Fatal inaction

15th May 2020 By: Martin Zhuwakinyu - Creamer Media Senior Deputy Editor

With Covid-19 having shaped up into a health crisis of unprecedented proportions – with equally unprecedented economic implications – it is not inconceivable that governments and other stakeholders may be tempted to drastically scale down efforts to tackle existing health threats, preferring to invest a big chunk of available resources in programmes to mitigate the pandemic and its impacts.

But the consequences of such a course of action would be dire and could prove fatal in many instances. Take malaria, for instance, which in 2018 killed 405 000 people in sub-Saharan Africa, equivalent to 93% of the global tally. That’s an average of 1 100 daily, which is akin to four jumbo jets crashing every day of the year.

While it would not be unreasonable for governments in the region to channel well-nigh all available resources to their Covid-19 response programmes, they need to guard against disrupting malaria prevention and treatment. The consequences would be too ghastly to contemplate. According to a new modelling analysis from the World Health Organisation (WHO), should the distribution of insecticide-treated nets in the malaria-prone countries of sub-Saharan Africa be disrupted and access to antimalarial medicines be curbed because Covid-19 is taking precedence, malaria deaths in the region this year would spike to unprecedented levels.

Conducted in collaboration with the Malaria Atlas Project and the Bill and Melinda Gates Foundation, besides other partners, the analysis considers nine scenarios, with the worst, where all insecticide-treated net campaigns are suspended and access to antimalaria medicines tumbles to 75%, likely to lead to 769 000 malaria-related deaths in sub-Saharan Africa this year. This will represent a regression to mortality levels last seen about two decades ago.

The analysis was released just days ahead of April 25, which is World Malaria Day.

Of the more that 400 000 malaria deaths that were reported globally in 2018, 69 occurred in South Africa. The country reported 9 540 malaria cases that year, 5 742 of which were imported. It is estimated that 5.7-million South Africans are at risk of contracting the mosquito-borne disease. Risk areas include the north-eastern parts of Limpopo, Mpumalanga and KwaZulu-Natal, which share borders with neighbouring countries with a heavy malaria burden, such as Mozambique and Zimbabwe.

Governments in sub-Saharan Africa should not see the Covid-19 pandemic as a reason for diverting funding away from malaria prevention and treatment. As the WHO has correctly pointed out, although the number of sub-Saharan Africans who have contracted the coronavirus is increasing literally by the day, the number of cases is only a tiny proportion of the global total. “This means that countries across the region have a critical window of opportunity to minimise disruptions in malaria prevention and treatment and save lives at this stage of the Covid-19 outbreak,” the WHO argues in a statement. I cannot agree more.

Some countries in the region have already heeded this call. These include Benin, Chad, the Democratic Republic of Congo and Sierra Leone, which, the WHO says, have initiated insecticide-treated net roll-outs despite the advent of the Covid-19 pandemic.

These countries should be lauded, and those that may be tempted to cease their efforts on this front in order to ramp up efforts to deal with Covid-19-related challenges should be reminded that ‘inaction’ will cause many avoidable malaria deaths.

Another major setback to antimalaria efforts – and indeed to efforts to curb other existing epidemics, such as HIV/Aids and tuberculosis – could come from companies that manufacture diagnostic kits opting to make coronavirus test kits instead of HIV and TB test kits. Those in the know say companies can get as much as $10 for a coronavirus test kit, compared with a paltry 18c for a rapid malaria test.