Prevention of malaria shouldn’t stall due to Covid

Friday August 14 2020
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Dr Benjamin Pretorius

As Covid-19 threatens to derail more than a decade’s worth of hard-won gains in the fight against malaria, Dr Benjamin Pretorius, managing director at ERADA Technology Alliance, warns that diversions of malaria resources and interruptions to prevention programmes may cost thousands of lives.

He said: “2020 was heralded as the year the global community stepped up its fight to eradicate malaria once and for all. Slowing death rates and mortality, coupled with advancements in detection and research, painted an encouraging picture.
“Now Covid-19 threatens to derail the significant progress we have made.

“Malaria still takes the lives of 400,000 people every year. Halting prevention programmes in order to concentrate efforts on Covid-19 will see that number almost double in the worst case scenario, with sub-Saharan Africa being the hardest hit.
Additionally, many countries in the south of the continent are approaching their rainy season, when we see the majority of malaria cases.

All the components for a devastating spike in cases and mortality rates are aligning perilously close. Experts predict that in the worst-case scenario, we will see levels of cases and mortality rates last seen 20 years ago.

“Governments and world leaders cannot allow this to happen, and it would not be the first time that hard-won gains against malaria have been devastated by a novel pandemic.

The 2014 Ebola outbreak took priority over neglected tropical diseases (NTDs), such as malaria, HIV and tuberculosis. As prevention efforts waned, the number of NTD cases steadily grew and stretched vulnerable African health systems to the limit.

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“Failing to maintain prevention of NTDs during the Ebola outbreak cost lives. In fact, the final death toll from diseases such as malaria, HIV, and tuberculosis, outweighed the number of deaths caused by Ebola on its own.

“There are worrying signs that history is about to repeat itself. In 2018, The Democratic Republic of Congo reported another strain of Ebola, which coincided with a significant surge in malaria cases. After Nigeria, the DRC has the highest burden of malaria cases and transmission risks, and so is well-versed in experiencing outbreaks.

“In fact, it was already fighting four diseases before Covid-19 began to spread: Cholera, measles, Ebola, and malaria. In a healthcare system already pushed to its limit, Covid-19 poses an even greater threat to DRC’s recovery.

“Malaria prevention must continue, not just because it is one of the world’s deadliest diseases in its own right, but because its early warning symptoms are similar to that of Covid-19 and Ebola. While it will initially be difficult to distinguish which disease a patient is carrying, diagnostic testing for malaria must remain accessible in order to prevent health facilities becoming overloaded with cases in the future.

“The difficulty is gaining access to people suspected of carrying these diseases during the time of physical distancing. Typically, malaria is first diagnosed by a frontline healthcare worker, but this group has been limited in movement due to Covid-19.
Furthermore, restrictions on the distribution of anti-mosquito nets has put those in malaria-endemic regions in greater peril.

“In order to address this issue, the World Health Organisation (WHO) called for countries at a high risk of malaria to maintain their prevention efforts and advised how to tailor these in the face of Covid-19.
Such measures include the continuation of net and spray deployment, early treatment for fever, and ensuring diagnostic tests for malaria are still accessible.

Dr Benjamin Pretorius is the managing director
of ERADA Technology Alliance.

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