

Diagnostics


10


5


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage



100


80

60

60

Cases (%)

80

40

0


Impact






0

40 20

20

ABER (%)

Population (%)

Follow-up

25

0

Positivity rate (%)

Max

AS+AQ

30

V.

Min Median

1 000 100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases


Mauritania

African Region


Algeria


%

2 090 000 1 100 000 354 000 3 544 000

59 31 10


Atlantic Ocean Mali


Senegal

Major plasmodium species: P. falciparum (100%), P. vivax (0%) Major anopheles species: An. gambiae, arabiensis, pharoensis

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100




ITN/LLIN


Yes No

1998 –

IRS


No No

– –

IPT


Yes

2008

Yes Yes Yes No

2011 2011 2009 –

Yes

–


Financing

Antimalaria policy

Medicine

Year adopted


AS+AQ AL ;AS+AQ – QN –

– – – – –



Year

No. of studies

Contribution (US$m)

8

ITNs

6

Diagnostics

4


2


0


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage



80

80

60

60

40

40 20

20

0


50

1.2

40

1.0

30 20 10

0.8 0.6 0,4 0.2






Impact

ABER (%)

Positivity rate (%)

Cases (%)

100

Population (%)

100

V.

Follow-up


10

0

Max


12

IV.

Min Median

100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases

Mexico



United States of America


%

344 000 3 790 000 111 000 000 115 134 000

0 3 96


Gulf of Mexico

Pacific Ocean

Parasites and vectors Major plasmodium species: P. vivax (100%) Major anopheles species: An. pseudopunctipennis, albimanus

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100





Yes Yes

– 2005

IRS


No Yes

– 2005

IPT


N/A

–

Yes No No No No

– – – – –


Financing


Medicine


– – – – –

Year

No. of studies

Min Median

Max


20

ITNs

15


10 5

IV.

Coverage

WHO/UNICEF




60

60

Cases (%)

80

40

40 20


2006

0




0.40 60 0.35 50 0.30 40 0.25 0.20 30 0.15 20 0.10 10 0.05 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 ABER (Micr. & RDT) RDT posivity rate Slide positivity rate


ABER (%)

Impact



Others

100

V.

Diagnostics


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Follow-up


Cases

Contribution (US$m)


25

0


Year adopted


30

Positivity rate (%)

Medicine

8 000

10

6 000

8 6

4 000

4

2 000

2

Number of deaths

III.

Antimalaria policy

0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Deaths

Confirmed cases


Mozambique

African Region


Angola Zambia


%

23 900 000 0 0 23 900 000

100 0 0


Madagascar

Zimbabwe Botswana South Africa


Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR




ITN/LLIN


Yes Yes

2003 2009

IRS


Yes Yes

2003 2005

IPT


Yes

2006

Yes Yes Yes Yes

2009 2007 2005 2010

Yes

2010


Financing

Antimalaria policy

Medicine

Year

AL

2005–2008


No. of studies

Contribution (US$m)

3.1

28 days

ITNs Diagnostics


4


2


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Coverage



80

80

60

60

Cases (%)

100

40

40 20

20

0


50

25

40

20

30

15

20

10

10

5






Impact

ABER (%)

Population (%)

1.6

Follow-up



Positivity rate (%)

0

Max


6

V.

2004 2004 – 2004 –

Min Median

4

8

0

AL AL – QN –


10

IV.

Year adopted


12

0

Medicine

1 000 100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases

Myanmar



China India


%

17 900 000 11 100 000 19 300 000 48 300 000

37 23 40

Population (UN Population Division) High transmission ( 1 case per 1000 population) Low transmission (0-1 cases per 1000 population) Malaria-free (0 cases) Total

Thailand

Bay of Bengal

Cambodia

Parasites and vectors Major plasmodium species: P. falciparum (68%), P. vivax (32%) Major anopheles species: An. minimus, dirus, annularis, sundaicus

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100



ITN/LLIN


Yes Yes

– –

IRS


No No

– –

IPT


NA

–

Yes Yes Yes Yes Yes

– – – – –


Financing

First-line treatment of unconfirmed malaria – First-line treatment of P. falciparum (AL ;AM ;AS+MQ ;DHA-PPQ )+PQ For treatment failure of P. falciparum AS+D ;AS+T Treatment of severe malaria AM ;AS ;QN Treatment of P. vivax CQ+PQ(14d)

Medicine

Year

DHA-PPQ AL

2005-2011 2007-2011


No. of studies

Contribution (US$m)

0 0

Follow-up

5 5.9

28 days 28 days


8

ITNs

6

Diagnostics

4


2


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage



100

80

60

60

Cases (%)

80

40


2006

0





50

5

40

4

30

3

20

2

10

1


1 000


Impact

40 20

20

ABER (%)


0 0

Max


0

Positivity rate (%)

Min Median

17 13

10

IV.

– 2008 2008 2008 2008


12

V.

Year adopted

Medicine

3 000 2 500 2 000

100

1 500 1 000

10

500

Number of deaths

III.

Antimalaria policy

0 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Total microscopically confirmed cases


Namibia

African Region Angola


Zimbabwe


2011

%

1 560 000 116 000 651 000 2 327 000

67 5 28

Botswana


South Africa


Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR




ITN/LLIN


Yes No

1998 –

IRS


Yes Yes

1965 1965

IPT


Yes

2007

Yes No Yes Yes

2011 – 2005 2005

No

–

III.

Financing

Contribution (US$m)


7 6 5 4 3 2 1 0

Antimalaria policy

Medicine

Year

No. of studies

Max

Follow-up


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011




Source: Other Nat.

80

80

60

60

Cases (%)

Population (%)

Min Median


40

40 20

20

0


Impact


4.0 3.5 4 3.0 2.5 3 2.0 2 1.5 1.0 1 0.5 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 ABER (Micr. & RDT) RDT posivity rate Slide positivity rate





ABER (%)

5

Positivity rate (%)

2006 2006 2006 2006 2006



100

V.

