WHO, Lancet in malaria war

Days after a report in the British Medical journal the Lancet indicated malaria mortality almost double than previously estimated by the World Health Organisation (WHO), the international health organisation bounced back claiming that some key findings of the new study do not seem to be based on “strong evidence”.
The WHO has also recommended that there is no need for the malaria endemic countries to make any changes in the ongoing policies applied by them, following the recent Lancet report.
An article in the Lancet last week had estimated that 1.24 million people died of malaria in 2010 while for the same year, WHO had estimated that 655,000 people had died. “New data show that malaria mortality worldwide could be almost double that of previous estimates — at around 1.24 million deaths in 2010,” said the report in the Lancet. Led by Prof. Christopher Murray from the Institute for Health Metrics and Evaluation (IHME), University of Washington, experts had collected all data for malaria mortality from 1980 to 2010.
The Lancet report had also revealed more deaths in individuals aged five years or older than estimated in previous studies. While, the WHO estimated 55,000 deaths, the IHME 435,000 (nearly two-thirds of the total estimated deaths in children under five years of age in Africa). Doubting the classification of these deaths as malaria Robert D. Newman, MD, MPH director, Global Malaria Programme, WHO, said, “Such a result is unexpected in stably endemic areas, since partial immunity to malaria generally develops at an early age, protecting against severe disease and death. In other studies the quality of microscopic diagnosis used to validate cause of deaths has been challenged in other peer-reviewed articles. Moreover, other studies have found considerable over-diagnosis of severe malaria in health facilities. Hence, there is doubt about the classification of these deaths as malaria”.
Maintaining that the WHO stand by their previous estimates that was based on the methodology developed by the UN agency in collaboration with other partners, the WHO has urged the malaria global health community to exercise “caution when interpreting the malaria burden estimates.”
Claiming that coverage of the report in media has led to misleading conclusions, the experts at the WHO said, “While they appreciate the debate that the study will generate in the scientific world, some key findings do not seem to be based on strong evidence. The WHO, therefore, does not believe that any immediate changes are required to the policies currently being applied by malaria endemic countries with the support of implementing partners and donors,” added the director, Global Malaria Programme.

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