Op-Ed: What Africa can do to reverse its recent rise in malaria

By Olivia Ngou, Deputy Director, Africa, Malaria No More

Like most African countries, my native Cameroon has made great progress in fighting malaria, halving the number of malaria deaths in just a decade from 2005 to 2015.

This significant achievement was made possible by ramping up access to and use of proven, cost-effective tools such as insecticide-treated bed nets, anti-malarial drugs and diagnostic tests. Crucial to this was raising awareness about these tools and adapting them for use in malaria-affected communities.

So it is alarming that malaria cases – particularly in Africa, which accounts for approximately 90 per cent of the world’s malaria – are on the rise again for the second year in a row. Unless we stay focused on fighting malaria, especially in the highest burden countries, our hard-earned gains could be lost.

Cameroon, along with 10 of the highest burden countries, is taking action as part of a coordinated effort called The High burden to high impact: a targeted malaria response launched November 19. This response requires several actions to be fully supported by all parties involved.

First, we need greater investments to deliver the right set of tools and services to all those who are vulnerable to malaria. It is no coincidence that progress on malaria has flat-lined at the same time that investment in malaria control has barely increased and remained at 2013 levels.

In Africa, around half of people at risk for malaria are still not sleeping beneath insecticide-protecting bed nets. Current tools are helping to save hundreds of thousands of lives, and they could save even more if we fill gaps in key countries.

Second, we need to increase investments in researching and developing new ways to treat and prevent the spread of malaria.

And third, we must ensure that any new malaria control methods serve the most affected communities, who have the most at stake to end this preventable but deadly disease.

Community engagement was key to introducing Rapid Diagnostic Tests – an easy-to-use but transformative innovation – that drastically improved our ability to diagnose and treat malaria cases.

These tests use a finger prick of blood to quickly confirm if someone has malaria and help a health worker determine the appropriate action to take. Before these tests were widely available, getting a diagnosis was a lengthy and difficult process: people had to travel many kilometers to a clinic with a microscope and a lab technician. Many simply took anti-malarial drugs they may not have needed instead.

The Rapid Diagnostic Tests were a game changer only because community health workers learned how to use them for better diagnosis and treatment, and educated community members to accept the test results.

To replicate this success and to get ahead of malaria once and for all, we need new technologies. Emerging solutions such as a malaria vaccine or genetically modified malaria-carrying mosquitoes hold the potential to help significantly reduce malaria cases and deaths in the future. No one innovation will be a silver bullet, but taken together they make the end of this disease possible.

A malaria vaccine is in development and being rolled out in three African countries next year, while emerging gene drive research is advancing, but still many years away from field tests.

The PATH Malaria Vaccine Initiative and Target Malaria are working in African countries and supporting African researchers to explore these new potential tools. Both make concerted efforts to involve communities and are taking phased approaches in their research and development.

Those of us who face the threat and consequences of malaria daily are eager for greater access to existing tools, and continued commitment and funding to developing powerful new tools. We want them to have the best chance at succeeding, and this happens when communities are actively involved. This must continue to be a best practice.

In global health, we often hear about potential new, transformative tools. Tools are truly transformative when they get to the people who need them most, and communities have a voice in the process of shaping and accepting these technologies. This is what will help us achieve a malaria-free world.

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