Each year malaria sickens some 228 million people and kills 430,000, most of them in Africa, and most of them children. Spread by female Anopheles mosquitoes, malaria leads to fevers, lethargy, and chills. It can keep adults bedridden for weeks, take children out of school, and saddle families with crippling medical costs.
During the COVID-19 pandemic, the malaria community must remain committed to supporting the prevention of malaria infection, illness and death through preventive and case management services, while maintaining a safe environment for patients, clients, and staff. Deaths due to malaria and its comorbidities (anemia, undernutrition, etc.) must continue to be prevented. We must not lose the gains we have won throughout the past two decades of the malaria fight.
As outlined in BAAM’s position on COVID-19: “Keeping Malaria in Sight” and the BAAM Member COVID-19 Response Tracker we believe that we can and must take a multi-phased approach to first mitigate the impact of COVID-19 on the fight against malaria, and then build on those efforts to push closer to ending malaria for good.
Many global organizations are also funding focused responses to the pandemic. The WHO provided overarching principles as well as specific technical guidance for malaria interventions, including prevention of infection and disease, care and treatment of cases, testing, clinical services, supply chain and laboratory activities to take during the pandemic. Their data show that an overwhelming 769,000 deaths could occur this year, double that of 2018, due to disruptions in supply chains that affect bed net campaigns and access to antimalarial medicines. These figures represent those seen over two decades ago.
Furthermore, the Global Fund is at an important crossroads this year as it undertakes a mid-term review of their Global Fund Strategy 2017-2022 to assess the outcome and impact of investments in HIV, TB, and malaria in building resilient and sustainable health systems. Additionally, the Fund has launched its development process for its next strategy, scheduled to begin in 2023. BAAM members will have the opportunity to provide input into the strategy development process this Summer. Related to COVID-19, the Global Fund is engaging with key stakeholders to ensure the global response to the pandemic builds upon lessons learned from the historic fights against HIV, TB, and malaria.
The RBM Partnership has also mobilized workstream groups to help address the epidemic, and recently published their report “Monitoring and evaluation of malaria-related routine data during the COVID-19 pandemic”. Here they emphasize that routine disease surveillance will be critical for monitoring where malaria control, elimination and prevention of re-establishment efforts may be faltering during the pandemic as well as where COVID-19 may be spreading. Their recommendations include: 1) continuing to monitor key malaria (or malaria-related) indicators to assess where disruptions to access to care and to health service provision may be occurring, where malaria control, elimination or prevention of re-establishment may be faltering, or where COVID-19 may be spreading; 2) analyzing and interpreting indications where available; 3) understanding the context around the interpretation of these indicators; and 4) tailoring action to the observed trends.
As BAAM, we know that malaria eradication remains achievable in the coming decades. However, much depends on whether this year ultimately represents a blip on the radar or reversal in our progress. Governments, civil society, and international partners all need to collaborate to face the delicate balancing act to keep both COVID-19 and malaria under control. If the scales tip, hundreds of thousands of lives could be at risk.