GAMBIA, MOZAMBIQUE (REUTERS) - Global efforts to fight malaria may have hit a wall.

After years of steady decline, annual rates of the mosquito-borne disease have leveled off according to the World Health Organization's 2018 report.

It says the only solution is to focus on the countries hit hardest by the disease - most of which are in Africa.

Although scientists are working on vaccines and ways to control mosquito numbers, preventative measures are not working fast enough.

The WHO's malaria chief Pedro Alonso says methods of combating malaria need fine-tuning.

"The question to us is how do we get back on track to meet those targets. And that is what WHO in co-operation with partners across the world is launching a response that we have called from high burden to high impact, putting the focus on the highest burden countries, helping them get back on track by the four key elements - political leadership, the use of information to better target the response, improving our normative work and most importantly coordinating all partners around a national plan - a nationally owned and developed plan," said Alonso.

The estimated number of malaria cases worldwide fell from nearly 240 million in 2010 to just over 214 million in 2015 but then rose by five million, to 219 million, in 2017.

There is some good news - Alonso also says countries with fewer than ten thousand cases of malaria are now within reach of eliminating the disease completely.

India recorded a 24 per cent reduction in malaria cases in 2017 and Rwanda saw a 436,000 drop.

The WHO needs to get back on track quickly if it is to meet its target of reducing disease and mortality rates by 40 per cent by 2020.