The fight against malaria narrowly dodged a calamitous outcome after the spread of the COVID-19 pandemic last year. According to the World Health Organization (WHO), this “doomsday scenario” could have meant tens of thousands of more deaths from a disease that has historically left tropical countries ravaged.

On Monday, WHO released its latest edition of its World Malaria Report for 2020 which found a total of 241 million cases of the disease in 2020, up 14 million from 2019. The total number of deaths last year was 627,000, an increase of 69,000.

WHO's Director-General Dr. Tedros Adhanom Ghebreyesus said that the "hard work of public health agencies in malaria-affected countries" prevented the worst outcomes from coming to pass. He emphasized the focus should now be on harnessing the same efforts to "reverse the setbacks caused by the pandemic and step up the pace of progress against this disease.”

Dr. Pedro Alonso, director of WHO’s Global Malaria Program, echoed Tedros' praise of public health officials who helped stabilize the situation in their countries despite COVID-19. 

“I think we can claim that the world has succeeded in averting the worst-case scenario of malaria deaths that we’d contemplated as a likely or possible scenario a year ago,” said Alonso, adding that the “doomsday scenario has not materialized.” 

Alonso did caution against breathing any sigh of relief too soon. He warned that “we are not on a trajectory to success” given the continued spread of COVID-19, which has seen a new variant emerge in recent weeks. 

“How things will evolve over the coming weeks and months I wouldn’t dare to say at this point,” Alonso told reporters on Monday.

Malaria has largely been eradicated across the globe, but the bulk of contemporary cases are concentrated in sub-Saharan Africa, which accounts for 95% of all malaria cases and 96% of all deaths in 2020. About 80% of those who die from the disease are under the age of 5, according to WHO.

This year has seen some noticeable progress in the fight against malaria. In October, WHO officially recommended use of the RTS,S/AS01 (RTS,S) malaria vaccine in children after years of testing. The agency said the recommendation has the potential to “change the course of public health history."