Africa continues to be the world’s most malaria-affected continent. In 2020, 95% of malaria cases and 96% of malaria deaths were reported by the World Health Organization (WHO) to have occurred in this region of the world. Yet funding is dropping off, and malaria-affected countries’ healthcare systems, already strained by the three-year struggle against COVID-19, are being undermined by the emergence of resistance to treatments and insecticides.
The appearance in Africa of the Anopheles stephensi mosquito species is, therefore, worrisome to specialists. This malaria vector, native to Southeast Asia, is resistant to conventional insecticides and, unlike African anopheles, is particularly well adapted to the urban environment. A 2020 model suggests the species could threaten up to 126 million people in Africa were it to spread to the continent’s major cities.
Combating malaria at every level
In response to an upsurge in malaria, efforts to control the disease continue. L’Initiative is working with stakeholders in more than 40 countries.
These obstacles are all preventing the international community from reaching the WHO target of reducing malaria case incidence and mortality rates by at least 90% between 2015 and 2030.
Alongside the Global Fund and its country partners, Expertise France, through L’Initiative, provides technical assistance and innovation support in partner countries to increase the impact of programs financed by the Global Fund. Supported by research institutes, local NGOs, and governmental institutions, these programs apply prevention tools and strategies recommended by the WHO to control the disease: distribution of long-lasting insecticidal nets and/or indoor residual spraying for vector control, rapid access to diagnostic tests in case of suspected malaria, and treatment of confirmed cases with antimalarials.
Other projects supported by L’Initiative relate to WHO recommendations for vulnerable population groups, including intermittent preventive treatment for pregnant women and infants. Malaria affects pregnant women and under-fives most severely due to their weak immune systems, with a child dying from malaria every two minutes in the world, mostly in Africa. Finally, seasonal malaria chemoprevention, which has been recommended for the past ten years, has been shown to be effective, inexpensive, safe, and practicable for the prevention of malaria in children under five years of age in areas of high seasonal malaria transmission.
In Ethiopia, HDAMA and the Malaria Consortium are about to launch a joint project to address the needs of seasonal mobile workers at risk of malaria.
Find the article “Malaria elimination in Ethiopia: the case of seasonal mobile workers“
A report calls for community health workers to be more widely integrated into healthcare systems in the Greater Mekong subregion.
The importance of malaria research
Research is also progressing. The WHO recently announced that it is recommending a vaccine for children at risk of malaria. The RTS,S vaccine is currently being rolled out in three sub-Saharan African countries. However, financial support is needed to meet the public health challenges of strengthening health systems in high-incidence countries and of engaging communities to support vulnerable population groups. Without this support, all these tools can only have a limited impact.
Also, as the malaria parasite evolves and drug resistance rises, other approaches and new tools need to be developed. L’Initiative, therefore, remains committed to operational research and, since 2018, has put out a specific annual call for projects in order to support researchers. Operational research is key to ending major pandemics. Among other benefits, it tests innovative approaches to prevention, screening, and care and helps to develop more effective response strategies.