While malaria is preventable and treatable, the lack of prevention and treatment due to economic and social instabilities results in millions of deaths every year. This life-threatening disease caused by parasites is transmitted to people through the bites of infected Anopheles mosquitoes. In 2018, total funding for malaria control and elimination reached an estimated $2.7 billion. Of this figure, $900 million came from the contributions from governments of endemic nations, representing 30% of total funding.
However, many experts fear that tracing and prevention of malaria will be disrupted due to the rapid spread of COVID-19 worldwide. Governments of the most marginalized nations will be especially hard hit as they face the pandemic while also protecting the progress made against other deadly diseases such as malaria.
Malaria Facts and Figures
Malaria is responsible for approximately one to two million deaths per year. Of these deaths, the overwhelming majority are in children aged 5 years or younger, while 80% to 90% of the deaths each year are in rural sub-Saharan Africa. The World Health Organization (WHO) reported that Africa continues to carry a disproportionately high share of the global malaria burden. The region reportedly had 93% of malaria cases and 94% of malaria deaths in 2018.
In 2018, the countries that accounted for more than half of all malaria cases worldwide included Nigeria (25%), the Democratic Republic of the Congo (12%), Uganda (5%), and Côte d’Ivoire, Mozambique and Niger (4% each). Unfortunately, some population groups are at considerably higher risk of contracting malaria than others. Children under 5 years of age, for instance, are the most vulnerable group affected by malaria. They accounted for 67% of all malaria deaths worldwide in 2018.
Early diagnosis and treatment of malaria not only reduce disease and prevent deaths but also reduce malaria transmission. As of now, P. falciparum malaria, an artemisinin-based combination therapy (ACT), is the best available treatment. Governments and international organizations are working hand-in-hand to control the disease. In 2015, the WHO adopted the Global Technical Strategy for Malaria 2016-2030, providing a technical framework for all malaria-endemic countries.
The framework sets ambitious but achievable global targets, including reducing malaria case incidence by at least 90% by 2030, reducing malaria mortality rates by at least 90% by 2030; eliminating malaria in at least 35 countries by 2030, and preventing a resurgence of malaria in all malaria-free countries.
Impact of the Current Pandemic on Malaria Treatment and Prevention
Recently, Zimbabwe reported a significant spike in malaria. The country’s Matabeleland South province has already reported three times more malaria cases than last year. Notho Dube, the provincial environmental health officer, said they recorded a total of 896 cases throughout the province with Beitbridge recording 819 and Gwanda 60. “Another worrisome development is that this year we recorded malaria cases in districts where we had never recorded any cases before,” he said.
Thus, the new guidance from the WHO said that COVID-19 could complicate tracing and treatment of malaria and compromise wider public health programmes. It could make the virus deadlier in countries most affected by malaria. The organization also said that there’s a possibility that the number of deaths from malaria in Sub-Saharan Africa this year could double due to the pandemic.
According to the World Economic Forum, an independent international organization committed to improving the state of the world by engaging business, political, academic, and other leaders of society to shape global, regional, and industry agendas, malaria deaths in Sub-Saharan Africa could jump to 769,000 if all insecticide-treated net campaigns are suspended and access to antimalarial medicine falls dramatically. Experts also fear that patients may or will suffer both from coronavirus and malaria, which can co-exist with other infections.
“The confirmation of a malaria infection does not rule out the possibility that the patient might also be suffering from Covid-19; similarly, suspected or confirmed Covid-19 patients in malaria-endemic areas should also receive a malaria diagnostic test. Tailoring malaria interventions in the Covid-19 response,” the WHO’s Global Malaria Programme said.
Experts also fear that the increasing demand for COVID-19 tests and finding drugs and vaccines for the virus may destabilize the fight against malaria and other diseases that kill millions, mostly in low- and middle-income countries. According to The Guardian, a British daily newspaper, Dr. Catharina Boehme, the chief executive of the Foundation for Innovative New Diagnostics (Find), said that some companies are planning to reduce or stop malaria, HIV, and TB test production to shift their production to COVID-19 tests.
“Given the risk that Covid-19 undermines our continued progress in the fight against existing epidemics, this is not the time to be to doing anything that weakens our ability to diagnose and treat those infected with HIV, TB, and malaria in a timely and cost-effective way. Doing so would cost lives,” Peter Sands, the executive director of the Global Fund, said.
In recent months, many have reported disruptions in the supply chains of essential malaria commodities, including long-lasting insecticidal nets, rapid diagnostic tests, and antimalarial medicines. This is mainly due to the lockdowns and suspensions of the importation and exportation of goods in response to COVID-19. It’s been proven that during past pandemics and outbreaks, losing sight of other health threats will only lead to a surge of diseases.
When the 2014 Ebola virus hit Guinea, Liberia, and Sierra Leone, malaria deaths surged. Studies conducted after the epidemic documented that malaria deaths far exceeded the numbers of those who died from the Ebola virus.
Dr. Marie Lamy, Asia Pacific Leaders Malaria Alliance director on access and policy, said that they are already being alerted of potential shortages of medicines including malaria drugs. About 10% of orders for HIV/AIDS, TB, and malaria medicines are facing delays of more than 30 days. This shows that many governments have shifted their focus to COVID-19, which is extremely worrying as many countries will soon enter the monsoon season with an expected surge in malaria cases.
The WHO encourages access to malaria prevention, care, and treatment for people at risk during the COVID-19 pandemic. “Do not scale back your planned malaria prevention, diagnostic and treatment activities. If someone living in a place. with malaria develops a fever, he or she should seek diagnosis and care as soon as possible,” Dr. Pedro Alonso, the Director of WHO’s Global Malaria Program, said.