Asia is hit with 30 million cases of malaria a year resulting in 42,000 deaths, a report said Friday as experts called for an urgent response to the disease which stalks billions in the region.
Most international efforts to defeat malaria have so far been concentrated on Africa, where the majority of the 650,000 worldwide deaths occur.
But out of the 3.3 billion people at risk from the mosquito-borne disease, 2.5 billion live outside the African region -- mostly in Asia where growing resistance to the frontline drug treatment is also causing concern.
Leading scientists and health experts meeting in Sydney this week at the "Malaria 2012: Saving Lives in the Asia-Pacific" conference flagged the need for tougher political leadership and regional coordination.
Fatoumata Nafo-Traore, director of the Roll Back Malaria Partnership, the global framework for coordinated action against the disease, called for a renewed focus in Asia which has the second-highest malaria burden after Africa.
"In the face of persistent economic uncertainty and profound changes in the landscape of global development aid, the region needs strong political leadership," she said.
"It also needs to develop financing strategies that include substantive and sustained domestic investment, traditional multilateral and bilateral aid and truly innovative sources of funding."
She was speaking at the launch of a new report, "Defeating Malaria in Asia, the Pacific, Americas, Middle East and Europe", a joint initiative with the World Health Organization.
It showed that the parasite threatens more than two billion people each year in the Asia-Pacific region, while smaller numbers are at risk in the Americas (160 million) and Middle East (250 million).
There were some 34 million cases of malaria outside Africa in 2010, claiming the lives of an estimated 46,000 people.
The Asia-Pacific, which includes 20 malaria-endemic countries, accounted for 88 percent, or 30 million, of these cases and 91 percent, or 42,000, of the deaths.
India, Indonesia, Pakistan, Myanmar and Papua New Guinea were hardest hit.
Australian Foreign Minister Bob Carr, who attended the three-day Sydney conference, on Friday pledged US$100 million over the next four years to fight the scourge in the Asia-Pacific.
"Malaria does not respect borders," he said. "Our focus must be on cross-regional action alongside traditional single-country strategies."
The conference focused on growing resistance to the drug used everywhere to cure the life-threatening disease -- artemisinin, which is central to the efficacy of anti-malarial treatment.
Resistance has been detected in Cambodia, Thailand, Myanmar, and Vietnam and the report said it stood to "unravel the hard-won gains of recent years".
This includes 43 malaria-endemic countries worldwide reporting declines in malaria cases by 50 percent or more compared to the year 2000, according to the WHO.
The Asia-Pacific has traditionally been the epicentre for the emergence of drug-resistant malaria parasites, and the report said the spread of artemisinin resistance needed to be urgently addressed.
"Anti-malarial drug resistance is one of the greatest challenges to continued success in controlling and eliminating malaria in the Asia-Pacific," said Robert Newman, director of the WHO's Global Malaria Programme.
"It will be critical to galvanise political action and secure investments to implement an emergency response plan for the Greater Mekong sub-region."
Despite the progress, an estimated 216 million malaria cases still occur in the world every year and cause around 650,000 deaths, mostly African children under five.