By Anietie Udobit
Every April
25, the world is reminded of millions of human population who have been
‘unripely wiped’ out of existence by the scourge of malaria. This year 2020, a
grassroots campaign that aims to keep malaria high on the political agenda,
mobilize additional resources, and empower communities to take ownership of
malaria prevention and care, is launched, themed: “Zero malaria starts with
me”.
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In recent
years, campaign against malaria has ground to a standstill. WHO’s World malaria
report 2019, shows no global gains in reducing new infections over the period
2014 to 2018.
And so, the
“Zero malaria” campaign is to engage all members of society: political leaders
who control government policy decisions and budgets; private sector companies
that will benefit from a malaria-free workforce; and communities affected by
malaria, whose buy-in and ownership of malaria control interventions is
critical to success.
With greater
concern of the world towards minimizing the impact of Covid-19 pandemic, campaign
against malaria may likely become a less or non-issue.
Although WHO
has urged countries to move fast and distribute malaria prevention and
treatment tools at this stage of the COVID-19 outbreak in sub-Saharan Africa,
and to do their utmost to safely maintain these essential malaria control
services, it is not clear, if that will be taken serious.
The world health
body has raised concern, that under the worst-case scenario, in which all
insecticide-treated net (ITN) campaigns are suspended and there is a 75%
reduction in access to effective antimalarial medicines, the estimated tally of
malaria deaths in sub-Saharan Africa in 2020 would reach 769 000, twice the
number of deaths reported in the region in 2018. This would represent a return
to malaria mortality levels last seen 20 years ago.
According to
the World malaria report 2019, sub-Saharan Africa accounted for approximately
93% of all malaria cases and 94% of deaths in 2018. More than two-thirds of
deaths were among children under the age of five.
The shift in
focus to COVID-19 is becoming worrisome as the region soon enters [the] monsoon
season with an expected surge in malaria cases.
Fortunately,
to date, the number of reported cases of COVID-19 in sub-Saharan Africa has
represented only a small proportion of the global total, though cases are
increasing every day. This means that countries across the region have a
critical window of opportunity to minimize disruptions in malaria prevention
and treatment and save lives at this stage of the COVID-19 outbreak.
The COVID-19
pandemic has led to a surge of interest in certain drugs to treat the disease.
This includes hydroxychloroquine and chloroquine, oral drugs known as treatment
against malaria and other conditions, such as lupus.
These drugs
are part of the World Health Organization’s “Solidarity trials,” and in 35
ongoing clinical trials, according to a recent study that reviewed a list of
known online clinical trial registries. The U.S. Food and Drug Administration
has also given emergency use authorization for these drugs’ usage for treatment
or prevention of COVID-19.
There are
concerns that surge demand for these drugs could lead to shortages and
availability for those who need it, despite limited information of its
effectiveness. While it has yet to be
proven safe and effective for COVID-19 treatment, governments have started
placing large orders of these drugs.
It then means
that if chloroquine is eventually proven safe and effective for treatment of
COVID-19 there is fear that even with increased manufacturing there may not be
enough to support malaria treatments when chloroquine is indicated.
Currently, there
are shortages of commodities due to disruptions in production and supply
chains. These disruptions can lead to patchy supply of quality-assured
medicines which may open a door for poor-quality alternatives to infiltrate the
supply chain. And it is the communities at the end of the road who are most at
risk of accessing these substandard or falsified medicines.
Africa, a
continent heavily burdened with malaria and poor health systems, is at high
risk in these circumstances. There are increasing fears that COVID-19 could
impact the fight against malaria, which claimed 405,000 lives in 2018, with
Africa accounting for 94 percent of the global burden. The coronavirus is
putting pressure on national health systems, and threatening the wellbeing of markets
and businesses large and small.
According to
the Global Fund, COVID-19 could derail progress on HIV, TB and malaria through
disruption to access treatment or other interventions, or to supply chains of
critical medicines and medical supplies. Experience from the 2015 Ebola
outbreak in West Africa suggests that unless mitigating action is taken,
additional deaths from existing diseases such as malaria can be comparable or
greater than those from the outbreak itself.
Therefore,
Preventive therapies for pregnant women and children must be maintained. The
provision of prompt diagnostic testing and effective antimalarial medicines are
also essential to prevent a mild case of malaria from progressing to severe
illness and death.
Measures to
deliver essential antimalarial commodities and services must be considered
ahead of the rainy season, when malaria transmission is highest, although this
is already being complicated by lockdowns and travel bans, restricting
movements of health workers and causing some supply chain disruptions.
Anietie
Udobit is a Journalist and Social worker; Managing Editor of UNITY TIMES and
Executive Director of HELPALIVE CAREGIVERS