Journal
NATURE
Volume 526, Issue 7572, Pages 207-+Publisher
NATURE PORTFOLIO
DOI: 10.1038/nature15535
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Funding
- UK Medical Research Council (MRC) [K00669X]
- UK Department for International Development (DFID) MRC/DFID [K00669X]
- Bill and Melinda Gates Foundation (BMGF) [OPP1068048, OPP1106023]
- BMGF [OPP1106023, OPP1032350, OPP1110495, OPP1119467, OPP1093011]
- Wellcome Trust [095066]
- RAPIDD program of the Science & Technology Directorate, Department of Homeland Security
- Fogarty International Center, National Institutes of Health
- MRC Fellowship [G1002284]
- Global Good Fund
- Medical Research Council [MR/K010174/1B, G1002284, MR/K00669X/1] Funding Source: researchfish
- MRC [G1002284, MR/K00669X/1] Funding Source: UKRI
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Since the year 2000, a concerted campaign against malaria has led to unprecedented levels of intervention coverage across sub-Saharan Africa. Understanding the effect of this control effort is vital to inform future control planning. However, the effect of malaria interventions across the varied epidemiological settings of Africa remains poorly understood owing to the absence of reliable surveillance data and the simplistic approaches underlying current disease estimates. Here we link a large database of malaria field surveys with detailed reconstructions of changing intervention coverage to directly evaluate trends from 2000 to 2015, and quantify the attributable effect of malaria disease control efforts. We found that Plasmodium falciparum infection prevalence in endemic Africa halved and the incidence of clinical disease fell by 40% between 2000 and 2015. We estimate that interventions have averted 663 (542753 credible interval) million clinical cases since 2000. Insecticide-treated nets, the most widespread intervention, were by far the largest contributor (68% of cases averted). Although still below target levels, current malaria interventions have substantially reduced malaria disease incidence across the continent. Increasing access to these interventions, and maintaining their effectiveness in the face of insecticide and drug resistance, should form a cornerstone of post-2015 control strategies.
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