Over the past two decades we’ve made great progress in the malaria fight, saving more than 7 million lives and preventing over 1 billion malaria cases. However, as long as malaria exists, it threatens the poorest and most vulnerable, and has the potential to resurge in times of public health crises – like the threat of COVID-19 the one facing us now. According to the World Health Organization’s 2019 World Malaria Report, the rate of progress in the fight against malaria has slowed in recent years, following a period of exceptional success in reducing the burden between 2000 and 2015.[i] Advocates have been pushing for urgent action to get the global response to malaria back on track. These have included calls to step-up financing for malaria control and elimination to fill the gap between 2018’s estimated US $2.7 billion in committed financing and the funding target of US $5 billion.

Today, the ongoing COVID-19 pandemic threatens to further hinder progress and usurp funding for the fight against malaria. In the absence of a coordinated commitment to continuing critical malaria programs, COVID-19 threatens to derail the fight against malaria in those countries in sub-Saharan Africa that account for more than 90% of global malaria cases and deaths. If the past is any guide, the experience of the West Africa Ebola epidemic[ii] shows that countries stand to see additional malaria-related deaths that are at least as high as those from the COVID-19 outbreak itself. The World Health Organization suggests that severe disruptions to ITN campaigns and access to antimalarial medicines due to COVID-19 could lead to a doubling of malaria deaths, potentially resulting in up to almost 800,000 malaria deaths in 2020[iii].

The Business Alliance Against Malaria (BAAM) believes that it is within the global malaria community’s power to rewrite the narrative—all stakeholders can learn from the challenges of the Ebola outbreak to try to ensure service and supply continuity and avert excess malaria infections and deaths. For example, BAAM commends efforts by multi-lateral partners like the RBM Partnership to End Malaria (RBM), the Global Fund to Fight HIV, Tuberculosis, and Malaria (TGF), and the President’s Malaria  Initiative (PMI), and the WHO to quickly provide technical guidance, advocacy resources, and flexible financing solutions to low-resourced health systems that are grappling with the challenges of managing both COVID-19 and ongoing infectious disease programming. Looking ahead, the global community needs to take a multi-phased approach to first mitigate the impact of COVID-19 on the fight against malaria, and then build on those efforts to push closer to ending malaria for good.

In the immediate term, preserving supply and access to malaria prevention, diagnosis and treatment services is imperative. Interventions such as the mass distribution of insecticide treated nets and seasonal malaria chemoprophylaxis (SMC) have a long history of making a critical impact in the fight against malaria. To allow the COVID-19 pandemic to disrupt these distribution campaigns would be disastrous.

The COVID-19 pandemic is impacting global health product supply chains across the full product lifecycle, from R&D, ingredient procurement to finished health products and distribution between and within countries. Close monitoring will be needed to identify and quickly address supply chain disruptions to essential components related to insecticide treated nets (ITNs), rapid diagnostic tests (RDTs), and antimalarial medicines. These products are essential to the fight against malaria.  Our health product supplier members are working closely with partners to keep them abreast of potential disruptions. The importance of the timely delivery of these products is difficult to overstate: Innovations in treatment, along with widespread use of tools such as long-lasting insecticide-treated nets and rapid diagnostic tests, have helped save over seven million lives and prevent over one billion new malaria infections since the early 2000s.

BAAM members urge governments and partners to continue their prevention, diagnosis, and treatment programs for malaria. We can fight COVID-19 and malaria at the same time—it is not only possible, but necessary. BAAM members applaud the countries that have already heeded the call to continue their planned malaria programs while taking precautionary measures against COVID-19. We also want to thank the various NGO’s and consortiums sustaining critical initiatives like seasonal malaria chemoprevention campaigns.

Once access to vital malaria programs is ensured, opportunities for enhanced cross-border and cross-sectoral collaboration have the potential to accelerate gains in both the fight against malaria, as for COVID-19.

BAAM strongly believes in the power of committed and intentional cross-sector and cross-industry collaboration in the fight against malaria. The disease is complex, with many different drivers ranging from environmental factors to social inequities and increasingly drug and insecticide-resistant pathogens. Malaria is a complex killer, and thus calls for the action of an interconnected web of diverse stakeholders if we are to see the disease brought to heel in our lifetime. The COVID-19 pandemic is teaching us that such coordinated and interconnected action is possible on a global scale with enough political will. In this environment where we see a renewed global commitment to collaboration, BAAM calls on countries and partners to protect and advance progress in the fight against malaria through enhanced cooperative efforts and strengthened funding commitments. We can learn much from the COVID-19 experience that could accelerate efforts to fight malaria.

Looking to the future, increased investments in health systems strengthening activities and the development of new innovative tools and technologies will leave us prepared to both beat malaria and address new emerging deadly diseases.

BAAM believes that resources invested in the fight against malaria play a central role in building overall stronger and more resilient health systems. Every dollar invested in the fight against malaria helps to safeguard access to quality healthcare for all people—including the most vulnerable—in malaria-affected countries. In fact, it is estimated that every dollar invested in the fight against malaria generates up to a 40:1 return on investment.[iv] Strong health systems are therefore absolutely central to combatting emerging deadly diseases like COVID-19. For instance, in light of similarities at symptom level between COVID-19 and malaria, local health facilities fighting COVID-19 need to be able to conduct simultaneous screenings for malaria, which will prevent the under-treatment and under-reporting of malaria cases.

Further, investments in malaria programs strengthen supply chain management systems, boost laboratory capacity, and are even building real-time surveillance and data management systems that can be deployed to address future infectious pandemic threats. The fight against malaria and Covid-19 complement, not compete, with one another.[v]

While health system investments are critical, BAAM calls on the global community to prioritize investments in the development and scale-up of new tools and technologies for fighting malaria and emerging disease threats. Innovative and ever-evolving tools are crucial in fighting diseases like malaria and COVID-19 that have the potential for the causative organism to mutate and/or develop resistance to vital interventions. For example, developments in rapid diagnostic testing technologies can be useful for addressing either disease.

BAAM urges the global community to remain vigilant and prepared even after the COVID-19 crisis passes to protect gains in the fight against malaria and preserve human lives.

[i] https://www.who.int/malaria/publications/world-malaria-report-2019/World-Malaria-Report-2019-briefing-kit-eng.pdf?ua=1

[ii] https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(15)00075-4/fulltext

[iii] https://www.who.int/news-room/detail/23-04-2020-who-urges-countries-to-move-quickly-to-save-lives-from-malaria-in-sub-saharan-africa

[iv] https://www.mmv.org/sites/default/files/uploads/docs/publications/RBM_AIM_Report.pdf

[v] https://www.who.int/malaria/publications/atoz/tailoring-malaria-interventions-covid-19.pdf