On 11-12 August 2024 in Kigali, the capital of Rwanda, the world’s leading politicians, health experts, and stakeholders gathered under one roof for the First Kigali Summit on Malaria. The tropical disease malaria remains one of the world’s most critical public health problems, especially in sub-Saharan Africa. Against this backdrop, the First Kigali Summit on Malaria provided a valuable opportunity to assess progress and challenges. Stakeholders reflected on advancements and discussed how the global health community can overcome obstacles to accelerate and sustain malaria control. In this article, I will report on the outcomes of the Kigali Summit.
1. Progress in Malaria Control
a. Significant Reductions in Malaria Cases
Among the key success stories of the summit was the report that malaria cases had declined in many high-burden countries. Successes were attributed to several factors.
- Expanded delivery of ITNs (insecticide-treated nets): Large-scale distribution campaigns have resulted in at least tens of millions of ITNs being delivered to at-risk populations and a decrease in transmission in targeted areas.
- More Indoor Residual Spraying (IRS): expanded IRS programs in areas with high malaria transmission are reducing mosquitoes that carry malaria.
- Expanded diagnostic and treatment services: better access to rapid diagnostic tests (RDTs) and more effective antimalarial treatments, including artemisinin-based combination therapies (ACTs), provided more timely and appropriate treatments.
b. Innovative Vector Control Strategies
The summit showcased several innovative approaches in vector control that have yielded positive results:
- Genetic Control Technologies: Because malaria is transmitted by mosquitoes that breed in untreated stagnant water near people, groups are trialing technologies to suppress mosquito population numbers and degrade their ability to pass on the parasite through genetic modification and gene drive technologies.
- Biological Control Methods: larvivorous (egg-eating) fish and bacteria are being used to control the mosquito larvae at breeding sites.
- Automated Traps and Electronic monitoring devices to measure potential vectors are getting more accurate and efficient through automated traps and electronic monitoring systems that allow for more effective targeting of interventions.
c. Strengthened International Collaboration
Global partnerships and collaborations have played a crucial role in malaria control efforts:
- Funding and Resources: Support from international donors and organizations has increased, giving countries the resources to expand malaria control programs and research.
- Research and innovation: Some of these tools, like malaria vaccines and new diagnostic tests, have resulted from collaborative research initiatives.
- Thanks to this mutual exchange of lessons learned and best practices, countries have benefited from the experiences of others, making their interventions more effective and evidence-based.
2. Ongoing Challenges
a. Insecticide and Drug Resistance
A significant challenge highlighted at the summit is the growing problem of resistance:
- The emergence of insecticide-resistant mosquito strains is also beginning to weaken ITNs and IRS through overuse and the development of resistance mechanisms in the mosquito population.
- Drug resistance: Malaria parasites are already resistant to antimalarial drugs, in particular ACTs, reducing the efficacy of treatment and complicating control efforts. New therapeutic options need to be developed.
b. Funding Gaps and Resource Allocation
Despite progress, several funding and resource challenges persist:
- Limited Funding: Poor countries are often unable to afford full and sustained malaria control programs That’s it. Nothing more. A single sentence, two short paragraphs, and a hopeless level of cash-strapped despair. But there’s something better than repeating ‘meh’. It’s adding reality. Moving away from the limp oversimplifications of thought-terminating clichés. There is much more that can be said about Nigeria.
- Inequity of resource distribution: the high-burden areas receive fewer resources than the others. The final closure is the Inequity of resource distribution: the high-burden areas receive fewer resources than the others. This final closure deals with the resource uneven distribution, which leads to the failure of malaria fighting. The writer has included the similar ‘or’ and ‘and’ word closures. The slight mildness can only be seen in the ‘I could stare at my computer for hours before accomplishing it’ clause.
c. Operational and Logistical Issues
Operational and logistical challenges continue to hinder malaria control efforts:
- Supply Chain Interruptions: Programmes could be delayed if the supply chain for diagnostics, treatments, and vector control products is disrupted.
- Data Management and Surveillance: gaps in the ability to monitor and respond to localized patterns can occur when data management systems are inadequate. Improving data management is critical for the successful implementation of malaria control approaches.
d. Climate Change and Environmental Factors
Climate change and environmental factors are influencing malaria transmission patterns:
- Transmission Dynamics Changing: A rise in temperature, rainfall, and humidity is modifying the habitats of mosquitoes and the locations where the disease of malaria is spreading.
- Adaptation and resilience: Responding to climate-driven shifts in malaria transmission is going to rely on adaptation and resilience planning.
3. Strategic Recommendations
a. Enhancing Research and Development
The summit emphasized the need for continued investment in research and development:
- New Tools and Technologies: Developing new insecticides, antimalarial drugs, and vaccines more rapidly would allow us to overcome resistance and strengthen malaria control.
- Innovation in Vector Control: Research and development of new vector control innovations, such as genetic control technologies and advanced surveillance systems, will help vector management and reduce transmission.
b. Strengthening Health Systems
Improving health systems and infrastructure is essential for effective malaria control:
- Integration of malaria control with health services: By integrating efforts to control malaria with broader health services, it will also be possible to improve access to diagnostics and treatment overall, and to enhance health more generally.
- Capacity building: strengthening the capacity of healthcare providers and community health volunteers with training in malaria diagnosis and treatment can improve diagnosis and cure rates.
c. Increasing Funding and Resource Mobilization
Addressing funding and resource gaps requires:
- Mobilise Financial Resources: Governments, international donors and the private sector must increase financial resources for malaria control in high-burden areas.
- Better Use of Resources: Ensuring equitable distribution of resources and focusing on high-risk areas can make targeted interventions more effective and impactful.
d. Adapting to Climate Change
Developing strategies to address the impact of climate change involves:
- Surveillance of Environmental Changes: The implementation of surveillance systems that detect environmental changes that affect transmission can reduce the impact of climate change.
- RESILIENCE PLANNING: Climate resilience integrated into malaria control efforts will maintain the effectiveness of programs in a climate-changed context.
The fight against malaria reached a recent peak with the Kigali Summit on Malaria in December 2018, which followed the introduction of innovative insecticides, new diagnostic tests, and effective treatments. Yet perennial challenges, such as insecticide and drug resistance, interruptions in funding to critical programs, mitigating the effects of climate change, and innovative strategies for maintaining traction towards achieving elimination, were all brought to the fore at the summit. The need for continued mobilization and investment in the fight requires the commitment of governments, international organizations, development partner agencies, researchers, and communities to accelerate progress toward elimination.