AL AL QN QN AL


Coverage

0

Year adopted



Medicine

1 000 100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases

Nepal



China


%

1 130 000 24 400 000 5 000 000 30 530 000

4 80 16

Population (UN Population Division) High transmission ( 1 case per 1000 population) Low transmission (0-1 cases per 1000 population) Malaria-free (0 cases) Total

India

Parasites and vectors Major plasmodium species: P. falciparum (13%), P. vivax (84%) Major anopheles species: An. fluviatilis, annularis, maculatus

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100





Yes Yes

2007 2007

IRS


Yes No

1962 –

IPT


NA

–

Yes Yes Yes Yes No

1962 2007 2007 2009 –


Financing

Contribution (US$m)

7 6 5 4 3 2 1 0


Medicine AL

No. of studies

Min Median

8

0

0

Max

Follow-up

0

28 days



2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Coverage



60

60

Cases (%)

80

40

40 20

20

Impact

2006

0




Confirmed cases and deaths (per 100 000)

10

5

8

4

6

3

4

2

2

1


14 000 12 000 10 000 8 000 6 000 4 000 2 000 0

Cases and deaths (log)

0 2000

Source: other Nat.

ABER (%)


2004 2004 – 2004 2004



Positivity rate (%)

Year 2005-2010


100

V.

AL+PQ AL+PQ QN CQ+PQ(14d)



Year adopted

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Deaths

45 40 35 30 25 20 15 10 5 0

Number of deaths

III.

Medicine

Antimalaria policy

Confirmed cases


Nicaragua



Honduras El Salvador


%

76 300 2 870 000 2 920 000 5 866 300

1 49 50


Caribbean Sea

Pacific Ocean

Parasites and vectors Major plasmodium species: P. falciparum (16%), P. vivax (84%) Major anopheles species: An. albimanus, pseudopunctipennis

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100





Yes Yes

2004 2004

IRS


Yes No

1959 –

IPT


N/A

–

Yes Yes Yes No No

– – – – –


Financing


Medicine

Year

CQ

2005–2006


Min Median

1

0

0

Max

Follow-up

0

28 days

8

ITNs

6

Diagnostics

4


2


IV.


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Coverage

100

WHO/UNICEF


Others



Source: Other Nat.

80

60

60

Cases (%)

80

40


Impact

40 20

20

2006

0





30 000

10

4

20

25 000

8

19

20 000

3 2

18

Cases

5

ABER (%)

Contribution (US$m)

No. of studies




– – – – –


10

0

Positivity rate (%)

– CQ+PQ AS+MQ ;AS+SP QN+CL CQ+PQ


12

V.

Year adopted

6

15 000

4

17

10 000

16

5 000

2


0

0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

1


Deaths

Confirmed cases

Number of deaths

III.

Medicine

Antimalaria policy

Niger

African Region


Algeria


%

11 100 000 4 980 000 0 16 080 000

69 31 0


Mali Chad


Burkina Faso

Major plasmodium species: P. falciparum (100%), P. vivax (0%) Major anopheles species: An. gambiae, arabiensis, funestus

Nigeria

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR




ITN/LLIN


Yes Yes

2005 –

IRS


Yes No

2003 –

IPT


Yes

2005

Yes No No No

– – – –

No

–


Financing

Antimalaria policy

Contribution (US$m)

AL AL QN QN –

2005 2005 2005 2005 –


Year

AL

2006–2006


No. of studies 1

Min Median

Max

Follow-up

4.4

4.4

28 days

4.4


2 500


2 000

ITNs

1 500

Diagnostics


1 000


500 0


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage



100

Source: DHS 2006

80

60

60

Cases (%)

80

40

V.

Impact


80

50

40 20



100

60

0


40 30 20 10


10 000


0

40 20

20

ABER (%)

Population (%)

Year adopted


3 000

Positivity rate (%)

Medicine

1 000 100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases


Nigeria

African Region Niger


Chad


Benin 2011

%

162 000 000 0 0 162 000 000

100 0 0


Cameroon

Parasites and vectors Major plasmodium species: P. falciparum (100%), P. vivax (0%) Major anopheles species: An. gambiae, arabiensis, funestus, Moucheti, melas, nili

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR





Yes Yes

2001 2009

IRS


Yes No

2007 –

IPT


Yes

2004

Yes No Yes Yes

2006 – 2009 2006


Financing

Contribution (US$m)

160 140 120 100 80 60 40 20 0

Yes

2009

Antimalaria policy

Medicine

Year adopted


AL ;AS+AQ AL ;AS+AQ QN AM ;AS ;QN –

2004 2004 2004 2004 –


Year

No. of studies

2002–2007

5

0

0

2

28 days

2004–2006

5

0

0

7.8

28 days




2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Coverage


100 Source: DHS 2003, DHS 2008, MIS 2010

60

60

Cases (%)

80

40

40 20

20

0







Impact

ABER (%)



80

V.

Follow-up

AS+AQ


100

0

Max

AL


Min Median

100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases

Pakistan

Eastern Mediterranean Region China


Afghanistan


%

26 500 000 148 000 000 1 770 000 176 270 000

15 84 1



India

Parasites and vectors Major plasmodium species: P. falciparum (36%), P. vivax (64%) Major anopheles species: An. culicifacies, stephensi

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100

Distribution of confirmed malaria cases (per 1 000 population), year 2010




Yes Yes

2008 2008

IRS


Yes No

1961 –

IPT


NA

–

– No Yes Yes Yes

– – 2009 2007 2007


Financing

Contribution (US$m)

8 7 6 5 4 3 2 1 0


Medicine

Year

AS+SP

2007-2011


No. of studies

Min Median

7

0

0

Max

Follow-up

1.5

28 days


ITNs No data reported for 2011


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Coverage


Cases tested and antimalarials delivered: Programme data (public sector) 100 Source: DHS 2007, other Nat.

80

60

60

Cases (%)

80

40


2006


15

4

5



20

10

0


3 2 1



Impact

40 20

20

ABER (%)


– 2007 – 2007 2007


100

V.

CQ AS+SP QN AM ;AS ;QN CQ+PQ(14d)



Year adopted

1000

50 40

100

30 20

10

10

Number of deaths

III.

Medicine

Antimalaria policy

0 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases


Panama



Caribbean Sea


%

157 000 2 540 000 871 000 3 568 000

4 71 24


Colombia

Pacific Ocean

Parasites and vectors Major plasmodium species: P. falciparum (0%), P. vivax (100%) Major anopheles species: An. albimanus, pseudopunctipennis, punctimacula, aquasalis, darlingi

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100





No No

– –

IRS


Yes No

1957 –

IPT


N/A

–

Yes No No No No

1957 – – – –


Contribution (US$m)

7 6 5 4 3 2 1 0

Financing


Year

No. of studies

Min Median

Max

Follow-up


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Coverage

WHO/UNICEF


Others



60

60

Cases (%)

80

40

40 20

20

Impact

2006

0





3.5 10 3.0 8 2.5 6 2.0 1.5 4 1.0 2 0.5 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 ABER (Micr. & RDT) RDT posivity rate Slide positivity rate


6 000

10

5 000

8

4 000

Cases

0 2000

ABER (%)


– – – – –



Positivity rate (%)

– SP SP+PQ MQ CQ+PQ


100

V.

