Pandemic foils fight against malaria in sub-Saharan Africa: WHO

The coronavirus pandemic has hampered decades of progress against a deadly parasitic disease — disrupting healthcare services and leading to tens of thousands of additional malaria-related deaths worldwide, the World Health Organization announced on Monday.

There were an estimated 241 million malaria cases and 627,000 related deaths worldwide in 2020, or 14 million more cases and 69,000 more deaths than in 2019, according to the WHO’s latest World Malaria Report. Of these additional deaths, about two-thirds of the total — 47,000 — were linked to disruptions in malaria prevention, diagnosis and treatment mechanisms, and the vast majority occurred in sub-Saharan Africa, the report found.

Yet WHO officials expressed some relief that a “doomsday scenario” predicted by the organization had not come to pass.

“The first message is a good news message,” Dr. Pedro Alonso, director of the WHO Global Malaria Program, said in a statement. “Thanks to urgent and strenuous efforts we can claim that the world has succeeded in averting the worst-case scenario of malaria deaths.”

Early on in the pandemic, the WHO had projected that malaria deaths could potentially double in 2020, but emergency action implemented by many countries averted this worst-case scenario, according to the organization.

Sub-Saharan Africa accounted for about 95 percent of all malaria cases and 96 percent of all related deaths in 2020 — with about 80 percent of the deaths among children under 5 years old, the report said.

The increase in malaria-related deaths was due to the combined effects of the pandemic and the point in time at which the pandemic hit, according to the study. Although significant gains had been made in the fight against the disease from 2000 to 2017 — a 27-percent reduction in case incidence and a 51-percent reduction in mortality rate — progress had hit a plateau by the end of that period, the report found.

“Even before the COVID-19 pandemic struck, global gains against malaria had leveled off,” WHO Director-General Tedros Adhanom Ghebreyesus said in a statement, acknowledging the efforts countries had taken to avoid a doomsday scenario. 

Pandemic related challenges notwithstanding, about three-quarters of insecticide-treated mosquito nets had been distributed in malaria endemic nations by the end of 2020 as planned, according to the report. Thirteen countries in Africa’s Sahel subregion were able to provide 11.8 million more children with preventative antimalarial medicines during the 2020 rainy season, in comparison to that of 2019.

The WHO also credited six countries in southeast Asia’s Greater Mekong region for their “impressive declines” in malaria caseload, while noting that China and El Salvador were certified by the organization as malaria-free in 2021 and Iran achieved three consecutive years of zero indigenous cases in 2020.

“Now, we need to harness that same energy and commitment to reverse the setbacks caused by the pandemic and step up the pace of progress against this disease,” Ghebreyesus said.

Despite all of these achievements, however, the WHO Africa region experienced a 12-percent surge in malaria-related deaths in 2020 in comparison to the previous year, according to the report.

To build off previous gains, WHO called upon countries to ensure more equitable access to all health services, by strengthening primary healthcare and boosting both domestic and international investments. Current funding levels — about $3.3 billion in 2020 — will need to more than triple, to $10.3 billion annually by 2030, according to the report.

The organization also pointed to innovation as “a critical strategy for accelerating progress,” noting that in October, the WHO began recommending a new “RTS,S” vaccine for children living in sub-Saharan Africa to reduce malaria transmission.

“While African countries rallied to the challenge and averted the worst predictions of fallout from COVID-19, the pandemic’s knock-on effect still translates to thousands of lives lost to malaria,” Matshidiso Moeti, WHO regional director for Africa, said in a statement. “African governments and their partners need to intensify their efforts so that we do not lose even more ground to this preventable disease.”