A shortage of drugs and funds coupled with delays in distributing mosquito nets has led to an increase of people dying from malaria.
About 350 million to 500 million people in more than 100 countries each year catch the disease, which can kill in hours, the World Health Organisation (WHO) and UN Children's Fund (Unicef) said in Tuesday's World Malaria Report 2005.
Billed as the first global report, it follows a scathing editorial in The Lancet medical journal last month accusing an international partnership of more than 90 organisations and countries of failing to control malaria, saying they might have done more harm than good.
The Roll Back Malaria partnership (RBM), which includes the WHO and World Bank, was set up in 1998 to coordinate the fight against the mosquito-borne disease. Its goal is to halve malaria mortality by 2010 and again by 2015.
Africa is the hardest-hit region, with 80% of deaths worldwide, the majority south of the Sahara where the deadliest species of the malaria parasite thrives, the report said.
"Malaria is a neglected disease"
Roll Back Malaria
"Malaria remains the infectious disease that takes more lives of children in Africa than any other - three times as many as HIV infection," new Unicef executive director Ann Veneman, a former US agriculture secretary, said.
The UN report said donors were providing only a fifth of an estimated $3.2 billion needed each year to meet its goals.
"Malaria is a neglected disease, but a lot has been done since 2000 ... . We need more financial resources," Awa Coll-Seck, executive secretary of the RBM partnership, told a briefing.
There were "very positive trends" in malaria control, especially in Asia and Latin America, the WHO's Allan Schapira said.
The report pointed to "clear evidence of successful control efforts" in many countries, citing wider distribution of insecticide-treated mosquito nets in Ghana, Nigeria and Togo.
But many African countries only recently had increased access to treatment and prevention, making it too soon to say whether the global burden of malaria had increased or decreased since 2000, according to the report.
"[Malaria] kills at
least one million
people a year"
"Not until several years after high coverage with malaria prevention and treatment has been achieved will the worldwide impact on mortality be measurable," it said.
Insecticide-treated bed nets and the latest combination therapy (ACT) drugs, based on the traditional Chinese herbal medicine artemisinin "must reach many more people before we can have a real impact on malaria", WHO director-general Lee Jong-wook said.
Malaria "kills at least one million people a year, yet it is treatable and largely preventable with the tools available now", he said.
Swiss drug maker Novartis, which is providing its ACT drug Coartem at cost for use in developing countries, announced in November that its Chinese suppliers of the main ingredient were unable to deliver enough this year.
It would only be able to make 30 million doses in 2005, half of the expected global demand.
The recent shortage of artemisinin-based drugs had "hindered efforts to reduce the impact of the disease", the report said.
But global demand for all ACTs, estimated at 100 million to 120 million next year, is expected to be met, Schapira said.