Year adopted




Medicine

6

3 000

4

2 000 1 000

2

0

0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Deaths

Confirmed cases

Number of deaths

III.

Antimalaria policy

Papua New Guinea

Western Pacific Region Philippine Sea Indonesia

Phase: Control. Impact: 75% decrease in case incidence 2000–2011.

Plurinational State of Bolivia


Brazil 2010

%

0 236 000 6 330 000 6 566 000

0 4 96


Argentina

Parasites and vectors Major plasmodium species: P. falciparum (70%), P. vivax (30%) Major anopheles species: An. darlingi, albitarsis

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100





No No

– –

IRS


Yes No

1957 –

IPT


N/A

–

Yes No Yes No No

1957 – 2005 – –


Financing

Medicine


Contribution (US$m)

– – – – –

Year

No. of studies

Min Median

Max


ITNs

3

Diagnostics

2


1


IV.

Follow-up



2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Coverage

WHO/UNICEF


Others



100

80

60

60

Cases (%)

80

40

0 2000 2001 2002 2003 2004 2005 Population at risk protected with IRS* All ages who slept under an ITN * Total population at risk used

2006

0

2007 2008 2009 2010 2011 Population at risk protected with ITNs* Households with at least one ITN


8 70 7 60 6 50 5 40 4 30 3 20 2 10 1 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 ABER (Micr. & RDT) RDT posivity rate Slide positivity rate


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Suspected cases tested Cases treated with any antimalarial

ConfirmedMicroscopically confirmed cases and deaths

Cases

Impact

40 20

20

ABER (%)


– AL – – CQ+PQ


4

0

Positivity rate (%)

Year adopted


5

V.

Medicine

8 000 10 7 000 8 6 000 5 000 6 4 000 4 3 000 2 000 2 1 000 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Deaths

Confirmed cases

Number of deaths

III.

Antimalaria policy

Peru



Ecuador

Colombia


Brazil 2011

%

1 320 000 3 380 000 24 700 000 29 400 000

4 11 84


Pacific Ocean Bolivia


Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100





Yes Yes

– –

IRS


– Yes

– –

IPT


N/A

–

Case Patients of all ages should receive diagnostic test Yes management RDTs used at community level Yes ACT is free for all ages in public sector – Pre-referral treatment with recommended medicines Yes Oral artemisinin-based monotherapies are not registered –

– – – – –

Financing

Medicine

Year

AS+MQ

2005-2006


No. of studies

1

Contribution (US$m)

Max

Follow-up

1.1

1.1

28 days

1.1

ITNs Diagnostics


2 1


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Coverage

WHO/UNICEF


Others



100

80

60

60

Cases (%)

80

40

40 20

20


Impact

2006

0






0 2000

ABER (%)


Min Median



Positivity rate (%)

– – – – –


3

V.

AS+MQ – – CQ+PQ


4

IV.

Year adopted


5

0

Medicine

1000

30 25 20

100

15 10

10

5

Number of deaths

III.

Antimalaria policy

0 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases


Philippines



Philippine Sea


%

6 800 000 68 900 000 19 200 000 94 900 000

7 73 20


Viet Nam

Parasites and vectors Major plasmodium species: P. falciparum (75%), P. vivax (25%) Major anopheles species: An. flavirostris, maculatus, balabacensis, Litoralis

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100




ITN/LLIN


Yes Yes

2006 2000

IRS


Yes No

– –

IPT


N/A

–

Yes Yes Yes Yes No

2004 2002 2003 2009 –


Financing

40 35 30 25 20 15 10 5 0


Medicine

Year

AL

2006-2009


No. of studies

Min Median

4

0

0

Max

Follow-up

4

28 days


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Coverage




60

60

Cases (%)

80

40

40 20

20 0 2000

Impact

2006

0


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Suspected cases tested Cases treated with any antimalarial P. falciparum cases potentially treated with ACT



600

50 000

500

40 000

400

30 000

300

20 000

200

1

10 000

100


0

15 10 5


5 4 3 2

Cases

20

ABER (%)


2009 2009 2002 2002 2002



Positivity rate (%)

AL AL+PQ QN+T QN+T CQ+PQ(14d)


100

V.

Year adopted


Government* Global Fund World Bank USAID/PMI WHO/UNICEF AUSAID * Expenditure: costs for sub-national level, health systems, human resources, etc not included. IV.

Medicine

0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Deaths

Confirmed cases

Number of deaths

Contribution (US$m)

III.

Antimalaria policy

Republic of Korea



Sea of Japan


%

22 3 670 000 44 700 000 48 370 000

8 92


China Sea


Japan

Major plasmodium species: P. vivax (97%) Major anopheles species: An.sinensis

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100





Yes No

2001 –

IRS


– No

– –


Yes Yes Yes

2001 – 2001


Yes Yes

2001 –

III.

Financing

Contribution (US$m)

ITN/LLIN

7 6 5 4 3 2 1 0


Medicine


Max

Follow-up


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011




60

Cases (%)

60 40

40 20

20

Impact

2006

0




Microscopically confirmed malaria cases and indigenous cases 1.2

5 000

1.0

4 000

0.8 0.6 0.4 0.2



0 2000

ABER (%)


Min Median



Positivity rate (%)

No. of studies

Diagnostics

80

0.5

Year

ITNs

80

1.0

– – – – –


Coverage

1.5

CQ CQ+PQ(14d)


100

V.

Year adopted



Medicine

Antimalaria policy

3 000 2 000 1 000 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Confirmed cases


Rwanda

African Region

Phase: Control. Impact: >75% decrease in admission rates 2000–2011.

Uganda Democratic Republic of the Congo


%

10 900 000 0 0 10 900 000

100 0 0



Burundi


Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR





Yes No

2004 –

IRS


Yes No

2009 –

IPT


No

–

Yes Yes No Yes

2009 2008 – 2007

No

–


Financing


Medicine

Year

AL

2004–2007


No. of studies

Contribution (US$m)

2005 2005 2005 2005 –

0

1.5

Max

Follow-up

6.9

28 days


30

Diagnostics

20


10


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage



100

Source: DHS 2005, DHS 2008, DHS 2010

80

60

60

Cases (%)

80

40

0


Impact


60

30

50

25

40

20

30

15

20

10

10

5






0

40 20

20

ABER (%)

Population (%)

AL AL QN AM ;QN –

Min Median

3

40

0

Positivity rate (%)

Year adopted


50

V.

