Guillermo García
Senior Program Manager, Bioko Island Malaria Elimination Project,
Medical Care Development
Olivier Tresor Donfack
Technical Coordinator, Bioko Island Malaria Elimination Project,
Medical Care Development
Julie Niemczura
Senior Program Manager, Medical Care Development
In recent years, malaria cases have been on the rise. The disease transmission has changed — so the response to it must change too with a new, adaptive approach based on evidence and data.
Controlling malaria is — and has always been — a mammoth challenge. Decades after the first Global Malaria Eradication Programme was launched in 1955, this life-threatening disease still brings untold misery and death to many parts of the world. Indeed, malaria cases are on the increase. According to figures from the World Health Organization, there were 241 million cases in 2020 compared to 227 million in 2019.
There are a number of reasons for this rise, says Guillermo García, Senior Program Manager, Bioko Island Malaria Elimination Project at MCD, a global public health non-profit providing interventions across several health areas. “There are challenges, for example drug and insecticide resistance,” he says.
Understanding why there is a resurgence in malaria
Climate variability may also be partly responsible for the resurgence, as warmer temperatures and increased rainfall make better breeding conditions for mosquitoes; plus, the behaviour of mosquitoes is changing. “In some areas, there is evidence that insects are biting earlier in the evening, before people are indoors or protected by bed nets,” says Olivier Tresor Donfack, Technical Coordinator, Bioko Island Malaria Elimination Project, MCD.
To make matters worse, malaria control has faced huge funding constraints — and increased competition due to the global pandemic. This has hit resource-poor communities particularly hard as they face a disproportionate burden of illness, death, and declining economic productivity, welfare and wellbeing.
In this fight, there is often a need for more innovation and adaptation.
Guillermo García
Benefits of an adaptive evidence-based approach
To effectively respond to the resurgence and ultimately achieve elimination, it’s imperative that funding for malaria control continues. “Of course, any tools that are proven to work should continue to be deployed,” says García. “But in this fight, there is often a need for more innovation and adaptation.” After all, when traditional methods of malaria control prove inadequate, new approaches must be found.
This is why it’s important to adapt and optimise malaria control strategies through evidence-based decision making, based on the use of real-time spatially contextualised information. This can be delivered via different innovative systems.
For example, in Equatorial Guinea, MCD is using a tablet application (CIMS) to collect and use field-level malaria control data at the household and individual levels. Meanwhile, in other countries, MCD is supporting the integration of major health information databases to a common platform.
“Having a more efficient way of entering, processing and analysing data is a big benefit in the fight against malaria,” says Julie Niemczura, Senior Program Manager at MCD. “Real-time access to information shortens the feedback loop so that any deficiencies can be corrected immediately.”
Building local capacity with training and support
Not all solutions have to be hi-tech. “In some health facilities, wall charts filled out by hand are a simple way to track trends,” says Niemczura. “But how ever health managers receive the information, it’s crucial that they know how to use the systems and interpret the data to affect positive outcomes.” This requires building local capacity with robust training and support, delivered via different institutional partners.
An adaptive approach isn’t simply beneficial for controlling malaria. It can also promote sustainable health systems, strengthening their ability to respond rapidly and effectively to unforeseen challenges and emerging threats, such as the COVID-19 pandemic. “In Equatorial Guinea, a team that was fully trained to deliver clinical trials for malaria was quickly able to adapt to meet the demands of COVID-19,” remembers García.
Yet despite the increase in malaria cases, it’s important to keep things in perspective. “The resurgence does not mean that control programmes are failing,” stresses Donfack. “In fact, we’re optimistic that trends will change — if programmes adopt adaptive control measures based on evidence and data.”