Malaria remains a problem in many parts of the Asian and Pacific region despite a decrease in the number of cases reported. And while tuberculosis prevalence and death rates are on the decline in the region, they remain far higher than in Latin America and the Caribbean.

The number of malaria cases declined from over 5 million in 1990 to just over 3.1 million in 2005. The reduction was the fastest in the ASEAN region, more than a half. In 2005, the SAARC region accounted for two thirds of all cases in Asia
and the Pacific.

In terms of incidence, the Pacific is the most affected subregion. Timor-Leste had an incidence of 3,669 cases and Vanuatu had 4,566 new cases reported per 100,000 population, but both are dwarfed by Solomon Islands, where 16,249 cases per 100,000 population were reported in 2005.

Figure 7.1 Ten most affected countries/areas for malaria incidence, 1990 and 2005

In South-West Asia, Afghanistan and the Islamic Republic of Iran have considerably reduced malaria incidence since the early 1990s. While Afghanistan had an incidence of 2,508 cases per 100,000 population in 1990, by 2005 that incidence had been reduced to 266. During the same period, the Islamic Republic of Iran reduced malaria incidence from 137 to 27. Nonetheless, Afghanistan still has one of the highest incidences of malaria in the region, despite an increase in the use of insecticide-treated mosquito nets, one of the simplest and most effective ways to reduce exposure.

Another major disease of concern across Asia and the Pacific is tuberculosis. As in the rest of the world, both prevalence and death rates related to this disease have started to decline in the region. Nonetheless, while tuberculosis prevalence, at 238 per 100,000 population, is about half that in Africa, it is far higher than in Latin America and the Caribbean.

Most groups of countries have made good progress in reversing the incidence of tuberculosis and thus reducing prevalence. Although prevalence in Asia and the Pacific declined by 39 per cent between 1990 and 2005, in the ASEAN and SAARC regions they dropped by 43 per cent and 45 per cent, respectively. In Central Asia, however, tuberculosis prevalence, as well as incidence, has increased over the levels prevailing in 1990.

Annual incidence figures for Central Asia increased to 117 per 100,000 population in 2005, against 60 in 1990. This prompted an increase in prevalence figures from 100 to 141 per 100,000 population during the same period. In the Russian Federation, prevalence increased from 82 to 150 per 100,000 population in a decade and a half, while in Kazakhstan, prevalence increased from 96 to 155 per 100,000. Finally, the prevalence in Tajikistan, which had been 196 per 100,000 population in 1990, rose to 297 in 2005, the highest in the subregion.

Cambodia and Timor-Leste, with prevalence higher than 700 per 100,000 population, have the most serious tuberculosis problem among the countries of the region. In the Pacific, the most serious problems occur in Kiribati, Papua New Guinea and Tuvalu, with rates over 400 per 100,000 population, although these the numbers for these countries are considerably lower than in 1990.

Figure 7.2 Tuberculosis incidence in Asia and the Pacific, 1990 and 2005