Medicine

1 000 100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases

Sao Tome and Principe

African Region


Atlantic Ocean


2011

%

169 000 0 0 169 000

100 0 0


Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR




ITN/LLIN


Yes No

2005 –

IRS


Yes No

2003 –

IPT


Yes

2004

Yes No Yes Yes

2001 – 2009 2004

No

–


Financing


Medicine


Year

No. of studies

Contribution (US$m)

Max

Follow-up

ITNs Diagnostics Antimalarial medicines

1


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage



100

Source: DHS 2009

80

60

60

Cases (%)

80

40

40 20

20

0




60

120

50

100

40

80

30

60

20

40

10

20


100 000


Impact

ABER (%)

Population (%)

Min Median

2

0

Positivity rate (%)

2004 2004 2004 2004 –


3

V.



4

0

Year adopted


5

IV.

Medicine

10 000 1 000 100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases


Saudi Arabia



Iraq




Egypt

%

68 – 24 900 000 27 400 000

91

Oman

Red Sea

Sudan


Yemen

Major plasmodium species: P. falciparum (38%), P. vivax (62%) Major anopheles species: An.arabiensis, sergentii, bacroftii, funestus, albimanus

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100




ITN/LLIN


Yes Yes

– –

IRS


– No

– –


Yes Yes Yes

– – –


Yes Yes

– –

III.

Financing

Contribution (US$m)

35 30 25 20 15 10 5 0


Medicine


Year

No. of studies

Min Median

Max

Follow-up


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011




60

60

Cases (%)

80

40

40 20

20

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Population at high risk protected with ITNs Population at high risk protected with IRS All ages who slept under an ITN Households with at least one ITN Malaria test positivity rate and ABER

0.5

10

Positivity rate (%)

8 6 4 2 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 ABER (Micr. & RDT) RDT posivity rate Slide positivity rate


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Suspected cases tested Cases treated with any antimalarial P. falciparum cases potentially treated with ACT Microscopically confirmed malaria cases and indigenous cases


Impact

ABER (%)


– 2007 2007 2007 –


100

V.

AS+SP AL AM ;QN CQ+PQ(14d)


Coverage

0

Year adopted



Medicine

Antimalaria policy

7 000 6 000 5 000 4 000 3 000 2 000 1 000 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Confirmed cases

Senegal

African Region


Mauritania


%

12 300 000 511 000 0 12 811 000

96 4 0


Mali

Atlantic Ocean


Guinea-Bissau

Major plasmodium species: P. falciparum (100%), P. vivax (0%) Major anopheles species: An. gambiae, arabiensis, funestus, pharoensis

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR




ITN/LLIN


Yes Yes

1998 1998

IRS


Yes No

2005 –

IPT


Yes

2003

Yes Yes Yes Yes

2007 2008 2010 2005

Yes

2010

III.

Financing

Contribution (US$m)


40 35 30 25 20 15 10 5 0

Antimalaria policy

Medicine

Year adopted


AS+AQ AL ;AS+AQ – QN –

2005 2005 – 2005 –


Year

Max

Follow-up

AS+AQ

2002–2008

7

0

0

0.5

28 days

AL

2002–2008

6

0

0.9

3.2

28 days


No. of studies

Expenditure by intervention in 2011 Insecticides & spray materials ITNs Diagnostics Antimalarial medicines Monitoring and evaluation Human resources & technical assistance

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage

Source: DHS 2005, MIS 2006, MIS 2009, Other Nat.

60

60

Cases (%)

80

40


50

4

10

3 2 1


1 000


5

20



60

30

0


Impact

40

40 20

20

ABER (%)

Population (%)


80

V.

Positivity rate (%)


100

100

0

Min Median

100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases


Sierra Leone

African Region


Guinea


2011

%

6 000 000 0 0 6 000 000

100 0 0

Atlantic Ocean

Liberia


Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR




ITN/LLIN


Yes No

2002 –

IRS


Yes No

2010 –

IPT


Yes

2005

Yes Yes Yes Yes

2010 2008 2010 2010

No

–


Financing

Antimalaria policy

Medicine

Year adopted


AS+AQ AL ;AS+AQ QN AM ;QN –

2004 2004 2004 2004 –


Year

AS+AQ

2004–2004


No. of studies 1

Contribution (US$m)

28 days

6

Diagnostics

4


2


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Coverage




100

Source: DHS 2008

80

60

60

Cases (%)

80

40

40 20

20

0







Impact

ABER (%)

Population (%)

Follow-up

27

ITNs


Positivity rate (%)

Max

8

0

V.

27


10

0

27


12

IV.

Min Median

1 000 100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases

Solomon Islands




%

547 000 0 5 520 552 520

99 0 1

Population (UN Population Division) High transmission (≥1 case per 1000 population) Low transmission (0-1 cases per 1000 population) Malaria-free (0 cases) Total Parasites and vectors Major plasmodium species: P. falciparum (63%), P. vivax (37%) Major anopheles species: An. farauti, punctulatus, koliensis

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100




ITN/LLIN


Yes Yes

2009 1996

IRS


Yes No

– –

IPT


N/A

–

Yes No Yes Yes No

1968 – 2008 1978 2009


Financing


Medicine

Year

AL

2008–2009


No. of studies

Contribution (US$m)

2009 2007 2007 2007 2007

Min Median

1

0

0

Max

Follow-up

0

28 days


4

ITNs

3

Diagnostics

2


1


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Government* Global Fund World Bank USAID/PMI WHO/UNICEF AUSAID * Expenditure: costs for sub-national level, health systems, human resources, etc not included. IV. 100

Coverage



Source: MIS 2011

80

60

60

Cases (%)

80

40


2006

0







Impact

40 20

20

ABER (%)


AL AL QN AL ;AS AL+PQ(14d)

5

0

Positivity rate (%)

Year adopted


6

V.

Medicine

80 70 60 50 1 000 40 100 30 20 10 10 1 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

10 000

Admissions

Deaths

Number of deaths

III.

