While COVID-19 has rightly dominated headlines across the world over the past two years, another – much older and deadlier – disease arguably presents a more urgent challenge for Africa.
Today, the World Health Organization’s (WHO) annual World Malaria Report revealed the most accurate picture to date of the impact of malaria on the continent. Tragically, more people died of malaria in Africa in 2020 than from COVID-19.
Dating back millions of years, malaria remains the greatest and most persistent threat to public health across the continent, with Africa accounting for 96% of the 627,000 lives claimed by the disease globally in 2020. Disruptions to malaria programmes due to COVID-19 also caused two-thirds of additional malaria deaths, with a 12% overall increase in malaria deaths in 2020 compared to revised 2019 figures. Most malaria victims are children under the age of five.
However, the picture could have been much worse. Countries, partners and community health workers worked tirelessly to prevent the worst-case scenario – a potential doubling of malaria deaths that could have resulted from the pandemic disrupting life-saving malaria prevention and treatment programmes in sub-Saharan Africa last year alone. Long-term and new investments and close collaboration with countries and partners were critical to helping minimize COVID-19’s impact on malaria.
Today, nearly two years into the COVID-19 pandemic and after several years of sluggish progress, we are at a precarious junction. Now, more than ever, we must remain steadfast in our efforts to eradicate malaria, while at the same time helping countries build resilience to withstand future health emergencies.
Funding for global malaria control and elimination interventions fell drastically short of last year’s US$6.8 billion target, reaching only US$3.3 billion in 2020. This shortfall has resulted in thousands of lives lost to a preventable and treatable disease and means even greater investment is now needed if we are to achieve the 2030 targets for malaria.
But we should not be deterred, as our track record of past successes show that our strategy works. Since 2000, strong political commitment, an unprecedented injection of funding, and new and effective interventions have saved the lives of 10.6 million people and prevented 1.7 billion new malaria infections. In that time, 23 countries from every region worldwide achieved three consecutive years of zero malaria cases, with seven certified malaria-free by WHO in the last five years, despite the pandemic, proving that eradication is possible. More and more African countries are rolling out Zero Malaria Starts with Me campaigns and launching national End Malaria Councils and Funds to mobilize domestic resources in the fight against malaria.
We have a wide range of tools in our armoury that can be deployed to defeat malaria. WHO’s recent approval of the RTS,S vaccine for widespread use in children in high-burden settings, especially in Africa, will help save tens of thousands more children. The Gavi Board’s recent decision to fund malaria vaccine programmes will bring new vigour to the malaria fight. More and more high-burden countries are applying sub-national tailoring and using real-time data to ensure smarter and more effective surveillance that enables us to better target resources.
We have a robust pipeline of innovations – from next-generation nets to antimalarial medicines, to new malaria vaccines such as BioNTech’s mRNA vaccine – that, if accelerated, could deliver more effective and transformative tools within the decade. By maintaining these efforts, we can once again start to see a rapid decline in malaria deaths and infections while building resilience throughout local health systems.
These are just a few of the reasons why we must now see a significant increase in annual global malaria investments. We know that Africa shoulders the vast majority of the global burden, with some countries spending up to 40% of their health budgets on the fight against malaria. Eradicating malaria would free up resources and give them the capacity to deal with other existing and emerging diseases.
The return on this investment can be measured in economic terms too. A study by WHO showed that a country’s GDP could be boosted by 0.3% for every 10% reduction in malaria cases. This rises to an almost 2% increase in GDP for high-risk high-burden countries. The same study showed that malaria is responsible for an annual loss of US$12 billion dollars in productivity each year in Africa alone, drastically impeding the continent’s economic growth potential.
If we seize the opportunity and act with urgency, we can repeat and extend the success of malaria efforts in the early 21st century, saving millions of lives and driving economic recovery across the world’s most impoverished regions. The systems we put in place, the infrastructure we build and the innovations we develop and bring to scale will cement resilience against future disease outbreaks and pandemics. By doing so, we will usher in the end of malaria within a generation.