By Kate Kelland
LONDON, Nov 29 (Reuters) - Progress in the global fight against malaria has stalled amid signs of flatlining funding and complacency that the mosquito-borne disease is less of a threat, the World Health Organization said on Wednesday.
Malaria infected around 216 million people in 91 countries in 2016, an increase of 5 million cases over the previous year, the WHO said in its annual World Malaria Report. It killed 445,000 people, about the same number as in 2015.
The vast majority of deaths were in children under the age of five in the poorest parts of sub-Saharan Africa.
"Globally ... after an unprecedented period of success, we are no longer making progress," said Abdisalan Noor, a WHO expert on malaria and lead author of the report. "I am concerned that we have become complacent."
WHO Director-General Tedros Adhanom Ghebreyesus added that "in some countries and regions, we are beginning to see reversals in the gains achieved".
Pedro Alonso, director of the WHO's global malaria programme, said that partly due to funding, and partly due to governments shifting focus away from malaria, the progress seen in the past decade is no longer being sustained.
"We want (this to be) a wake-up call to the malaria community," he told reporters on a teleconference. "We are not on track, and we need to get back on track."
Overall funding for malaria has levelled off since 2010. In 2016, an estimated $2.7 billion was invested in malaria control and elimination efforts globally. In 2015, funding totalled $2.9 billion - almost the same as in 2010.
The WHO says a minimum annual investment of $6.5 billion is needed by 2020 to meet targets on controlling malaria by 2030.
The WHO report found that when analysed on a country-by-country per capita basis, funding in countries where there is a high threat of malaria has fallen to an average of less than $2 per year per person at risk.
Noor said that alongside stagnating funding, the report found "equally concerning" gaps in access to and use of vital malaria prevention, diagnostic and treatment tools such as bed nets, indoor spraying and primary healthcare.
Fewer than half of households in countries in sub-Saharan Africa have enough bed nets to protect against mosquito bites, and only about a third of children in Africa with a fever have access to free public health sector medical care.
Tedros, who spent many years as a government minister fighting malaria in Ethiopia before coming to the WHO, said it would take robust financial resources and political leadership to swing the pendulum back towards a malaria-free world
"We are up against a tough adversary. But I am also convinced that this is a winnable battle," he said.
(Editing by Alison Williams and William Maclean)