Learning from COVID-19 and the continuing malaria fight

In countries where the disease burden of malaria is high, health systems have long felt the strain as governments seek to reduce its devastating impact. The positive news is that we are now at a tipping point in many countries where we know malaria can be beaten, even in remote communities, and areas affected by protracted conflict. Huge gains have been made since the Abuja Declaration of 2000 but those gains are fragile, with the pandemic serving only to exacerbate.

Malaria burden reduction is still possible with the right tools, investment & infrastructure

Reducing the burden of malaria is possible when: the appropriate tools are available for prevention and accurate and timely diagnosis and treatment, the latter increasingly being supported with digital solutions; when domestic and other funding are prioritised and there is long-term and meaningful community engagement to improve demand for and sustainability of health services; and when there is robust disease surveillance and response infrastructure capable of identifying outbreaks, alongside a culture of data-informed decision-making.

Disease surveillance and response must identify outliers/outbreaks of diseases otherwise in control

In the 16 months since COVID-19 was declared a global pandemic, countries have focused on containment and recovery, with an understandable need to re-allocate resources – both human and financial – to manage disease outbreaks. However, with a focus on malaria burden reduction – effective surveillance, differential diagnosis and response remain critical, with an additional priority of building community resilience to outbreaks as we move towards elimination. Surveillance and response approaches need to be carefully considered, resourced and planned.

Digital solutions at community level strengthen disease control

The COVID-19 pandemic has highlighted the potential of digital solutions to improve prevention, diagnosis and treatment of disease. In Mozambique, support was given for community health workers, who play a critical role in managing infectious diseases, to respond to the pandemic. By making adaptations made to the country’s existing upSCALE digital platform, COVID-19 health messages were provided for the community health workers. With misinformation arising from a lack of accurate and up-to-date evidence on the virus, supporting the accurate diagnosis of the disease at the community level is critical in helping to reduce the burden not only of COVID-19, but also of diseases such as malaria and pneumonia, which have similar symptoms.

Major interventions were still possible despite COVID-19

2020 presented new challenges for implementing community-based malaria control interventions. This included seasonal malaria chemoprevention (SMC), one of the most effective, preventive interventions for children aged five and under in areas where transmission is highly seasonal. Our 2020 campaign reached more than 12 million children and was implemented while following strict infection prevention and control (IPC) measures to minimise the risk of transmitting COVID-19. The measures were central to the safe implementation of the campaign, and their adoption into national guidelines to inform the 2021 campaign remains essential. SMC campaigns also proved a powerful platform to share vital other public health information on COVID-19 prevention and transmission.