Progress in the fight against malaria, the deadliest disease in the history of mankind, has stalled. So on World Malaria Day 2019, the World Health Organization (WHO) is marshaling global efforts to push the limits of creativity and technology to regain momentum and beat back malaria by empowering the communities most affected by the disease.
As a longtime actor on several fronts of this fight, we are stepping up efforts by strengthening our award-winning Schoolchildren against Malaria program. We are also exploring drone delivery as a path toward a truly agile supply chain for drugs and diagnostic kits in the Mekong region of Southeast Asia, which is experiencing a dangerous uptick in drug-resistant malaria cases after 15 years of constant progress.
In 2016, 91 countries reported a total increase of five million cases over the previous year with the WHO revealing that no significant gains were made against malaria from 2015 to 2017. It reported an estimated 435,000 malaria deaths in 2017, “virtually unchanged” from 2016.
Malaria is a complex disease. The parasite that causes it is transmitted to humans through the bite of the Anopheles mosquito. The parasite colonizes and destroys red blood cells, causing the sudden onset of symptoms such as fever, fatigue, headache, shivering and vomiting. The disease can lead to severe anemia, convulsions, coma, kidney failure, and even death.
The mosquitos that carry the parasite are difficult to eradicate from human settlements, especially in impoverished and isolated areas. Among remote villages and itinerant populations, the “last mile” of the treatment and diagnostic supply chain is a key factor.
The five countries that make up the Mekong sub-region, including Laos, Vietnam, Cambodia, Myanmar and Thailand, are extremely difficult to reach during the rainy season, and the region has long been known for drug-resistant strains of malaria.
That is why Sanofi has partnered with the French drone company, Atechsys, and with the support of local non-governmental organizations and government authorities, to develop a cost effective, easy-to deploy and use, drone-delivery system called Faster2Care.
The program is at the proof-of-concept stage for now, said François Desbrandes, Head of Access to Healthcare for the Underserved, Sanofi Social Corporate Responsibility. Test flights have been run in France but not yet in the Mekong region, he said.
Different malaria strains respond to different drugs and drug combinations, Desbrandes said, and the situation is constantly evolving. Drones could make the supply chain agile enough to improve efforts to stop the worst strains from evolving and expanding into other countries. It would provide the ability to make several quick trips to try different treatments and lead to less stockpiling and waste.
He said simplicity and cost effectiveness were the current priorities. Small, helicopter-like drones would drop packages of less than 2 kilograms by parachute, rather than having to land or take off in the target area. “So it's safe for the drone and also for the population, and you would not have to train people to relaunch or pilot the drone,” Desbrandes said.
Reaching people is one obstacle to eradication, awareness is another, which is why we are also building a program around the next generation. Most of the victims of this disease are children, and according to WHO statistics a child dies from malaria every two minutes.
“They are the first victims of malaria,” said Isabelle Villadary, Head of Malaria Programs at Sanofi. But she added that children also are good ambassadors for behavioral change. “They are very good at engaging their community in the prevention and awareness of the disease.”
With this in mind, Sanofi launched the Schoolchildren against Malaria program in 2008 in Côte d’Ivoire. Since then it has expanded to 17 sub-Saharan African countries, where the program distributes the MOSKI KIT® to schools. These kits, developed in partnership with national malaria-control programs, contain a board game, memory cards, posters, and other materials to help kids understand the key messages around awareness, prevention, diagnosis and treatment, remember them, and spread the word.
The most recent additions to the program are a PC-based MOSKI MEMORY® game that gives kids a modern, multilevel quiz to learn about the dangers of malaria while playing, and a 12-minute video. In both the memory game and the video, characters like “Eddy the Ambassador” bring children key messages such as:
- Get rid of stagnant water and the high grass that allow mosquitos to live and breed.
- Treat houses with pesticides, put screens on windows, shut doors and light mosquito coils.
- Use treated bed nets properly and consistently.
- Don’t buy drugs in the local market–see only qualified medical personnel for diagnosis and treatment.
- Learn what the symptoms are and take them seriously.
- Give preventative medicine to pregnant women.
Villadary stressed that Sanofi has always developed fun, educational tools like these alongside local experts. “We always work with the Ministry of Education or a partner that in the past had disseminated printed materials in Africa,” she said.
The kits for school children take into account the large age range typical of an African classroom, she explained. “The materials are created for children who are not able to read as well as for those who are able to read and want to practice their reading.”
Malaria is both preventable and treatable. It has been eradicated from dozens of countries where it once was a major health problem. So why do the WHO statistics show that setbacks are happening in certain areas and that progress has stalled?
It’s a difficult question to answer simply and quickly, Villadary said, because there are so many variables and new problems are constantly cropping up–the collapse of Venezuela’s health care system and the mass exodus of its people, for example, has led to a huge rise in the number of malaria cases.
She emphasized the importance of funding and coordination and hitting the problem from all sides simultaneously. For example:
- Making people aware that bed nets work, but also distributing the nets effectively.
- Urging people to seek real medical professionals instead of traditional healers, but also making sure they have access to clinical centers.
- Providing good treatments but also making sure patients follow them to the end.
While Sanofi is best known for inventing and manufacturing effective treatments, the schoolchildren program and the drone effort demonstrate our commitment to a coordinated, creative and relentless global campaign to eliminate malaria.