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WHO is urging countries to move quickly to save lives from malaria in sub-Saharan Africa
Severe disruptions to insecticide-treated online campaigns and access to antimalarial drugs could double malaria deaths in sub-Saharan Africa this year compared to 2018, according to a new modeling analysis released by WHO and partners ahead of World Malaria Day (April 25 ).
WHO encourages countries to rapidly advance and distribute malaria control and suppression tools at this stage of the COVID-19 outbreak in sub-Saharan Africa and to do everything they can to safely maintain these basic malaria surveillance services.
The analysis considers nine scenarios of possible disruptions to access to basic malaria control tools during a pandemic in 41 countries and the resulting increases that can be observed in cases and deaths.
Under the worst-case scenario, with all insecticide-treated (ITN) networks suspended and 75% access to effective antimalarial drugs reduced, the estimated number of deaths from malaria in sub-Saharan Africa in 2020 would reach 769,000, double the number of deaths cases reported in the region in 2018. This would represent a return to malaria mortality last seen 20 years ago.
According to 2019 World Malaria Report, sub-Saharan Africa accounted for about 93% of all malaria cases and 94% of deaths in 2018. More than two-thirds of deaths were among children under five.
The window of opportunity
To date, the number of reported COVID-19 cases in sub-Saharan Africa has represented only a small proportion of the global total, although cases are increasing every week. This means that countries across the region have a critical opportunity to reduce malaria prevention and treatment disorders and save lives at this stage of the COVID-19 outbreak.
Mass vector control campaigns need to be accelerated, ensuring that healthcare professionals and the community are protected from COVID-19 transmission. WHO and partners welcome leaders from Benin, the Democratic Republic of the Congo, Sierra Leone, Chad and to launch ITN campaigns during the pandemic. Other countries are adjusting their allocation strategies to ensure that households receive networks as quickly and safely as possible.
Preventive therapy for pregnant women and children must be maintained. Allowing rapid diagnostic testing and effective antimalarial drugs are also essential to prevent the transition of a small case of malaria to serious illness and death.
WHO and partners have developed guidelines to ensure that those suffering from malaria can carelessly receive the care they need within the package of essential health services provided in the COVID-19 environment. Adaptation of malaria interventions in response to COVID-19 includes guidelines on infection prevention through vector control and chemoprevention, testing, case management, clinical services, supply chain and laboratory activities.
Note to the editor
The WHO conducted the modeling analysis in close collaboration with partners including PATH, the Malaria Atlas Project and the Bill & Melinda Gates Foundation.
The analysis is subject to uncertainties. They do not take into account, for example, the effects of interruption of internal residual spraying or seasonal chemoprevention of malaria (except in Burkina Faso); suspension of these basic malaria prevention tools would also lead to significant loss of life.
In addition, there is limited understanding of the spread of COVID-19, its epidemiology, and its interaction with malaria. The model will be updated as such information becomes available and countries are provided with relevant information to adjust their responses accordingly.
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