World Malaria Day 2020
Global health has never been more in the public eye than right now and it is vital to ensure that while we tackle to challenges COVID-19 brings to our health, economies, and society as a whole, we continue to work together to improve health around the world through increased access and greater equity.
With that in mind and to recognise World Malaria Day, I had the honour of recently interviewing Dr Abdourahmane Diallo, CEO of the RBM Partnership to End Malaria and ask him about malaria at the time of climate change, COVID-19 and working together across sectors to end malaria for good. I am pleased to share it with you.
How would you describe the current situation in the fight against malaria?
Since 2000, sustained global investments have driven malaria cases and deaths to historically low levels, saving 7 million lives and preventing more than 1 billion malaria cases. Efforts to fight malaria have been a hallmark of global cooperation of the early 21st century. We have already achieved some great milestones; the delivery of 2 billion insecticide-treated nets, the widespread use of artemisinin-combination therapies and the first malaria vaccine being rolled out.
However, despite remarkable progress, every two minutes a child still dies of malaria. Today, half the world remains at risk of malaria – 405,000 people died in 2018 from the disease and more than 90% of cases and deaths are concentrated in Africa. As we enter the new decade of action, we must continue to hold leaders accountable, raise funding against the disease and drive much needed research and development. The elimination of malaria must remain a global health priority.
What countries are seeing a decline, and which are seeing a rise in cases?
Several countries with a high burden of malaria have achieved significant reductions in malaria cases - India reported 2.6 million fewer malaria cases in 2018 over the previous year, while Uganda reported 1.5 million fewer cases. Furthermore, at least 10 countries that are part of the WHO “E-2020” initiative are on track to reach the 2020 elimination milestone of the global malaria strategy.
In recent years, however, global progress in reducing malaria infections and deaths has levelled off, particularly in countries with a high burden of malaria. In one year, from 2016 to 2017, the crisis in Venezuela also accounted for a 170% increase in reported cases, and the country now accounts for 53% of all known cases in the Americas region.
More detail on progress made against malaria is available in the WHO World Malaria Report 2019.
How do you think climate change will alter the geographical patterns of malaria and what challenges will it bring?
Climate change and malaria are inextricably linked. As a disease, malaria is very climate-sensitive; as the globe gets warmer, malaria will be able to thrive in previously untouched areas. The World Health Organisation estimates that climate change will lead to 60,000 additional deaths per year due to malaria between 2030 and 2050. Extreme weather events can also play a part in this, as mosquitoes thrive in stagnant groundwater, which can be greatly increased by flooding. When tackling malaria and climate change, it is important that environmental experts and public health experts work together as the two are more connected than many may think.
Obviously, malaria was a focus alongside NTDs at the planned CHOGM in Kigali in June. As the meeting has now been postponed due to the pandemic, will you still be able to achieve the malaria goals you had?
he Commonwealth Heads of Government Meeting in 2018, when 53 leaders of the Commonwealth committed to halving malaria cases and deaths in the Commonwealth by 2023, was a significant event for progressing the fight against malaria. The CHOGM that had been planned for this June has now been officially postponed, however the global malaria community will nevertheless continue to adapt its approach to advocate for malaria elimination in the context of COVID-19. Our top priority at this time is to ensure the supply of vital malaria control tools used to protect millions of people across the world, particularly in countries with a high burden of the disease, as well as their safe delivery, including availability of personal protective equipment (PPE) for frontline health workers.
At RSTMH, we have been publishing and showcasing the challenges of malaria since the early 1900s but these days malaria is lucky to have many organisations wholly focused on its elimination. What role do you think we should be playing in the fight against
We have made great progress against malaria over the past two decades, however the fight is far from over and we cannot put our tools down! The Royal Society of Tropical Medicine and Hygiene plays a valuable role in education and research and RSTMH’s insights will be vital to ensure we stay ahead of the evolving mosquito. In fact, last year the Lancet Commission on Malaria Eradication Report and WHO SAGme Executive Summary studies confirmed that a malaria-free world can and should be achieved, but that this will only be possible with increased investment in researching, developing and scaling up transformative tools to combat growing drug and insecticide resistance and to prepare us for the next set of challenges in the malaria fight.
Malaria is one of the world’s deadliest diseases, yet it is entirely treatable and preventable. Only by continuing to actively fight it, increasing our capacity and boosting innovation can we reach elimination. With the emergence of COVID-19, this is now more important than ever.
How do you ensure malaria is not forgotten during a pandemic like COVID-19?
The current COVID-19 outbreak underscores the critical importance of having strong surveillance and health care systems to effectively address existing infectious diseases like malaria and new and emerging ones like COVID-19. Efforts to limit the spread of COVID-19 are necessary to protect health systems, yet these efforts must not compromise access to life-saving malaria prevention, diagnosis and treatment services or threaten to reverse decades of hard-fought progress against malaria.
This World Malaria Day will emphasise the importance of upholding progress and commitments made in the global fight to end malaria. We must continue, safely, universal coverage campaigns for long-lasting insecticide treated nets (LLINs), seasonal malaria chemoprevention (SMC) and indoor residual spraying (IRS), focusing on reaching those at highest risk – women and children under 5 in sub-Saharan Africa. We cannot leave anyone behind.
What actions that we could take to tackle COVID-19, may also help the fight against malaria?
Robust health systems are our primary line of defence against disease. Every dollar invested in the fight against malaria helps build stronger and more resilient health systems, which are central to combatting existing threats like malaria and emerging ones like COVID-19. Investments in malaria increase capacity of health workers, strengthen supply chain management systems, build real-time surveillance and data management infrastructure, improve laboratories, and reinforce monitoring and evaluation.
 From the World Malaria Report