Every April 25 countries across the globe observe World Malaria Day which was established during the World Health Assembly in 2007. The day aims to raise global awareness on the issue, keep it high on the political agenda, as well as mobilize resources for malaria prevention and control, emphasizing the need for continued investment.
This year, World Malaria Day is marked under the theme "Time to deliver zero malaria: invest, innovate, implement." On this occasion, Sputnik outlines some major challenges faced by Africa, where this life-threatening disease is the most prevalent, as well as providing some insight into the continent's progress in the fight against malaria.
The WHO in its latest World malaria report indicated that in 2021, there were 247 million cases of malaria, while the estimated number of malaria-related deaths globally stood at 619,000. It was highlighted that the situation was largely aggravated by frequent disruptions associated with the COVID-19 pandemic, which resulted in 13 million more malaria cases and 63,000 deaths.
Major Challenges Along the Way
According to the WHO, as the disease is widely spread primarily in tropical and subtropical countries, Africa bears the highest share of the "global malaria burden."
In 2021, approximately 95% of all malaria cases and 96% of deaths were registered on the continent. Four African nations – Nigeria, the Democratic Republic of the Congo, Tanzania and Niger – accounted for more than a half of all malaria deaths worldwide.
Furthermore, children under five years old, as the most vulnerable and exposed to the disease group, accounted for almost 80% of all malaria deaths in Africa. The most devastating in these statistics is that despite global efforts to eliminate malaria, it remains to be persistent and still affects people's health and livelihoods in various regions of the world.
One of the reasons for the high malaria cases in Africa is that the continent is home to the most efficient malaria vectors. For example, the malaria parasite species Plasmodium falciparum causes the majority of infections and is responsible for most lethal cases. If untreated, P. falciparum malaria can progress to a severe form of illness and death within 24 hours.
The African malaria-transmitting mosquito species can be characterized by a long lifespan and strong human-biting habit. Moreover, both the malaria vectors and parasites have appeared to be highly adaptable, demonstrating a growing insecticide, diagnostic and drug resistance.
Another reason could be the level of socio-economic development of the malaria-endemic countries, as most of them are the world's poorest nations. In this case, malaria could be both a cause and a consequence of widespread poverty.
High mobility also presents a challenge to Africa's malaria elimination aspirations, as marginalized and vulnerable populations of the continent tend to travel vast distances across countries, thus contributing to the spread of infectious diseases.
Africa's Progress in Malaria Elimination
The fight against malaria requires significant investments, which is also a major obstacle for the continent. Only two African countries – Morocco and Algeria – have reached a malaria-free status, which the WHO assigns to those nations that achieved at least 3 consecutive years of zero indigenous cases.
It is known that malaria can be prevented by avoiding mosquito bites. In this regard, one of the least expensive and most effective weapons in this fight are long-lasting insecticidal nets. According to UNICEF, since 2004, more than 2.5 billion have been distributed globally, 87% of which were distributed in sub-Saharan Africa. In recent years, the continent has made progress in household ownership of the nets, with an average coverage of 66%.
Apart from that, new long-lasting insecticide-treated nets, insecticide formulations for vector control, as well as novel strategies for parasite suppression have recently appeared, building up Africa's toolbox aimed at malaria elimination.
There are also some innovative solutions implemented in various countries across the continent. In particular, Rwanda is among the first countries in Africa to integrate drones in the country's most endemic areas to fight mosquitoes. Drones are used to map mosquito breeding sites, allowing for targeted interventions. After the project was crowned with success, it was extended in 2023.
As of now, there are two malaria vaccines. The RTS,S, known by the brand name Mosquirix, was the first vaccine to be approved by the WHO for public use. As of 2022, it has been already given to about one million children in Ghana, Kenya and Malawi. Another vaccine, called R21/Matrix M, was greenlighted by Nigeria and Ghana, even before WHO approval. The new malaria inoculation is expected to enable African nations to effectively combat malaria and finally reach their malaria elimination targets.