Antimalaria policy

Confirmed cases


Somalia



Ethiopia


%

6 690 000 2 870 000 0 9 560 000

70 30 0


Indian Ocean

Kenya

Parasites and vectors Major plasmodium species: P. falciparum (100%), P. vivax (0%) Major anopheles species: An. arabiensis, funestus

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100




ITN/LLIN


Yes No

2005 –

IRS


Yes No

2004 –

IPT


Yes

2005

Yes No Yes Yes No

2006 – 2006 2006 –


Financing


Medicine

Year

AS+SP

2005-2006


No. of studies

Contribution (US$m)

1

28 days

ITNs Diagnostics

4


2


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Coverage




100

Source: MICS 2006.

80

60

60

Cases (%)

80

40

0 2000 2001 2002 2003 2004 Population at risk protected with IRS All ages who slept under an ITN

2005

2006

0



80 2.5 70 2.0 60 50 1.5 40 1.0 30 20 0.5 10 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 ABER (Micr. & RDT) RDT posivity rate Slide positivity rate




Impact

40 20

20

ABER (%)


0.5

Follow-up



Positivity rate (%)

0

Max


6

V.

2006 2006 2006 2006 2006

Min Median

2

8

IV.

AS+SP AS+SP QN QN CQ+PQ(14d)


10

0

Year adopted

1 000

90 80 70 100 60 50 10 40 30 1 20 10 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases

Number of deaths

III.

Medicine

Antimalaria policy

South Africa

African Region


Mozambique

Botswana Namibia


%

2 020 000 3 030 000 45 400 000 50 450 000

4 6 90


Indian Ocean



Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR




ITN/LLIN


No No

– –

IRS


Yes Yes

– 1945

IPT


No

–

Yes Yes Yes No

– – – –

No

–


Financing


Medicine

Year

AL

2007-2007


No. of studies

Contribution (US$m)

Min Median

2

0

2.6

Max

Follow-up

5.2

28 days


40

ITNs

30

Diagnostics

20


10


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage



80

80

60

60

Cases (%)

100

Population (%)

– 2001 2001 2001 2001 –

50

0

40

40 20

20 0

0


Impact






ABER (%)

30

Positivity rate (%)

– AL ;QN+CL ;QN+D AS ;QN QN AL+PQ CQ+PQ


60

V.

Year adopted

Medicine

10 1 0.1 0.01 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases


Sri Lanka



India

Bay of Bengal


%

46 1 500 000 19 500 000 21 000 000

7 93


Laccadive Sea

Parasites and vectors Major plasmodium species: P. falciparum (4%), P. vivax (96%) Major anopheles species: An.culicifacies, subpictus

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100




ITN/LLIN


Yes Yes

1992 2004

IRS


Yes No

1945 –


Yes Yes Yes

1911 – –


Yes Yes

1958 2008

III.

Financing


Medicine


Contribution (US$m)

– 2008 – 1936 2008

Year

No. of studies

Min Median

Max

Follow-up


6

Diagnostics

4


2


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage



100

80

60

60

Cases (%)

80

40

40 20

20

0


Impact





Microscopically confirmed malaria cases and indigenous cases 250 000 200 000


0

ABER (%)


AL+PQ QN CQ+PQ(14d)


8

0

Positivity rate (%)

Year adopted


10

V.

Medicine

Antimalaria policy

150 000 100 000 50 000 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Confirmed cases

South Sudan





Ethiopia

%

10 300 000 0 0 10 300 000

100 0 0

Central African Republic



Major plasmodium species: P. falciparum (7%), P. vivax (93%) Major anopheles species: An. superpictus, stephensi, pulcherrimus, subpictus, hyrcanus, culicifacies

Insufficant data

Not applicable

0

0–0.1

Kenya

Uganda

0.1–1.0

1.0–10

10–50

50–100

≥100

Distribution of probable and confirmed malaria cases (per 1 000 population)



ITN/LLIN


Yes Yes

2008 2008

IRS


No No

– –

IPT


Yes

2006

No No Yes Yes No

– – 2006 2006 –


Financing


Medicine

Year

No. of studies

Contribution (US$m)

Max

Follow-up

AS+AQ

2003–2005

2

1

3.1

5.1

28 days

2004–2004

1

2.8

2.8

2.8

28 days



ITNs

15

Diagnostics

10


5


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage



100

Source: Other Nat.

80

60

60

Cases (%)

80

40


Impact

40 20

20

2006

0



1.4 1.2 40 1.0 30 0.8 0.6 20 0.4 10 0.2 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 ABER (Micr. & RDT) RDT posivity rate Slide positivity rate



ABER (%)

50



Min Median


0

Positivity rate (%)

2006 2006 2006 2004 –

AL

20

V.

AS+AQ AS+AQ AL AM ;AS ;QN (AS+AQ)+PQ


25

IV.

Year adopted

10 000

1 200 1 000

1 000

800 600

100

400

10

200

Number of deaths

III.

Medicine

Antimalaria policy

0 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases


Sudan



Egypt

Libya

Saudi Arabia


%

28 500 000 5 830 000 0 34 330 000

83 17 0


Chad

Eritrea

Ethiopia


Insufficant data

Not applicable

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100

Distribution of probable and confirmed malaria cases (per 1 000 population)



ITN/LLIN


Yes Yes

2005 2010

IRS


Yes No

1956 –

IPT


No

–

Yes Yes Yes Yes Yes

2009 2008 2005 2004 2004


70 60 50 40 30 20 10 0

Financing


Medicine

Year

No. of studies

Min Median

Max

Follow-up

AS+SP

2005–2010

8

0

2

5.3

28 days

2005–2010

11

0

0

4.5

28 days



2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Coverage



Source: Sudan Household Health Survey, MIS 2009.

80

60

60

Cases (%)

80

40

2006

0

2007 2008 2009 2010 2011 Population at risk protected with ITNs* Households with at least one ITN







Impact

40 20

20

ABER (%)


2006 2006 2006 2006 2006


0 2000 2001 2002 2003 2004 2005 Population at risk protected with IRS* All ages who slept under an ITN * Total population at risk used

Positivity rate (%)

AS+SP AS+SP AL AM ;QN AL

AL


100

V.

Year adopted



Medicine

3 000 2 500

1 000

2 000 1 500

100

1 000

10

500

0 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases

Number of deaths

Contribution (US$m)

III.

