Combined Impact Of COVID-19 And Malaria Could Be ‘Catastrophic’, Warns Leading Research Group

The combined impact of Covid-19 and malaria in regions where malaria is widespread “could be catastrophic,” warned David Reddy, CEO of Medicines for Malaria Venture (MMV), the Geneva-based product development partnership, just ahead of World Malaria Day, which is celebrated on Saturday, 25 April.

His commment to Health Policy Watch,  came in the wake of WHO’s publication of a new study that forecast malaria deaths could double in sub-Saharan Africa in 2020 – effectively winding the clock back to levels seen two decades ago – if the delivery of core malaria control tools, including bednets and antimalaria drugs, is interrupted due to the pandemic response.

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 antimalariala,  malaria deaths in sub-Saharan Africa in 2020 would reach 769 000, nearly twice the number of deaths reported in 2018 and comparable to levels seen at the turn of the millennium, the new WHO study warned.

“Having witnessed the devastating impact of the pandemic on health systems around the world, we know this intuitively to be the case, and this study backs that up with modelling data,” Reddy said. “We need to act now and do all we can to avoid this catastrophic loss of life. Among other measures, this means ensuring bednets and antimalarials are available and accessible to people that need them – especially children under 5 years of age and pregnant women who are at greatest risk of malaria morbidity and mortality.”

Children and Pregnant Women Among the Most Vulnerable

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.  Altogether, there were an estimated 228 million cases of malaria worldwide and 405 000 malaria-related deaths.

Malaria was also one of the top 5 killers of adolescent girls and young women aged 15-19 in 2019.  Due to physiological changes that reduce natural immunity during the first pregnancy,  pregnant teenagers and young women may become seriously ill and even die from malaria, experts point out. In 2016, malaria caused some 10,000 maternal deaths, mostly in sub-Saharan Africa, where there is moderate to high transmission of the parasite, according to expert reviews.

“Across the world, this pandemic has surfaced a deep anxiety for the loss of lives of our loved ones,” Reddy said, noting that was also “an anxiety that echoes the deep, unheard concern of millions of parents of malaria-infected children every day. ”

The new WHO analysis considers nine scenarios for potential disruptions in access to core malaria control tools during the pandemic in 41 countries, and the resulting increases that may be seen in cases and deaths.

In a press release issued ahead of World Malaria Day, WHO urged countries to move fast and distribute malaria prevention and treatment tools at this, still early, stage of the COVID-19 outbreak in sub-Saharan Africa, and to do their utmost to safely maintain essential malaria control services even if the regional epidemic accelerates.

COVID-19 Cases Comparatively Small – But Rapidly Rising In Africa 

At 17000 cases and 748 deaths as of Thursday, the number of reported COVID-19 infections in WHO’s African Region has represented a comparatively small proportion of the global total, though hundreds of new cases are now being reported every day.

But countries across the region still 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, WHO says.

The organization advised that mass malaria vector control campaigns be accelerated, while ensuring that they are deployed in ways that protect health workers and communities against potential COVID-19 transmission. WHO and partners commend the leaders of Benin, the Democratic Republic of the Congo, Sierra Leone and Chad for initiating ITN campaigns during the pandemic. Other countries are adapting their net distribution strategies to ensure households receive the nets as quickly and safely as possible.

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.

WHO and its partners have developed guidance on maintaining malaria services in COVID-19 settings.  The document, Tailoring malaria interventions in COVID-19 response includes guidance on the prevention of malaria infection through vector control and chemoprevention, testing, treatment of cases, clinical services, supply chain and laboratory activities.

 

 

Image Credits: UNICEF USA , Elizabeth Poll/MMV.