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Climate change and the global malaria recession


The current and potential future impact of climate change on malaria is of major public health interest1,2. The proposed effects of rising global temperatures on the future spread and intensification of the disease3,4,5, and on existing malaria morbidity and mortality rates3, substantively influence global health policy6,7. The contemporary spatial limits of Plasmodium falciparum malaria and its endemicity within this range8, when compared with comparable historical maps, offer unique insights into the changing global epidemiology of malaria over the last century. It has long been known that the range of malaria has contracted through a century of economic development and disease control9. Here, for the first time, we quantify this contraction and the global decreases in malaria endemicity since approximately 1900. We compare the magnitude of these changes to the size of effects on malaria endemicity proposed under future climate scenarios and associated with widely used public health interventions. Our findings have two key and often ignored implications with respect to climate change and malaria. First, widespread claims that rising mean temperatures have already led to increases in worldwide malaria morbidity and mortality are largely at odds with observed decreasing global trends in both its endemicity and geographic extent. Second, the proposed future effects of rising temperatures on endemicity are at least one order of magnitude smaller than changes observed since about 1900 and up to two orders of magnitude smaller than those that can be achieved by the effective scale-up of key control measures. Predictions of an intensification of malaria in a warmer world, based on extrapolated empirical relationships or biological mechanisms, must be set against a context of a century of warming that has seen marked global declines in the disease and a substantial weakening of the global correlation between malaria endemicity and climate.

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Figure 1: Changing global malaria endemicity since 1900.

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  1. Patz, J. A., Campbell-Lendrum, D., Holloway, T. & Foley, J. A. Impact of regional climate change on human health. Nature 438, 310–317 (2005)

    Article  ADS  CAS  Google Scholar 

  2. Lafferty, K. D. The ecology of climate change and infectious diseases. Ecology 90, 888–900 (2009)

    Article  Google Scholar 

  3. McMichael, A. J. et al. in Comparative Quantification of Health Risks: Global and Regional Burden of Disease due to Selected Major Risk Factors (eds Ezzati, M., Lopez, A. D., Rodgers, A. & Murray, C. J. L.) 1543–1649 (World Health Organization, 2004)

    Google Scholar 

  4. Tanser, F. C., Sharp, B. & Le Sueur, D. Potential effect of climate change on malaria transmission in Africa. Lancet 362, 1792–1798 (2003)

    Article  Google Scholar 

  5. van Lieshout, M., Kovats, R. S., Livermore, M. T. J. & Martens, P. Climate change and malaria: analysis of the SRES climate and socio-economic scenarios. Glob. Environ. Change 14, 87–99 (2004)

    Article  Google Scholar 

  6. Intergovernmental Panel on Climate Change. Climate Change 2007: Impacts, Adaptation and Vulnerability. Contribution of Working Group II to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change (eds Parry, M. L., Canziani, O. F., Palutikof, J. P., van der Linden, P. J. & Hanson, C. E.) (Cambridge Univ. Press, 2007)

  7. US Environmental Protection Agency. Endangerment and Cause or Contribute Findings for Greenhouse Gases Under Section 202(a) of the Clean Air Act (Technical Support Document) (US Environmental Protection Agency, 2010)

  8. Hay, S. I. et al. A world malaria map: Plasmodium falciparum endemicity in 2007. PLoS Med. 6, e1000048 (2009)

    Article  Google Scholar 

  9. Hay, S. I., Guerra, C. A., Tatem, A. J., Noor, A. M. & Snow, R. W. The global distribution and population at risk of malaria: past, present, and future. Lancet Infect. Dis. 4, 327–336 (2004)

    Article  Google Scholar 

  10. Snow, R. W., Guerra, C. A., Mutheu, J. J. & Hay, S. I. International funding for malaria control in relation to populations at risk of stable Plasmodium falciparum transmission. PLoS Med. 5, e142 (2008)

