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April 23, 2020
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WHO estimates malaria deaths could double because of interruptions caused by COVID-19

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Tedros Adhanom Ghebreyesus

Interruptions to access to antimalarial medicines and disruptions to insecticide-treated net campaigns, or ITNs, because of COVID-19 could potentially double the number of malaria deaths in sub-Saharan Africa in 2020 when compared with 2018, according to a WHO modeling analysis.

“This new modeling analysis reinforces WHO’s call for maintaining essential, life-saving services to prevent, detect and treat malaria during the COVID-19 pandemic. Countries have a critical window of opportunity now to ensure malaria services are maintained even as the virus spreads,” WHO Director-General Tedros Adhanom Ghebreyesus, PhD, MSc, said in a press release.

The new analysis takes nine scenarios into account that could lead to disturbances in core elements of malaria control during the COVID-19 pandemic in 41 countries, as well as the potential increase in case counts and deaths that could result. In what WHO calls “the worst-case scenario,” if all ITNs are halted, and there is a 75% decrease in access to antimalarial medicines, the estimated number of malaria-related deaths would reach 769,000 in sub-Saharan Africa in 2020, twice the number that were reported in the region in 2018.

"Visualizing the seasonality of malaria transmission highlights countries where the COVID-19 pandemic may coincide with the peak months of malaria burden and therefore areas where health systems may struggle to meet demand,” Hannah Slater, PhD, a research scientist with PATH, said in the release. “We must support ministries of health and maintain donor investment so that interventions can be prioritized and communities are protected.”

According to last year’s world malaria report, Sub-Saharan Africa accounted for approximately 93% of all malaria cases and 94% of deaths in 2018 — two-thirds of which occurred in children aged 5 years and younger. WHO also estimates that climate change will cause an additional 250,000 deaths per year from 2030 to 2050, 60,000 of which would be from malaria.

The authors emphasize that sub-Saharan Africa has a “critical window of opportunity” to limit interruptions to malaria prevention and treatment with COVID-19 case counts increasing each week. They recommend stepping up mass vector control campaigns and adjusting net distribution strategies to limit the adverse effects of the pandemic on malaria response efforts.

“Africa has made significant progress over the past 20 years in stopping malaria from claiming lives,” Matshidiso Moeti, MBBS, MSc, WHO Regional Director for Africa, said in the release. “While COVID-19 is a major health threat, it’s critical to maintain malaria prevention and treatment programs. The new modeling shows deaths could exceed 700,000 this year alone. We haven’t seen mortality levels like that in 20 years. We must not turn back the clock.” – by Eamon Dreisbach

Reference:

WHO. The potential impact of health service disruptions on the burden of malaria: a modelling analysis for countries in sub-Saharan Africa. https://who.canto.global/pdfviewer/viewer/viewer.html?v=WorldMalariaDay&portalType=v%2FWorldMalariaDay&column=document&id=1327fs737l01n9jvaat4plt72u&suffix=pdf. Accessed April 23, 2020.