Defeating an old foe, malaria, while surviving a new enemy, Covid-19 – Rebecca Akufo-Addo
2 July 2020 is the second anniversary of the Pan-African ‘Zero Malaria Starts with Me’ movement, which calls for the elimination of malaria across Africa. The current focus on COVID-19 should not distract us from the fight against malaria, which continues to take too many African lives, says Ghana’s First Lady, Mrs Rebecca Akufo-Addo
On 25 April 2020, I joined the National Malaria Control Programme and the Ghana Health Service to commemorate World Malaria Day. The official theme that year was ‘Zero Malaria Starts with Me’. This is also the slogan of the same campaign that I helped launch a year ago.
Any discussion of public health issues at this time must begin by acknowledging the new and growing crisis of COVID-19. My fellow Ghanaian and African citizens, are rightly worried that our health systems won’t cope if the spread of the virus gets out of control. The knock-on effects of COVID-19 are also potentially disastrous for public health and threaten our gains in malaria control over the last 20 years.
Previous disease outbreaks have disrupted health services and decreased the health-care capacity to treat other diseases, such as malaria. The 2014-2016 Ebola outbreak in Guinea, Liberia and Sierra Leone, led to a massive increase in malaria-related illness and deaths. It was estimated that 3.5 million additional malaria cases went untreated with 10,900 additional malaria-attributable deaths in the three countries during the Ebola outbreak, due to reduction of treatment coverage.
We – individuals, communities, governments, civil society, the media, private sector companies, and the international community – must all do everything in our power to prevent this from happening again. We must continue to hold ourselves accountable to the commitment towards a malaria-free Africa, despite the significant challenges involved in coping with a new epidemic.
Protecting vulnerable groups
Through the Infanta Malaria Prevention Foundation and The Rebecca Foundation, as well as in my role as First Lady of Ghana, I have been advocating for improved health outcomes for the vulnerable groups, who are disproportionately affected by malaria: the poor, pregnant women and children under five years old.
In 2018, children under five accounted for 67% (272,000) of the estimated 405,000 of all malaria deaths worldwide. Even before the COVID-19 epidemic struck, malaria resulted in 10,000 maternal deaths each year, with 11 million pregnant women in sub-Saharan Africa infected by this disease in 2018 alone. Malaria in pregnancy accounts for 11% of all new-born deaths and 20% of all stillbirths.
To my dismay, between January and March 2020, of the 95% of 2,346,677 suspected malaria cases tested in Ghana, 1,001,070 were confirmed positive for malaria. This number included 21,201 children under five years and 28,764 pregnant women.
Again 42%of the 58,775 admissions due to malaria were among children under five years. The country recorded 54 malaria deaths, out of which 16 were children under five years. This shows that malaria has not been on quarantine since the COVID-19 outbreak. It continues to cause mayhem.
Need to scale up solutions
These figures are unacceptable. It is evident that these vulnerable groups will suffer the most. We must scale up the solutions that can protect them.
Solutions exist to protect these vulnerable groups. For example, these maternal and neonatal deaths could have been prevented with a simple and cost-effective intervention known as Intermittent Preventive Treatment for pregnant women (IPTp) with sulfadoxine pyrimethamine (SP), delivered during routine antenatal care visits and prompt and effective diagnosis of suspected cases of fever and malaria.
In the wake of the COVID-19 pandemic, it is possible to lose sight of the deadly malaria disease and the gains made over the years both individually and collectively to protect ourselves. We risk reversing hard-won progress in the malaria fight. It is very important to sustain the efforts made by the Ministry of Health and its partners to advance efforts made to prevent, detect and treat malaria.
This is why, along with malaria partners around the globe, I am calling for the following actions in both the short and the long term.
Firstly, that both public and private sectors invest in robust health systems. They are the systems we will fall on, in the fight against existing threats like malaria and new ones like COVID-19.
Secondly, we must continue investments in life-saving malaria interventions such as bed-nets, indoor residual spraying, seasonal malaria chemoprevention and intermittent preventive treatment – interventions that save hundreds of thousands of lives every year.
Thirdly, we must work to close the $2 billion annual funding gap for malaria interventions through increased government funding, as well as innovative public-private financing mechanisms such as Malaria Funds and Foundations.
Increased financing is essential to scaling up the solutions that will protect the most vulnerable in society. I know in the advent of COVID-19, a lot of resources have been put into the fight against the pandemic but we should also maintain the fight against existing known diseases
For the last couple of years, the Pan-African Zero Malaria Starts with Me movement, has helped ensure that, malaria stays high on the political agenda, while promoting a multi-sectoral approach to the fight against malaria.
Only with joint efforts from all sectors of society can we reach the ambitious goal of zero malaria. Since the endorsement of all 55 Heads of State of the African Union in July 2018, Zero Malaria Starts with Me has been gathering momentum and now 15 countries have formally launched their national campaigns.
In Ghana, we are working to build political will, ensure efficient use of existing funding, increase private sector support and boost media engagement in order to kick start the decade that will end malaria.
This mission must not be jeopardised by the impact of COVID-19. As Africans, we are known for our sense of solidarity. Individually and as a whole, we all can contribute to both surviving a new enemy as well as fighting to defeat a familiar foe – malaria.
Following this World Malaria Day, I would like to entreat all and sundry to join the Zero Malaria Starts with Me movement and to stand in solidarity with our brothers and sisters at this period of heightened uncertainty.
Zero malaria is achievable when we all show commitment and collaborate better. It requires both our individual and collective effort.
Zero malaria starts with me, with you and with all of us.