April 23 (IPS) – The occasion of World Malaria Day amid a global pandemic calls for an examination of the intersection between our decades-long battle against the world’s oldest known fever and the newest known pathogen that feeds a global pandemic.
In our view, one theme is abundantly clear: Effective management of COVID-19 through consistent public health responses that protect their people is supported by command. We have been operating largely with the same set of public health guidelines as physical distancing and masking for months.
From Singapore to Spain, from Mauritania to Manhattan, the results, however, have been radically different. Yes, testing, monitoring and treatment capabilities vary greatly; the poor face increased risk exposure. Even with these disparities, it is clear that leadership is key: from accepting the leadership of science to the role of communities in translating policies into action.
When national leadership decides to prioritize an issue, there is no doubt that progress will follow; malaria provides a prime example. After two decades of strong political commitment and effective interventions, 21 countries in every region of the world have eliminated malaria and many more are on the verge of elimination. 7.6 million deaths have been reported since 2000.
So how can we, in the midst of a global pandemic, accelerate the fight against malaria? Indeed, what are the relevant lessons from malaria to public health amid COVID-19?
Three areas are key to re-accelerating momentum and ensuring that malaria eradication remains a viable goal.
First, we must maintain the political will that drives leadership at multiple levels: from families to communities to districts to the national level.
Second, we need sustained funding for malaria and to effectively communicate the return on investment in terms of better health outcomes to leaders.
Third, we need to clearly articulate the link between malaria and strengthening health systems.
- Leadership and continuous renewal of political commitment
The progress made to date has shown that political will is key to elimination. The leaders of the two regions have shown this political will.
From the 2000 Abuja declaration, the 2006 Abuja ban, the 2012 African Union roadmap, the 2013 Abuja declaration to the 2014 commitment of the leaders of the East Asia Summit to eradicate malaria in Asia. Pacific by 2030 and the commitment of African heads of state and government to eliminate malaria also by 2030.
We believe that with continued political leadership; bolstered by more public and private sector funding to expand access to life-saving tools, we can – and must – end malaria. The establishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria, the President’s Malaria Initiative, as well as ALMA and APLMA were due to this political commitment and demonstrate shared responsibility and global solidarity.
To effectively translate political will into action and impact, subnational leadership at the district, provincial and state levels is also critical, particularly as we approach elimination. Strong local leadership can support subnational personalization of interventions based on locally available data to maximize impact in both Asia Pacific and Sub-Saharan Africa.
To guide the malaria response, connecting the dots consistently across all levels of government, from heads of state to the hearts of communities, including the most vulnerable and hard to reach, is the only way to ensure sustainable change.
- Support funding for malaria
Political will translated into financial commitment for malaria must be supported. We have come this far and have a historic opportunity to end a preventable and treatable disease at a time marked by the devastating impact of communicable diseases.
Two decades of investment in malaria so far have saved a staggering 7.6 million lives and prevented 1.5 billion malaria cases, which in turn has significantly reduced the burden on health systems around the world. improved maternal and child health, survival and prosperity.
But the WHO’s 2020 Global Malaria Report shows that progress has stabilized by the end of 2019 with political will and funding dwindling. The stakes are too high if we don’t sustain the earnings momentum we’ve made to date: Malaria can strain economies, damaging some nations’ GDP by up to an estimated 5-6%.
It has been estimated that the malaria “penalty” to GDP ranges from 0.41% of GDP in Ghana to 8.9% in Chad, which could be recovered after malaria eradication. Complete eradication of the disease would increase Uganda’s GDP by $ 50 million.
In Asia, despite the progress made, eradicating malaria has the potential to save over 400,000 lives and warn 123 million cases of malaria, translating into nearly $ 90 billion in economic benefits for Asia Pacific.
African countries are launching and leading multi-sector malaria councils and funds that keep malaria at the top of the local political, development and funding agenda. These institutions have led to greater action by the private sector and the public, supporting the responses of countries.
The surge in investment to end malaria is the path to eradication and will strengthen our ability to respond to future threats in this pandemic era. Investments in malaria have supported the expansion of a community health workforce that serves as eyes and ears on the ground for millions of children, adolescents and adults suffering from fever who do not make it to health clinics.
- Fighting malaria to build stronger health systems
The fundamental but most critical component of the fight against malaria, the management of infectious diseases and public health in general is to try, follow and deal. Enhanced surveillance, real-time data and diagnostics are critical for the early diagnosis of malaria and other infectious diseases such as COVID-19.
Africa established the Africa CDC and its regional collaborative centers to support African countries in their efforts to strengthen health systems and improve surveillance, emergency response, disease prevention and control. Asia Pacific countries are trying to establish similar mechanisms in the wake of the pandemic.
Countries that have invested in frontline malaria capabilities and interventions – particularly community health workers – are now effectively harnessing them for the COVID-19 response. Last year alone, malaria control efforts prevented some 500 million fevers and one million community health workers with rapid malaria diagnostic tests diagnosed 267 million fevers. Seven of the ten symptoms overlap between malaria and COVID-19, driven by fever.
This speaks to the importance of integrating malaria surveillance into the wider health system. From 40,000 health workers and nearly three million Army Women’s Development volunteers in Ethiopia, 33,000 frontline trained health workers in Uganda, to 1 million village health volunteers in Thailand – all managing COVID-19 while continuing to provide effective management of malaria cases during the epidemic.
While there is no single magic bullet for malaria elimination, evidence suggests that investments in the fight against malaria can in turn strengthen health system preparedness and help protect against current and future pandemics.
On this World Malaria Day, we must come together as political, social, religious, administrative and economic leaders and reaffirm political will and combined action to protect our people, to accelerate malaria gains again and leverage investment in malaria to fight COVID-19 and emerging diseases.
We have the tools and technology to test, monitor and treat the most common forms of the malaria parasite. Countries like Bhutan or Botswana have shown us what progress is possible; places the ten countries with the highest burden in Africa and the countries with the highest burden in Asia Pacific such as India, Indonesia, Papua New Guinea and reveals what remains of the work.
We know these challenges can be addressed; seizing this moment to double the acceleration of malaria elimination by strengthening health systems is not only possible, but crucial for our planet in the age of pandemics. In support of this, platforms that enable the exchange of expertise between leaders in districts and across national borders, which help monitor policy progress towards the ultimate goal and guide accountability, can help make a difference.
Ms Joy Phumaphi he is Executive Secretary, African Leaders Malaria Alliance (ALMA), former Minister of Health, Botswana
Dr. Sarthak Das is DrPH, Chief Executive Officer, Asia Pacific Leaders Malaria Alliance (APLMA) and Communicable Disease Threats Initiative
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