Since the turn of the millennium, a concerted multilateral campaign against malaria has led to historically high levels of intervention coverage across much of sub-Saharan Africa. Understanding the impact of this unprecedented control effort is vital to inform decisions on the financing, planning, and implementation of post-2015 control efforts. However, national health records in 35 highly endemic African countries (together comprising about 90% of global malaria burden) are inadequate to assess trends in malaria cases. Official estimates of the incidence of clinical malaria instead incorporate an assumed intervention impact by extrapolating effect sizes derived from a small sample of efficacy trials. The real impact of malaria interventions on transmission and disease burden across the varied epidemiological settings of Africa therefore remains unknown. Here we present a Bayesian modeling framework that links continent-wide malaria field data with detailed reconstructions of changing intervention coverage to allow a direct evaluation of trends from 2000 to 2015, explore the attributable contribution of disease control, and assess the 2015 Millennium Development Goal (MDG) malaria targets.
Peter Gething is Associate Professor in Epidemiology at the University of Oxford and Director of the WHO Collaborating Centre in Geospatial Disease Modelling. He leads a group as part of the Malaria Atlas Project with broad interests in the development and application of empirical and biological models to address policy-relevant questions in tropical health. Areas of interest include the global mapping of Plasmodium falciparum and P. vivax endemicity and disease burden and understanding the patterns and determinants of changing disease risk.