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To defeat malaria, we need to invest in strong, integrated healthcare systems at the heart of nations with the greatest burden.
While the World Health Organization urges countries to continue their core malaria prevention, testing and treatment activities in the midst of COVID-19, there have been reports of initiatives being suspended in some countries. But we shouldn’t have to choose which battle to fight. “If we want to push forward, we can’t work in silos anymore – we need integrated healthcare systems,” explains Dr Sabine Dittrich, Head of Malaria and Fever at the Foundation for Innovative New Diagnostics (FIND).
Thousands of lives lost to malaria during global pandemics
We saw the disastrous impact of neglecting malaria in the wake of Swine influenza in 2009, Ebola in 2014 and Zika virus in 2015, when thousands more lost their lives to malaria than the disease outbreaks themselves.
We need to learn from our mistakes, which is why experts are urging global collaboration and investment in healthcare systems that can provide more coordinated care.
COVID-19 is disrupting vital supply chains
What happens on the ground is directly influenced by activities further up the supply chain – and those chains are being tested to the limit.
Manufacturing, research and testing have all been impacted by COVID-19, and import and export restrictions are disrupting deliveries. Such delays won’t just result in stagnation of activity on the ground.
As Jeff Smith, CEO of the Asia Pacific Leaders Malaria Alliance (APLMA) warns, “This could open the door for substandard products.”
Poor quality bed nets and sprays are certainly nothing new. They put lives at risk and also accentuate the problem of insecticide resistance, which threatens to reverse the huge global gains made in the last 20 years.
These concerns highlight the importance of strengthening national regulatory authorities and also reinforce the need for innovation.
“The model we’re using is to bring innovation to scale and increase access,” explains Dr Philippe Duneton a.i., Executive Director of Unitaid, a global development agency engaged in finding innovative solutions in global health. “You need a comprehensive approach. It’s a combination of prevention, testing and treatment, and we need to find the best weapons and combine them.”
Research and development
Malaria continues to outwit many of the tools in our current arsenal. Research and development is vital to bring new medication, improved vector controls and better diagnostics into play, but COVID-19 threatens to slow that process too.
“We’re currently modelling what the impact will be if production of these new chemistries is delayed by a month, or even a year. The prospect is scary,” continues Dr Nick Hamon CEO at Innovative Vector Control Consortium (IVCC).
Strong leadership is key
We know from experience that strong leadership can make a significant difference in these areas.
In 2014, heads of state at the East Asia Summit made a commitment to work toward the elimination of malaria in the region by 2030. That commitment was backed up by a regional road map and national investment.
Countries such as Thailand harnessed sophisticated technology to map the disease and monitor supply chains and budgets so resources could be deployed to areas of greatest need.
In Cambodia, innovation in insecticide treated clothing for outdoor workers has also reaped benefits – with the country reporting no malaria deaths since 2018.
Collaborating to fight disease
Putting activities to eradicate malaria on hold could have devastating consequences for a disease that already kills 405,000 people each year and infects 228 million.
If we are to protect lives, malaria initiatives can no longer be viewed in isolation.
No one should be forced to choose between fighting malaria or fighting COVID-19. By building a more integrated approach to healthcare in countries with the greatest malaria burden, benefits will be reaped across the board.
“If you strengthen entire healthcare platforms – you can cope with multiple diseases,” confirms Hamon, from IVCC.
Action is certainly needed right now to ensure that current malaria initiatives stay on track. However, as the world wakes up to the central role healthcare plays in all aspects of life, now is the time to renew efforts to strengthen those systems and push harder to eradicate malaria.