The COVID-19 pandemic has generated a hostile new environment for global health systems, including those in charge of preventing and controlling malaria. Consequently, as the world begins to emerge from the acute phase of COVID-19, it’s important to consider how strategies for malaria control will have to change in order to continue achieving hard-won progress in reducing the burden of this devastating disease. Furthermore, this article looks at how the pandemic has affected malaria control, as well as some of the challenges and opportunities presented by the new reality. Ultimately, it will explore how strategies for malaria elimination should adapt to deliver continued success.
The Impact of the COVID-19 Pandemic on Malaria Control
In the context of the COVID-19 pandemic, there have been multiple drivers of the impacts on global malaria control programming:
- Interruptions to Health Services: The COVID-19 pandemic triggered interruptions to health services in many places where malaria is endemic. Lockdowns, travel restrictions, and reallocation of human resources to prioritize COVID-19 response all decreased the availability of malaria services. Routine malaria prevention and treatment programs faced disruptions that limited access to ITNs and antimalarial drugs.
- Decreased access to preventive measures like ITNs and seasonal malaria chemoprevention (SMC) resulted from interrupted supply chains and logistical challenges. As a result, the number of households protected by these tools in sub-Saharan Africa fell by more than a third.
- Economic impacts: Financial support for malaria control programs decreased due to the economic downturn caused by the COVID-19 pandemic. This reduction resulted in fewer resources allocated to essential malaria activities. In each case, the focus is on environmental changes that create opportunities for malaria to spread, highlighting our vulnerability as individuals and societies to this mosquito-borne disease.
- Effectaria surveillance: The impact of the pandemic created large gaps in the ability of malaria surveillance systems to operate. This absence of data meant that many countries lost the ability to track cases, detect outbreaks, and optimally allocate resources to areas with the most at risk.
- Greater vulnerability, on account of the pandemic, causing further deterioration of the situation of some of the most at-risk communities due to exposure to poverty and the economic and social strains caused by the disruption in social, economic, and health services, and leading to reduced access to preventive and timely treatment.
Adapting Strategies for Continued Success in a Post-Pandemic World
Looking ahead, we need to evolve malaria control strategies to fit in a new global health landscape. Here are a few key strategies to maintain progress in the battle against malaria:
Reinforcing Health Systems
- Invest in and build up healthcare infrastructure: Malaria services need to be even more resilient to future disruptions than they were 12 years ago, so investment in and strengthening of infrastructure – for example, upgrading facilities, enhancing supply chains, and increasing distribution of malaria prevention and treatment tools – will be necessary.
- Integrated Services: Integrating malaria services with other health programs (eg, COVID-19 and other infectious disease programs) helps build an efficiency mindset and ensures that malaria control remains a priority (eg, co-location of services helps make access simpler, and reduces disruptions).
- Enhancing health workforce capacity: training and equipping frontline healthcare workers to deal with malaria and emerging health threats is essential. Enhancing capacity is critical to the resilience of health systems, which involves strengthening the capacity of health workers to provide quality care beyond malaria (diagnosis, treatment, and prevention) into other areas across the health spectrum.
Enhancing Malaria Prevention Measures
- Accelerate ITN Distribution: Reinvigorate ITN Distribution. Recommit the necessary resources to improve access to ITNs in areas where distribution faced delays or interruptions.
- Scaling Up Seasonal Malaria Chemoprevention (SMC): Revive SMC programs that were interrupted and expand them where needed to protect young children during peak transmission seasons. Efforts should focus on reaching all eligible children and ensuring adherence to treatment schedules.
- Scaling up Indoor Residual Spraying (IRS): IRS is a proven malaria control strategy, and scaling up IRS coverage and maintaining high-quality spraying programs are likely to make a significant contribution towards reducing mosquito populations and thus lower the risk of malaria transmission.
Improving Malaria Surveillance and Data Systems
- Improving Surveillance Systems: Malaria surveillance systems, with dedicated investments to develop data collection, reporting, and analysis, have the potential to capture more malaria cases and track temporal trends and geographical changes.
- Technological Leverage: By utilizing digital tools and technologies such as mobile health applications, geographic information systems (GIS), and population databases, the collection and monitoring of data can be rapidly improved. For instance, digital tools can incorporate real-time market information and administrative data sets to help with decision-making for malaria control on the ground.
- Data integration: Malaria data can be brought together with other health data systems to enhance the overall understanding of health trends and enable greater coordination between health programs.
Securing Sustainable Funding
- Call for increased funding: The generation of sustainable funding for malaria control deserves long-lasting strategies. Call for increased funding to governments, international organizations, and the private sector can continue and expand interventions.
- Further, Explore Financing Options: Scaling up could be achieved through additional finance through innovative approaches, such as results-based financing or public-private partnerships, which could also incentivize performance and attract additional sources of funding.
Strengthening Community Engagement
- Community action: Motivating all members of the community – community health workers, community leaders, and grassroots organizations – to prevent malaria and support treatment adherence will lead to more effective programs.
- Raising Awareness: Stepping up awareness about the disease and its prevention in pockets of resistance via targeted communications campaigns will provide better education to the communities, dispel wrong ideas, and reduce stigma. Awareness campaigns in the public health sphere can help to change human behavior.
- Boost buy-in: Create and sustain a trusting relationship between governments and communities – communities that are involved in the thinking and doing are more likely to accept and remain engaged in malaria control activities.
Supporting Research and Innovation
- Investing in Research: Research into new malaria preventions, treatments, and vaccines is a crucial area of investment. In particular, as new malaria prevention tools become available, investing in research that can enhance our ability to prevent, diagnose, and treat malaria will help save lives both now and in the future.
- Flexibility for emerging threats: Monitor emerging threats, such as drug resistance and invasive forms of mosquitoes, and adapt to protect us. Make sure research and surveillance stay up to date so we can address them before they undermine our control, and implement current guidelines for malaria care.
- Drawing upon lessons from COVID-19: We can leverage lessons learned from COVID-19 to improve the flexibility and adaptability of malaria control programs. For example, capitalizing on the use of innovative best practices and methods developed in the COVID-19 response can make malaria programs more resilient.
The COVID-19 pandemic has highlighted that health improvements in one part of the world benefit everyone, often by addressing the same pathogens. Moreover, it has shown that we best protect health when our systems are strong, flexible, and responsive to emergencies. As the world recovers from the coronavirus pandemic, it is crucial to examine how malaria control will adapt to this new reality to safeguard and build on the progress made against this ancient parasite.
To achieve this, we must renew our commitment to health systems strengthening, improve prevention and control measures, expand surveillance, secure adequate funding, scale up community engagement, and sustain research and discovery efforts. In doing so, we can consolidate the gains from decades of malaria control. Additionally, we can seize the opportunities presented by the post-pandemic era to safeguard the most vulnerable and advance our goal of eliminating this disease.
