COVID-19 casts a long shadow for the malaria fight in Africa

COVID-19’s rapid spread to all parts of the world not only profoundly changed our lives but presented yet another challenge in the fight against malaria. We must learn from the pandemic to reinvigorate our efforts towards a malaria-free Africa, says Dr Abdourahmane Diallo.

The novel coronavirus presented added challenges for the malaria response, putting millions more people at greater risk from this preventable and treatable disease, straining already fragile health systems, and further threatening historic progress-to-date against malaria.

Although the fight against malaria got harder this year, so did our resolve. Whilst there have been many challenges this year, the global malaria community’s commitment to the fight against this disease has not wavered.

Back in April, the World Health Organization (WHO) and partners forecast that the Covid-19 pandemic could double malaria deaths in Sub-Saharan Africa this year alone. Immediate action from governments around the world was necessary to prevent this worst-case scenario.

Thanks to continued action, commitment of country and global leaders and the dedication of health workers around the globe, 90% of planned malaria programmes are on track this year across nearly 30 countries. This means that 200m mosquito nets are on schedule to be delivered by the end of the year and over 20m children have been reached with seasonal malaria chemoprevention. This is a remarkable achievement – in large part due to the African countries’ leadership and determination – that deserves to be celebrated.

The world has made tremendous progress against malaria since 2000, preventing 1.5bn cases of malaria and saving 7.6m lives. This represents millions of children who have grown up to lead happy and productive lives as a result of our malaria control and prevention efforts.

However, despite remarkable progress since the turn of the century, most high burden countries in Africa are struggling to make significant or consistent gains in the fight against malaria in recent years. According to the latest World Malaria Report released today by WHO, global malaria deaths fell to the lowest figure on record in 2019 at 409,000, yet malaria cases increased slightly to 229m. Africa continues to shoulder the heaviest burden of malaria – over 90% of global infections and deaths.

Furthermore, despite countries’ heroic efforts this year, malaria cases and deaths are still projected to increase in 2020 as a result of Covid-19. As little as a 10% disruption in access to effective antimalarial treatment in sub-Saharan Africa could lead to 19,000 additional deaths – most of them are likely to be in young children who are at greatest risk of malaria.

As we look toward 2021, with the prospect of enduring health and economic impacts of Covid-19, it is critical that we continue to drive action against one of the world’s oldest and deadliest diseases. The truth is that every malaria death is avoidable, and it is simply unacceptable that hundreds of thousands of people continue to die each year from this preventable and treatable disease.

With support from global partners, malaria-affected countries must continue to protect tremendous gains against malaria, and together, we must sustain malaria investments that are pulling ‘double duty’ during the pandemic.

But we cannot achieve the progress we need with the current level of funding. Every year, global investments and political will to prioritise fighting malaria make a significant difference – without these, malaria deaths and cases would be significantly higher. Yet more is needed to close the $2.6bn a year gap in funding to reach all those at risk with the life-saving malaria tools they need. This must be a focus for the global malaria community next year, as the economic fallout from Covid-19 will force us to do more with less resources.

Investments in malaria bring outsize returns not only in terms of stronger health systems, but also stronger economies and communities. With so much to gain, the investment in malaria control, and ultimately elimination, is one of the greatest ventures any country can make.

The Covid-19 pandemic plainly showed how public health and the health of our economies are interlinked. Malaria’s heavy economic toll on the African continent – from the loss of productivity to a ‘growth penalty’ of up to 1.3% GDP – has been known for some time. We need to act with the same sense of urgency to prevent this ancient disease from sapping the lifeblood out of 21-century economies.

For this, we need everyone to play their part – not just governments but also businesses and communities. I am therefore encouraged by the recent Zero Malaria Business Leadership Initiative spearheaded by Ecobank together with the African Union Commission, non-profit organisation Speak Up Africa and the RBM Partnership to End Malaria, which seeks to engage Africa’s private sector –and especially small and medium sized enterprises that are the economic engine of the continent – in the fight against malaria.

Innovation will play a critical part in this. The Covid-19 pandemic reinforced how investing in real-time data is vital to effectively fight an infectious disease, and to win the malaria fight. As we move forward, we must leverage lessons from Covid-19 to innovate and adapt our responses and scale up our use of data. The African continent has made significant leapfrogs by using new technologies such as mobile banking in the past; today we need Africa-led innovations that will help us achieve the same breakthroughs in public health.

I am convinced that with greater investment, innovation and accountability, we can emerge stronger from the Covid-19 pandemic and deliver on our promise of a malaria-free Africa.

Dr Abdourahmane Diallo is CEO of the RBM Partnership to End Malaria.