Underfunding, resource diversion for Ebola could reverse recent successes

The number of people dying from malaria has been almost halved since 2000, although progress in West Africa risks being reversed by the Ebola outbreak, the World Health Organization said on Tuesday.

The UN agency also warned of major gaps in access to mosquito nets and anti-malaria treatments, as well as the worrying emergence of resistance to the most commonly used insecticides.

Worldwide, malaria deaths were down 47 percent between 2000 and 2013, the WHO said in its annual report on the disease.

In sub-Saharan Africa, where 90 percent of all malaria deaths occur, the mortality rate decreased by 58 percent among children under 5 years of age, the equivalent of about 3.9 million child deaths averted.

The number of infections in the region at any one time fell 26 percent during the same period.

Meanwhile, 13 of the 97 malarial countries reported no cases of the disease last year, including two, Azerbaijan and Sri Lanka, which recorded their first-ever zero results.

"These are truly unprecedented results and phenomenal news in terms of global health," said Pedro Alonso, director of the WHO's global malaria program.

He attributed the progress in large part to increasing financial and political commitment, in particular regional efforts to work together to eliminate malaria.

However, despite a threefold increase in investment since 2005, malaria programs are still underfunded - $2.7 billion in 2013 against a $5.1 billion international target.

And as a result, major gaps remain.

While access to insecticide-treated bed nets has improved, 278 million of the 840 million people at risk in sub-Saharan Africa still live in households without one.

As many as 15 million pregnant women do not receive any preventive treatment, while 437,000 African children are still dying from the disease each year.

Ebola threat

Any gains can be fragile. In Sierra Leone, Guinea and Liberia, the Ebola outbreak has halted malaria programs in some areas and put huge strain on health services.

"The collapse of health systems has affected all core malaria interventions and is threatening to reverse recent gains," WHO director-general Margaret Chan said.

Health workers had been increasingly using simple tests to diagnose malaria on the spot, but these have been suspended in Ebola areas.

Many people with malaria are also staying away from clinics, and if "they are not getting treated, you can be sure that mortality is going to increase", said Richard Cibulskis, lead author of the malaria report.

The death toll from malaria across the three countries was expected to be about 20,000 a year before the outbreak. Cibulskis would not predict a figure now.

More than 6,100 people have died from Ebola in the region in the past year.

Aside from the direct consequences, the resurgence of malaria could also harm the fight against Ebola because the two have similar symptoms, making it difficult to diagnose the deadly virus, the WHO has said.