Helen Pates Jamet
Global Head of Research and Market Access, Vestergaard
Gains made in the fight against malaria are in danger of being lost because of insecticide resistance. The world needs to think again about how it is tackling the disease — and fast.
There’s no doubt about it, says Helen Pates Jamet, Global Head of Research and Market Access at Vestergaard; in the fight against malaria, the world is at a crossroads.
This is alarming when such significant strides have been made in tackling the disease for more than a decade. The use of long-lasting insecticidal nets is largely credited with reducing malaria cases in Africa by 68% and individual access to an insecticide-treated bed net has increased from 34% in 2010 to 61% in 2016. However, last year the World Health Organization (WHO) reported an increase in the estimated malaria cases worldwide.
The gains we have made over the last decade are now in danger of being wiped out
WHO’s World Malaria Report 2017 reported an estimated 216 million malaria cases in 2016 — that’s an increase of around five million over the previous year — while deaths from the disease remained at a worryingly similar annual level (around 445,000 deaths globally).
The number of malaria countries reporting resistance to the chemical used on bed nets has increased from 71% in 2010 to 81%.
“One of the main concerns — and one of the biggest challenges we face — is insecticide resistance,” says Pates Jamet. “We have been warning about the danger of insecticide resistance for years, and now the number of malaria endemic countries reporting resistance to pyrethroids — the chemical used on bed nets — has increased from 71% in 2010 to 81% in 2016. There is an urgent need to use newer, more effective tools.” Unfortunately, the road to getting new products evaluated and to market can be frustratingly slow.
Vestergaard’s CEO, Mikkel Vestergaard, identifies another pressing need: the focus has to move from ‘coverage’ to ‘effective coverage’.
Take the bed net; a simple intervention: easy to give out, easy to use and designed to last for at least three years. “From a cost-effective point of view, nets are one of the cheapest ways on the planet to save a life,” he says. “But there’s no point in simply giving out millions of pyrethroid-only bed nets in areas with pyrethroid-resistant mosquitoes. We need to ensure that more effective nets that actually kill resistant mosquitoes are used at scale.”
We must improve access to effective protection
So, is Mikkel Vestergaard optimistic that malaria will ultimately be eliminated? “Well, first we need to get to the stage where no one is dying from the disease,” he says. And what’s particularly tragic is that the tools needed to achieve that goal are available right now. “Sadly, they’re not getting to the right places at the right scale. But the fact is, there’s no reason why anyone should die of malaria today. So, let’s get to that point — and then we can talk about ‘malaria elimination’.”