    Article  Google Scholar 

  11. World Health Organization. World malaria report 2009 (World Health Organization, 2009)

  12. Intergovernmental Panel on Climate Change. Climate Change 2007: The Physical Science Basis. Contribution of Working Group I to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change (eds Solomon, S. et al.) (Cambridge Univ. Press, 2007)

  13. Lysenko, A. J. & Semashko, I. N. [in Russian] in Itogi Nauki: Medicinskaja Geografija (ed. Lebedew, A. W.) 25–146 (Academy of Sciences, Moscow, 1968)

    Google Scholar 

  14. Mouchet, J. et al. Biodiversité du paludisme dans le monde [in French] (John Libbey Eurotext, 2004)

    Google Scholar 

  15. Small, J., Goetz, S. J. & Hay, S. I. Climatic suitability for malaria transmission in Africa, 1911–1995. Proc. Natl Acad. Sci. USA 100, 15341–15345 (2003)

    Article  ADS  CAS  Google Scholar 

  16. Martens, W. J. M., Jetten, T. H. & Focks, D. A. Sensitivity of malaria, schistosomiasis and dengue to global warming. Clim. Change 35, 145–156 (1997)

    Article  Google Scholar 

  17. Reiter, P. Global warming and malaria: knowing the horse before hitching the cart. Malaria J. 7, (Suppl. 1)S3 (2008)

    Article  Google Scholar 

  18. Lindsay, S. W. & Martens, W. J. M. Malaria in the African highlands: past, present and future. Bull. World Health Organ. 76, 33–45 (1998)

    CAS  PubMed  PubMed Central  Google Scholar 

  19. Martens, P. et al. Climate change and future populations at risk of malaria. Glob. Environ. Change 9, S89–S107 (1999)

    Article  Google Scholar 

  20. Smith, D. L., McKenzie, F. E., Snow, R. W. & Hay, S. I. Revisiting the basic reproductive number for malaria and its implications for malaria control. PLoS Biol. 5, e42 (2007)

    Article  Google Scholar 

  21. Okell, L. C., Drakeley, C. J., Bousema, T., Whitty, C. J. & Ghani, A. C. Modelling the impact of artemisinin combination therapy and long-acting treatments on malaria transmission intensity. PLoS Med. 5, e226 (2008)

    Article  Google Scholar 

  22. Smith, D. L., Hay, S. I., Noor, A. M. & Snow, R. W. Predicting changing malaria risk after expanded insecticide-treated net coverage in Africa. Trends Parasitol. 25, 511–516 (2009)

    Article  Google Scholar 

  23. Killeen, G. F. et al. The potential impact of integrated malaria transmission control on entomologic inoculation rate in highly endemic areas. Am. J. Trop. Med. Hyg. 62, 545–551 (2000)

    Article  CAS  Google Scholar 

  24. Kouznetsov, R. L. Malaria control by application of indoor spraying of residual insecticides in tropical Africa and its impact on community health. Trop. Doct. 7, 81–91 (1977)

    Article  CAS  Google Scholar 

  25. Fillinger, U., Ndenga, B., Githeko, A. & Lindsay, S. W. Integrated malaria vector control with microbial larvicides and insecticide-treated nets in western Kenya: a controlled trial. Bull. World Health Organ. 87, 655–665 (2009)

    Article  Google Scholar 

  26. Teklehaimanot, H. D., Teklehaimanot, A., Kiszewski, A., Rampao, H. S. & Sachs, J. D. Malaria in São Tomé and Principe: on the brink of elimination after three years of effective antimalarial measures. Am. J. Trop. Med. Hyg. 80, 133–140 (2009)

    Article  Google Scholar 

  27. Kleinschmidt, I. et al. Reduction in infection with Plasmodium falciparum one year after the introduction of malaria control interventions on Bioko Island, Equatorial Guinea. Am. J. Trop. Med. Hyg. 74, 972–978 (2006)

    Article  Google Scholar 

  28. Sharp, B. L. et al. Seven years of regional malaria control collaboration - Mozambique, South Africa, and Swaziland. Am. J. Trop. Med. Hyg. 76, 42–47 (2007)