Antimalaria policy

Suriname




%

83 100 0 446 000 529 100

16 0 84



Guyana


Brazil

Major plasmodium species: P. falciparum (11%), P. vivax (89%) Major anopheles species:

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100





Yes Yes

2006 2006

IRS


Yes No

2006 –

IPT


N/A

–

Yes Yes Yes Yes Yes

1955 2005 – – –


Financing


Medicine

Year

AL

2005–2011


No. of studies

2

0

2.4

Max

Follow-up

4.7

28 days

0.2

Coverage

Monitoring and evaluation Management and other costs

Others



60

60

Cases (%)

80

40

40 20


Impact

Antimalarial medicines Human resources & technical assistance

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 WHO/UNICEF

Diagnostics

2006

0





ABER (%)


18 000 16 000 14 000 12 000 10 000 8 000 6 000 4 000 2 000 0

30

Cases and admissions(log)

Contribution (US$m)


0.4

100


Min Median

ITNs


Positivity rate (%)

– – – – –


0.6

V.

AL+PQ AS+MQ AS CQ+PQ


0.8

IV.

Year adopted


1.0

0

Medicine

25 20 15 10 5

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Deaths

Number of deaths

III.

Antimalaria policy

0

Confirmed cases


Swaziland

African Region



2011

%

0 337 000 866 000 1 203 000

0 28 72

Mozambique South Africa


Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR




ITN/LLIN


Yes Yes

2002 2010

IRS


Yes Yes

1947 1956

IPT


No

–

Yes Yes Yes Yes

2010 2010 2010 2010

No

–


Financing

Antimalaria policy

Medicine


Year

No. of studies

Contribution (US$m)

Follow-up

Diagnostics


2


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Coverage




100

Source: DHS 2007

80

60

60

Cases (%)

80

40

40 20

20

0


100

10

80

8

60

6

40

4

20

2






Impact

ABER (%)

Population (%)

Max

ITNs


Positivity rate (%)

Min Median


4

V.

– 2009 2009 – –


6

0

– AL QN QN –


8

IV.

Year adopted


10

0

Medicine

100 10 1 0.1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases

Tajikistan

European Region

Phase: Elimination. Impact: >75% decrease in case incidence 2000–2011. 53 indigenous cases reported in Tajikistan in 2011. No locally acquired P.falciparum cases registered since 2009. Malaria elimination programme aimed to interrupt P.vivax transmission by 2015 is funded by the government, the Global Fun.

Uzbekistan Kyrgyzstan


China


2011

%

39 2 790 000 4 190 000 6 980 000

38 62

Afghanistan

Parasites and vectors Insufficient data

Major plasmodium species: P. falciparum (0%), P. vivax (100%) Major anopheles species: An.superpictus, pulcherrimus

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100




ITN/LLIN


Yes Yes

2006 2006

IRS


Yes No

1997 –


Yes Yes Yes

1997 2004 1997


Yes Yes

2007 2000

III.

Financing


Medicine

Year

QN

2003–2003


Contribution (US$m)

– 2008 2004 2004 2004

No. of studies

Min Median

1

0

0

Max

Follow-up

0

28 days


3

Diagnostics

2


1


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage

100



Source: MICS 2005.

80

80

60

60

Cases (%)


AL QN QN CQ+PQ(14d)


4

0

40

0

40 20

20

0


Impact






ABER (%)

10

Positivity rate (%)

Year adopted


5

V.

Medicine

Antimalaria policy

20 000 15 000 10 000 5 000 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011




Thailand

South-East Asia Region Myanmar


Laos


%

5 560 000 29 200 000 34 800 000 69 560 000

8 42 50


Cambodia Andaman Sea

Parasites and vectors Major plasmodium species: P. falciparum (40%), P. vivax (60%) Major anopheles species: An. minimus, dirus, maculatus, campestris, philippinensis, sundaicus

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100




ITN/LLIN


Yes Yes

2008 2008

IRS


Yes No

2003 –

IPT


N/A

–

Yes Yes Yes No No

2003 2008 2006 – –


Financing


Contribution (US$m)

– – – – –

Medicine

Year

AS+MQ

2001–2009


No. of studies

Min Median

20

0

0.5

Max

Follow-up

10.4

28 days


25


20

ITNs

15

Diagnostics

10


5 0


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage



100

80

60

60

Cases (%)

80

40


Impact

2006

0






Microscopically confirmed cases, admissions (per 100 000) and deaths 1000


0 2000

V.

40 20

20

ABER (%)


AS+MQ QN+D AS ;QN CQ+PQ(14d)


30

Positivity rate (%)

Year adopted

700 600 500 100 400 300 10 200 100 0 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases

Numver of deaths

III.

Medicine

Antimalaria policy

Democratic Republic of Timor-Leste




%

888 000 265 000 0 1 153 000

77 23 0


Timor Sea

Indonesia

Parasites and vectors Major plasmodium species: P. falciparum (81%), P. vivax (19%) Major anopheles species: An. subpictus

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100




ITN/LLIN


Yes Yes

2004 2004

IRS


Yes No

2010 –

IPT


N/A

–

Yes Yes Yes Yes No

2007 2009 2007 2007 –


Financing

Contribution (US$m)

7 6 5 4 3 2 1 0


Medicine


Year

No. of studies

Max

Follow-up



2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Coverage


Cases tested and antimalarials delivered: Programme data (public sector) 100 Source: Other Nat.

80

60

60

Cases (%)

80

40

40 20

20

Impact

50 40 30 20 10

2006

0





20 15 10 5




ABER (%)


Min Median

ITNs

60

Positivity rate (%)

– – – – –


100

V.

AL QN+D AM ;QN CQ+PQ(14d)



Year adopted

80 70 1 000 60 50 100 40 30 10 20 10 1 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Number of deaths

III.

Medicine

Antimalaria policy

Confirmed cases


Togo

African Region


Benin


2011

%

6 150 000 0 0 6 150 000

100 0 0

Ghana

Nigeria


Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR




ITN/LLIN


Yes Yes

2004 2011

IRS


Yes No

2011 –

IPT


Yes

2003

Yes Yes No No

2010 2007 – –

Yes

2010


Financing

Antimalaria policy

Medicine

Year adopted


AL ;AS+AQ AL ;AS+AQ – QN –

– – – – –


Year

Max

Follow-up

AS+AQ

2005-2009

8

0

0

6

28 days

AL

2005-2009

8

0

0.7

4.4

28 days


No. of studies


20


Contribution (US$m)

15

ITNs

10

Diagnostics


5 0


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage



80

80

60

60

40

40 20

20

0







Impact

ABER (%)

V.

