As World Malaria Day is celebrated across the globe, there is a fresh-spirited shift towards ending malaria in Africa. The African Leaders Malaria Alliance (ALMA) has augmented its efforts to accelerate the fight against malaria by enhancing action and accountability of African Governments.

This year’s theme, "Zero Malaria - Draw the Line Against Malaria", speaks well to ALMA’s efforts in bringing together

governments to consolidate progress, innovate, share data and learn from each other in this fight against a common enemy – Malaria. Even more exciting, ALMA is empowering Africa’s youth to play a prominent role in the fight against malaria, through an “ALMA Youth Army Strategy” being implemented across countries.

ALMA is a coalition of African Union heads of state and government working across Africa, with the regional economic communities, development partners, the private sector, and civil society all working together to eliminate malaria by 2030.

On this World Malaria Day 2021, ALMA emphasises the need toprotect and accelerate gains against malaria and leverage malaria investments to fight COVID-19 and emerging diseases. ALMA is calling on governments and heads of state to increase investments in malaria programmes and harness the potential of strong health systems including community health systems established for the fight against malaria and other diseases.

ALMA is also calling for governments to invest in the delivery of proven tools and interventions to prevent, test, treat and control malaria, and to ensure essential malaria services are delivered safely during the COVID-19 pandemic. Promotion of innovations including the use of real time data, and research and development of new interventions will help Africa stay ahead of the parasite and mosquito.

President Uhuru Kenyatta of Kenya, the current chair of ALMA, has emphasised that sustaining essential health services for malaria is a regional and global priority during the COVID-19 pandemic. Similarly, the ALMA quarterly reports to heads of state and government and high level government officials have highlighted the potentially destructive impact of COVID-19 on the fight against malaria and progress towards universal health coverage. The reports recommend mitigatory actions for countries to sustain essential malaria, neglected and tropical diseases (NTD) and Reproductive, Maternal, Neonatal, Child and Adolescent Health (RMNCAH) services.

ALMA Youth Advisory Council chairperson Aloyce Urassa participating in an event.

The chair of ALMA has identified four key strategies that will help African countries accelerate the war on malaria and get down to zero malaria deaths by 2030. First, the digitalisation and use of real time data, including through using and sharing country malaria scorecards so that all citizens are aware of the malaria situation, will improve decision-making and empower action.

Second, President Uhuru Kenyatta has called for the establishment of Country End Malaria Councils and Funds to mobilise additional domestic public and private resources and engage country leaders across all sectors and levels. Third is the recruitment of a new generation of malaria advocates, our youth, to champion political and resource commitments to support malaria control and elimination.

Lastly, President Uhuru has emphasised on the need to strengthen sub-regional coordination to support malaria control and cross-border coordination and mainstream malaria into ministerial and heads of state and government fora and summits. Sub-regional coordination builds upon several bilateral and multilateral, cross-border initiatives for the synchronisation and harmonisation of vector control, case management, surveillance, and data sharing. These efforts will ensure that heads of state and government work with Africa’s regional economic communities to drive progress at the sub-regional level.

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African countries can end malaria by 2030

In the face of the COVID-19 pandemic, African governments must not lose sight of the target to end malaria by 2030. In 2020, fragile health systems faced the dual burden of combatting millions of malaria infections and managing new COVID-19 infections.

African leadership meeting on investing in health.

Accelerating with urgency

As the world continues to respond to COVID-19, it is critical to maintain momentum against malaria to ensure lives are saved and progress is not lost. Over the last two decades, the development of new and effective interventions has made malaria both preventable and treatable, yet according to the World Health Organisation 225 million people suffered from the disease in 2019, more than 90 per cent of them in Africa. About 409,000 died, mostly children under the age of five.

In 2020, despite the COVID-19 pandemic, frontline health workers and governments, with support from partners, heroically innovated to sustain more than 90 per cent of planned campaigns for mosquito net distribution and seasonal malaria chemoprevention (SMC). This led to the distribution of more than 160 million mosquito nets and over 30 million children reached with SMC, averting the worst-case scenario of a doubling of malaria deaths due to COVID-19. 

To protect the tremendous gains made in the past two decades, countries and partners must continue prioritising safe delivery of life-saving malaria interventions. Enhanced use of data and disease surveillance have been crucial in the COVID-19 response and similar efforts are needed to maintain progress against malaria. Commodities must also be procured ahead of time, given the delays in shipments being seen across the globe. Investments in local manufacturing of malaria commodities will further secure the continent’s progress towards elimination.

Securing global health

ALMA recognises that ending endemic diseases like malaria is the pathway to beating emerging health emergencies like the COVID-19 pandemic. Notably, seven of 10 symptoms including fever, overlap between malaria and COVID-19. This has led to delays in prompt diagnosis and management of malaria cases, which contributes to higher mortality from both diseases. Further investments in ending malaria will reduce the burden on health systems, and increase capacity to prevent, detect and respond to health emergencies.

Across Africa, such as in Uganda, the government with the support of partners, trained frontline healthcare workers to safely identify and manage COVID-19 while continuing to provide effective malaria case management during the outbreak. In Rwanda, investments in the Health Information System that tracks malaria fevers and supply chain were used to also track and disseminate results by SMS for COVID-19 tests.

The RBM partnership to End Malaria led partners and countries in developing a Global Malaria Dashboard, is a one-stop shop of real-time data that tracks supply chain, planned campaigns, malaria epidemiology and technical assistance needs. This helped to address emerging bottlenecks in a timely way.