    Article  Google Scholar 

  29. Bhattarai, A. et al. Impact of artemisinin-based combination therapy and insecticide-treated nets on malaria burden in Zanzibar. PLoS Med. 4, e309 (2007)

    Article  Google Scholar 

  30. Smith, D. L., Dushoff, J., Snow, R. W. & Hay, S. I. The entomological inoculation rate and Plasmodium falciparum infection in African children. Nature 438, 492–495 (2005)

    Article  ADS  CAS  Google Scholar 

  31. Smith, D. L., Guerra, C. A., Snow, R. W. & Hay, S. I. Standardizing estimates of the Plasmodium falciparum parasite rate. Malar. J. 6, 131 (2007)

    Article  Google Scholar 

  32. Smith, D. L. & Hay, S. I. Endemicity response timelines for Plasmodium falciparum elimination. Malar. J. 8, 87 (2009)

    Article  Google Scholar 

  33. Guerra, C. A. et al. The limits and intensity of Plasmodium falciparum transmission: implications for malaria control and elimination worldwide. PLoS Med. 5, e38 (2008)

    Article  Google Scholar 

  34. Diggle, P. & Ribeiro, P. J. Model-based Geostatistics (Springer, 2007)

    MATH  Google Scholar 

  35. Stein, M. L. Space-time covariance functions. J. Am. Stat. Assoc. 100, 310–321 (2005)

    Article  MathSciNet  CAS  Google Scholar 

  36. Antosiewicz, H. A. in Handbook of Mathematical Functions (eds Abramowitz, M. & Stegun, I. A.) 435–479 (Dover Publications, 1964)

    Google Scholar 

  37. Davis, G. M. in Handbook of Mathematical Function (eds Abramowitz, M. & Stegun, I. A.) 253–295 (Dover Publications, 1964)

    Google Scholar 

  38. Hay, S. I., Guerra, C. A., Tatem, A. J., Atkinson, P. M. & Snow, R. W. Urbanization, malaria transmission and disease burden in Africa. Nature Rev. Microbiol. 3, 81–90 (2005)

    Article  CAS  Google Scholar 

  39. Killeen, G. F., Ross, A. & Smith, T. Infectiousness of malaria-endemic human populations to vectors. Am. J. Trop. Med. Hyg. 75, 38–45 (2006)

    Article  Google Scholar 

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We thank A. Bibby, H. C. J. Godfray, G. D. Shanks and G. R. W. Wint for comments on the manuscript. S.I.H. is funded by a Senior Research Fellowship from the Wellcome Trust (#079091) that also supports P.W.G. and previously A.J.T. R.W.S. is funded by a Principal Research Fellowship from the Wellcome Trust (#079080) that also supports A.P.P. D.L.S. and A.J.T. are supported by a grant from the Bill and Melinda Gates Foundation (#49446). D.L.S. and S.I.H. also acknowledge funding support from the RAPIDD program of the Science & Technology Directorate, Department of Homeland Security, and the Fogarty International Center, National Institutes of Health. This work forms part of the output of the Malaria Atlas Project (MAP,, principally funded by the Wellcome Trust, UK.

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S.I.H. conceived the research. P.W.G. and S.I.H. drafted the manuscript. P.W.G. led, and A.P.P., D.L.S., A.J.T. and R.W.S. contributed to, the analyses. All authors discussed the results and contributed to the revision of the final manuscript.

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Correspondence to Peter W. Gething or Simon I. Hay.

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The authors declare no competing financial interests.

Supplementary information

Supplementary Information

This file contains Supplementary Information on (A) the weakening geographical relationship between climate and malaria endemicity 1900-2007 and (B) estimating changing endemicity in terns of PfR0 effect size, Supplementary References, Supplementary Figures S1-S2 with legends and Supplementary Tables S1-S3. (PDF 644 kb)

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Gething, P., Smith, D., Patil, A. et al. Climate change and the global malaria recession. Nature 465, 342–345 (2010).

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