Positivity rate (%)

Cases (%)

100

Population (%)

100

0

Min Median

1 000 100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases

Turkey

European Region

Phase: Elimination. Impact: >75% decrease in case incidence 2000–2011. Along with imported cases 4 relapses of P. vivax were reported in the country in 2011. The national malaria elimination strategy aims for interruption of malaria transmission by 2012.

Russian Federation

Black Sea

Bulgaria

Georgia



%

0 0 73 600 000 73 600 000

100

Syrian Arab Republic


Iraq

Mediterranean Sea

Major plasmodium species: P. vivax (0%) Major anopheles species: An.sacharovi, superpictus

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100




ITN/LLIN


No No

– –

IRS


Yes No

1926 –


Yes Yes Yes

1926 – 1926


Yes Yes

1926 1926

III.

Financing


Medicine


Contribution (US$m)

– – – CQ+PQ(14d)

– – – – –

Year

No. of studies

Min Median

Max


30

Diagnostics

20


10


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage



100

80

60

60

Cases (%)

80

40

Impact

1.0



12 000 8 000 6 000 4 000 2 000


ABER (%)

10 000 0.5

0



0

40 20

20

V.

Follow-up


40

0


Year adopted


50

Positivity rate (%)

Medicine

Antimalaria policy

14 000 12 000 10 000 8 000 6 000 4 000 2 000 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011




Uganda

African Region South Sudan



%

31 100 000 3 450 000 0 34 550 000

90 10 0



Kenya


Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR





Yes No

2006 –

IRS


Yes No

2005 –

IPT


Yes

2000

Yes Yes Yes Yes

1997 – 2006 2002

Yes

2005


Financing

Antimalaria policy

Medicine

Year

AS+AQ

2002–2008


No. of studies

Contribution (US$m)

Max

Follow-up

8.9

28 days

ITNs Diagnostics Antimalarial medicines

50


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Coverage




100

Source: DHS 2006, MIS 2009, DHS 2011

80

60

60

Cases (%)

80

40

40 20

20

0







Impact

ABER (%)

Population (%)

2.3



Positivity rate (%)

0


100

V.

2004 2004 2004 2004 –

Min Median

8

150

0

AL AL QN QN –


200

IV.

Year adopted


250

0

Medicine

1 000 100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases

United Republic of Tanzania (Mainland)

African Region


Kenya


%

32 900 000 12 200 000 0 45 100 000

73 27 0



Indian Ocean

Zambia


Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR




ITN/LLIN


No No

– –

IRS


Yes No

2006 –

IPT


Yes

2001

Yes No No Yes

2009 – – 2001

Yes

–


Financing

Antimalaria policy

Medicine

Year

AL

2002–2008


No. of studies

Contribution (US$m)

2.9

Max

Follow-up

8.6

28 days

Insecticides & spray materials ITNs Diagnostics

100


50


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Coverage



80

80

60

60

Cases (%)

100

40

2001 2002 2003 2004 Modelled % of households ≥1 ITN Households with at least one ITN

Impact

2005

2006

0

2007 2008 2009 2010 2011 Population at risk protected with IRS All ages who slept under an ITN




50

25

40

20

30

15

20

10

10

5


10 000


0 2000

40 20

20

ABER (%)

Population (%)

0



Positivity rate (%)

2004 2004 2004 2004 –

Min Median

8

150

V.

AL AL QN QN –


200

IV.

Year adopted


250

0

Medicine

1 000 100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases


United Republic of Tanzania (Zanzibar)

African Region Kenya

Phase: Control. Impact: >75% decrease in admission rates 2000–2011.


2011

%

1 400 000 0 0 1 400 000

100 0 0

Indian Ocean


Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100




ITN/LLIN


Yes Yes

2005 2008

IRS


Yes No

2006 –

IPT


Yes

2004

Yes No No Yes

2006 – 2003 2004

Yes

2011


Financing


Medicine

Year

AL

2006-2007


No. of studies

Contribution (US$m)

0

0

Max

Follow-up

0

42 days


4

ITNs

3

Diagnostics

2


1


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Coverage



80

80

60

60

Cases (%)

100

40

2001 2002 2003 2004 Modelled % of households ≥1 ITN Households with at least one ITN

Impact

2005

2006

0

2007 2008 2009 2010 2011 Population at risk protected with IRS All ages who slept under an ITN







0 2000

40 20

20

ABER (%)

Population (%)

2004 2004 2004 2004 –

Min Median

1


Positivity rate (%)


5

0

V.

Year adopted


6

IV.

Medicine

1 000 100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases

Uzbekistan

European Region

Phase: Elimination. Impact: >75% decrease in case incidence 2000–2011. Malaria transmission risk exists in the area bordering Afghanistan. No indigenous cases reported in 2011. Malaria elimination is financed mainly by the government, with supplements from the Global Fund and WHO.

Kazakhstan



%

0 0 27 800 000 27 800 000

Turkmenistan

100

Tajikistan


Afghanistan

Major plasmodium species: P. vivax (0%) Major anopheles species: An.superpictus, pulcherrimus, hyrcanus, claviger

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100




ITN/LLIN


Yes Yes

2005 2005

IRS


Yes No

1925 –


Yes Yes Yes

1925 1939 1939


Yes Yes

1925 2000

III.

Financing


Medicine


Contribution (US$m)

– – – CQ+PQ(14d)

– – – – –

Year

No. of studies

Min Median

Max


1.5

Diagnostics

1.0


0.5


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage



100

80

60

60

Cases (%)

80

40

0

40 20

20

V.

Follow-up


2.0

0


Year adopted


2.5

0


Impact



ABER (%)



0.5

Positivity rate (%)

Medicine

Antimalaria policy

140 120 100 80 60 40 20 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011




Vanuatu




%

243 000 0 2 460 245 460

99 0 1


Pacific Ocean

Parasites and vectors Major plasmodium species: P. falciparum (41%), P. vivax (59%) Major anopheles species: An. farauti

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100




ITN


Yes Yes

2008 1990

IRS


No No

– –

IPT


N/A

–

Yes Yes Yes Yes No

2009 2009 2009 2009 –


Financing


Medicine


Contribution (US$m)

– 2007 2007 2007 2007

Year

No. of studies

Min Median

Max

ITNs

6

Diagnostics

4


2


IV.

Follow-up



2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Government* Global Fund World Bank USAID/PMI WHO/UNICEF AUSAID * Expenditure: costs for sub-national level, health systems, human resources, etc not included.

