Social distancing and government restrictions to combat the spread of COVID-19 are slowing the rates of hospital admittance and deaths, and easing the burden on overwhelmed health systems. But at the same time, the diversion of the world’s health resources toward halting and treating COVID-19 means less funding and an increasing burden on global healthcare efforts for other illnesses such as malaria.
While COVID-19 continues to rage, other diseases, such as malaria, cannot be ignored, and Sanofi is working to ensure that needed medicines are still reaching patients. On the occasion of World Malaria Day, it is preparing to work with several National Programs of Malaria Control, in particular in Senegal, on concentrated malaria education campaigns, through digital communication channels.
The challenge is to keep anti-malaria efforts on track, especially in Africa, where almost all malaria cases occur, and which has the weakest health systems in the world. The coronavirus pandemic has pushed even developed countries’ healthcare systems to the breaking point; it could easily overwhelm those in the African countries where malaria already extracts the heaviest toll.
The pillars of Sanofi’s holistic efforts are providing a range of accessible drugs and strengthening malaria education and awareness among children in low- and middle-income countries, particularly in sub-Saharan Africa.
Sanofi’s award-winning education tools include printed material and games, but new digital tools might be the best way to reach children who have to stay home during the COVID-19 crisis. They include a cartoon and videos available on YouTube and a progressive web app memory game. Children learn how to prevent, diagnose and manage malaria—important now because some symptoms of malaria and COVID-19 may overlap, such as fever.
“It's a very big part of what my team is doing,” Kuykens said of the digital education tools. “The focus is on how to teach children where malaria comes from and what they can do with their families to prevent it.”
Anti-malaria programs depend on diffusion of information, access to testing and medicines, and relatively simple vector control activities such as insecticide-treated mosquito nets and indoor spraying. Early diagnosis and treatment are key to reducing mortality. All of these activities are potentially under threat from coronavirus restrictions.
Health workers, even with adequate personal protective equipment, may not be welcome into homes. Conversely, people who are feeling ill may be afraid to go to clinics or hospitals, where they might be exposed to COVID-19.
The World Health Organization (WHO) has noted supply chain disruptions in the imports and exports of malaria test kits, netting, insecticides and medicines.1
With these complications in mind, the WHO and other actors in the global malaria community, including the RBM Partnership to End Malaria and the Global Fund, have issued calls to ensure that malaria-fighting efforts are not compromised by the fight against COVID-19.
As an example, the WHO points to the 2014-16 Ebola outbreak in west Africa, which “undermined malaria control efforts and led to a massive increase in malaria-related illness and death” in Guinea, Liberia and Sierra Leone. One study estimated more than one million additional cases in those three countries alone.2
Seeking new momentum
The global health community has set an ambitious target for 2030: A world free of malaria. Through substantial and sustained efforts and investment, the incidence of the disease fell by approximately 20 percent between 2010-18.
But there were still an estimated 228 million global cases of malaria in 2018, with 405,000 deaths. Children under age five are the most vulnerable, accounting for 67 percent of all deaths worldwide.3
But despite these encouraging numbers, progress has stalled.4 In the ten African countries with the highest rates of malaria, there were a total of 3.5 million more cases in 2017 compared with 2016, the United Nations said.5
There are good reasons to worry about malaria incidence in poor countries. Half of all global cases in 2018 were in just six African countries, with 93 percent of all cases on the continent as a whole. Malaria is the sixth-leading cause of death in low-income countries, according to the WHO; it’s not even in the top ten causes of death in richer countries.
But there is reason to hope that malaria prevention efforts can still have an effect during the COVID-19 pandemic, Villadary says. “Smartphone use and social media are well developed in African countries, and short videos with simple protection measures are important to reach children,” she said. “If there is one thing that COVID-19 has already demonstrated, it’s how digital channels can be a vehicle for information.”