World Malaria Report 2021

World Malaria report 2021

TRENDS IN THE BURDEN OF MALARIA
Malaria cases
■ Globally, there were an estimated 241 million malaria cases in 2020 in 85 malaria endemic
countries (including the territory of French Guiana), increasing from 227 million in 2019, with most
of this increase coming from countries in the WHO African Region. At the Global technical strategy
for malaria 2016–2030 (GTS) baseline of 2015, there were 224 million estimated malaria cases.
■ The proportion of cases due to Plasmodium vivax reduced from about 8% (18.5 million) in 2000 to
2% (4.5 million) in 2020.
■ Malaria case incidence (i.e. cases per 1000 population at risk) reduced from 81 in 2000 to 59 in
2015 and 56 in 2019, before increasing again to 59 in 2020. The increase in 2020 was associated
with disruption to services during the COVID-19 pandemic.
■ Twenty-nine countries accounted for 96% of malaria cases globally, and six countries – Nigeria
(27%), the Democratic Republic of the Congo (12%), Uganda (5%), Mozambique (4%), Angola
(3.4%) and Burkina Faso (3.4%) – accounted for about 55% of all cases globally.
■ The WHO African Region, with an estimated 228 million cases in 2020, accounted for about 95%
of cases.
■ Between 2000 and 2019, case incidence in the WHO African Region reduced from 368 to 222 per
1000 population at risk, but increased to 232 in 2020, mainly because of disruptions to services
during the COVID-19 pandemic.
■ The WHO South-East Asia Region accounted for about 2% of the burden of malaria cases globally.
Malaria cases reduced by 78%, from 23 million in 2000 to about 5 million in 2020. Malaria case
incidence in this region reduced by 83%, from about 18 cases per 1000 population at risk in 2000
to about three cases in 2020.
■ India accounted for 83% of cases in the region. Sri Lanka was certified malaria-free in 2016 and
remains malaria-free.

• In 2020, 29 of the 85 countries that were malaria-endemic accounted for 96% of malaria cases. India contributed 1.7% of malaria cases and 1.2% deaths globally.
• Between 2019 and 2020, all high burden to high impact (HBHI) countries except India reported increases in cases and deaths (and in India, the rate of reduction decreased compared with pre-pandemic years).
• Globally, there were an estimated 241 million malaria cases in 2020 in 85 malaria endemic countries, increasing from 227 million in 2019. Most of this increase came from countries in the WHO Africa Region, which accounted for 95% cases.
• Malaria deaths increased by 12% globally in 2020 compared with 2019, to an estimated 627 000. The percentage of total malaria deaths in children aged under 5 years reduced from 87% in 2000 to 77% in 2020.
• There were an estimated 14 million more malaria cases and 47 000 more deaths in 2020 compared to 2019 due to disruptions to services during the pandemic. However, things could have been far worse if not for the efforts of malaria-endemic countries to maintain essential health services.