Coverage

100



Source: Other Nat.

80

80

60

60

Cases (%)


AL QN QN AL+PQ(14d)


8

0

40


Impact

40 20

20

2006

0







Cases

ABER (%)

50

Positivity rate (%)

Year adopted


10

V.

Medicine

18 000 16 000 14 000 12 000 10 000 8 000 6 000 4 000 2 000 0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Deaths

Confirmed cases

16 14 12 10 8 6 4 2 0

Number of deaths

III.

Antimalaria policy

Venezuela (Bolivarian Republic of )




%

765 000 4 770 000 23 900 000 29 435 000

3 16 81


Guyana Colombia Brazil

Parasites and vectors Major plasmodium species: P. falciparum (11%), P. vivax (89%) Major anopheles species: An. darlingi, aquasalis, nuneztovari, braziliensis, albitarsis

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100





Yes Yes

2005 2005

IRS


Yes No

– –

IPT


N/A

–

Yes No Yes No No

1936 – 2004 – –


Financing

First-line treatment of unconfirmed malaria – First-line treatment of P. falciparum AS+MQ+PQ For treatment failure of P. falciparum QN+CL ;QN+D ;QN+T Treatment of severe malaria AM ;QN Treatment of P. vivax CQ+PQ

Medicine

Year

AS+MQ

2004–2005


No. of studies

1

0

Follow-up

0

28 days


40

ITNs

30

Diagnostics


20


10

IV.


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Coverage

WHO/UNICEF


Others



100

80

60

60

Cases (%)

80

40


Impact

2006

0






ABER (%)

V.

40 20

20


Contribution (US$m)

0

Max




Min Median

50

0

– – – – –


60

Positivity rate (%)

Year adopted

Medicine

1 000

45 40 30 100 25 20 15 10 10 5 1 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Number of deaths

III.

Antimalaria policy

Confirmed cases


Viet Nam

Western Pacific Region China


Myanmar


Thailand 2011

%

15 600 000 17 700 000 55 500 000 88 800 000

18 20 63


Cambodia

Parasites and vectors Major plasmodium species: P. falciparum (66%), P. vivax (34%) Major anopheles species: An. minimus, dirus, sundaicus

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100




ITN/LLIN


Yes Yes

1992 1992

IRS


Yes No

1991 –

IPT


N/A

–

Yes Yes Yes Yes No

– 2005 2000 1994 –


Contribution (US$m)

III.

Financing

14 12 10 8 6 4 2 0


Medicine

Year

No. of studies

DHA-PPQ 2001–2010


– 2009 2003 2003 2003

Min Median

14

0

0

Max

Follow-up

6.1

28 days


ITNs Diagnostics No data reported for 2011


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Coverage



Source: AIS 2005, MICS 2006

80

60

60

Cases (%)

80

40

2006

0



5

20

4

15

3 2 1

10 5






100

160 140 120 100 80 10 60 40 20 10 0 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Number of deaths


Impact

40 20

20

ABER (%)


DHA-PPQ AS+MQ ;QN AS ;QN CQ+PQ(14d)


100

V.

Year adopted



Medicine

Admissions

Deaths

Confirmed cases

Yemen



Saudi Arabia

Oman


%

10 700 000 5 560 000 8 500 000 24 760 000

43 22 34


Gulf of Aden

Parasites and vectors Major plasmodium species: P. falciparum (99%), P. vivax (1%) Major anopheles species: An. arabiensis, culicifacies, sergentii

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

10–50

50–100

≥100




ITN/LLIN


Yes Yes

2002 2009

IRS


Yes No

2001 –

IPT


No

–

Yes Yes Yes Yes Yes

2001 2009 2009 2009 2009


14 12 10 8 6 4 2 0

Financing


Medicine

Year

AS+SP

2007-2011


No. of studies

Min Median

6

0

0

Max

Follow-up

1.5

28 days



2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


Coverage


Cases tested and antimalarials delivered: Programme data (public sector) 100 Source: MIS 2009

80

60

60

Cases (%)

80

40


2006

0






100

1 000

80


Impact

40 20

20

ABER (%)


2009 2009 2009 2009 –


100

V.

AS+SP AS+SP AL AM ;QN CQ+PQ(14d)



Year adopted

60

100

40

10

20

Number of deaths

Contribution (US$m)

III.

Medicine

Antimalaria policy

1 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases


Zambia

African Region

Phase: Control. Impact: 50%–75% decrease in admission rates projected 2000–2015.




%

13 500 000 0 0 13 500 000

100 0 0


Angola Malawi Mozambique Zimbabwe


Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR





Yes Yes

2005 1998

IRS


Yes Yes

– 2001

IPT


Yes

2001

Yes Yes Yes Yes

2001 2007 2003 1998

Yes

2003

III.

Financing

Contribution (US$m)


70 60 50 40 30 20 10 0

Antimalaria policy

Medicine

Year

AL

2005-2009

No. of studies

Min Median

9

0

0

Max

Follow-up

6.7

28 days

Insecticides & spray materials ITNs Diagnostics Antimalarial medicines Monitoring and evaluation Human resources & technical assistance

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Coverage



Cases tested and antimalarials delivered: Programme data (public sector) 100 Source: DHS 2002, DHS 2007

60

60

Cases (%)

80

40

40 20

20

0







Impact

ABER (%)


2002 2002 2002 2002 –


80

V.

AL AL QN QN –



100

0

Year adopted



Medicine

1 000 100 10 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases

Zimbabwe

African Region


Zambia


%

6 380 000 0 6 380 000 12 760 000

50 0 50


Mozambique Botswana


Insufficient data

0

0–0.1

0.1–1.0

1.0–10

>75 0

PR





No No

– –

IRS


Yes Yes

1948 2004

IPT


Yes

1997

Yes Yes Yes Yes

2008 – 2008 1998

No

–


Financing

Antimalaria policy

Contribution (US$m)

2004 2004 2004 2004 –


Year

AL

2007–2007


No. of studies

Min Median

3

0

0

Max

Follow-up

1.9

28 days


20

ITNs

15

Diagnostics

10


5


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011



Coverage



100


80

60

60

Cases (%)

80

40

0


Impact






0

40 20

20

ABER (%)

Population (%)

AL AL QN QN –

25

0

Positivity rate (%)

Year adopted


30

V.

Medicine

100 10 1 0.1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Admissions

Deaths

Confirmed cases
