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How new tools, drugs could eliminate malaria



How new tools, drugs could eliminate malaria

From eradication, United Nation (UN) agencies have set 2030 target for the elimination of the malaria globally. With Algeria and Argentina getting the World Health Organisation (WHO) malaria-free certification, the role of everyone – government leaders, community health workers and individuals to achieve zero malaria, could pave the way for its complete abolition, reports APPOLONIA ADEYEMI who recently attended the World Health Assembly (WHA) meeting on malaria in Geneva, Switzerland


It is not news again that some countries have exited the club of malaria burdened countries. As at May 22, 2019, the World Health Organisation (WHO) certified both Algeria and Argentina free of malaria, the life-threatening disease that is preventable and curable.
Such a certification is granted when a country proves that it has interrupted indigenous transmission of the disease for at least three consecutive years.
Contracted through the bite of an infected female anopheles mosquito, malaria remains one of the world’s leading killers, with an estimated 219 million cases and over 400 000 malaria-related deaths in 2017.
Approximately 60 per cent of fatalities occasioned by malaria, occur among children aged under five years.

Countries with WHO malaria-free certification
Algeria is the second country in the WHO African region to be officially recognised as malaria-free, after Mauritius, which was certified in 1973. Argentina is the second country in the WHO region of the Americas to be certified in 45 years, after Paraguay in June 2018. Algeria and Argentina reported their last cases of indigenous malaria in 2013 and 2010 respectively.
The world has made tremendous progress in the fight against malaria in the past 15 years. According to the World Malaria Report, malaria case incidence was reduced by 41 per cent and malaria mortality rates were reduced by 62 per cent between 2000 and 2015.
At the beginning of 2016, malaria was considered to be endemic in 91 countries and territories, down from 108 in 2000. Despite this progress, malaria continues to place a heavy toll on the world. In 2015, 212 million cases occurred globally, leading to 429,000 deaths, most of which occurred in children under age five years in Africa.
It is important to note that more than 100 countries have eliminated malaria in the past century. Of the 106 countries with ongoing transmission in 2000, 57 reduced malaria incidence more than 75 per cent by 2015, in line with the World Health Assembly target for 2015 of reducing the malaria burden by 75 per cent.
Similarly, an additional 18 countries reduced incidence by more than 50 per cent, also achieving target 6C of the Millennium Development Goals (MDGs), which called for halting and beginning to reverse the global incidence of malaria by 2015.
In spite of this development, the WHO recently alerted the world community over the rise in the number of new malaria infections being recorded globally, saying the development was happening in 10 high burden countries. Details from the annual World Malaria Report shows that in 2017 there were an estimated 219 million cases of malaria globally, with around 435,000 deaths.
Reacting to the development, the Director of the WHO’s global malaria programme, Dr. Pedro Alonso said he was particularly concerned about the report’s finding that, in 2017, there were an estimated 3.5 million more cases of malaria in the 10 highest malaria burden African countries over the previous year.
The 10 malaria high burden countries are Burkina Faso, Cameroon, Democratic Republic of the Congo (DRC), Ghana, Mali, Mozambique, Niger, Nigeria, Uganda and Tanzania. There were an estimated 151 million malaria cases and 275,000 malaria deaths in these countries in 2017, the report shows.
Director-General WHO, Tedros Ghebreyesus, warned that as progress in the fight against malaria stagnated, the global community was at risk of squandering years of investment and success in reducing the number of people suffering from the disease.
“The fact that every two minutes a child dies from this preventable and curable disease is unacceptable,” he wrote in the report.
African countries account for 92 per cent of all infections from the mosquito-borne parasite, which causes the potentially lethal fever disease.

Elimination as new trend in malaria fight
Despite the above background, the new trend is that an increasing number of countries are moving towards the elimination of malaria, which prompts the question: where exactly is Nigeria concerning this plan. Presently, Nigeria alone contributes 80 per cent of the number of malaria cases from the entire African continent. Out of those 80 per cent, 90 per cent of the cases affects children.
In spite of this huge malaria burden in Nigeria, the current global plan is to rid the world of this disease. However, question that has been agitating the minds of many stakeholders, personalities and individuals is: can Nigeria truly eliminate malaria from its environment against the background of wrong attitude of its people towards the disease?
According to concerned civil society organisations and medial experts, the way to go is to emulate countries that have achieved it and toe their line. What did they do right? What was the magic wand?

Call for R&D, new technology
Speaking on steps malaria high burden countries and other malaria burdened nations could adopt to rid their nations of the disease, Alonso who spoke at an event tagged innovation with unitaid, PM, and RBM partnership, held in Geneva, Switzerland on May 22, said one of the factors that should be looked into was current tools being used to fight malaria. For instance, while he admitted that the use of the Long Lasting Insecticide Treated Bednets (LLIT) reduces malaria by about 40 per cent, according to the WHO, “Some tools used in malaria fight are imperfect.”
When seasonal malaria chemoprevention (SMC) is deployed in treatment, he noted, “We need to recognise that we don’t have modern tools; hence, Alonso urged the world community to do more in the area of Research and Development (R&D). SMC is defined as the intermittent administration of full treatment courses of an antimalarial medicine to children in areas of highly seasonal transmission during the malaria season.

New medicines
According to Alonso, if countries want to move forward as well as progress in the malaria fight, we must deploy not only modern and better tools but newer effective drugs.
He also advised that adopting new approach in vector control could bring new and improved vistas into the activities to eliminate malaria.
The director of WHO malaria programme also highlighted the RTS,S (developed by PATH Malaria Vaccine Initiative (MVI) and GlaxoSmithKline (GSK) with support from the Bill and Melinda Gates Foundation. The RTS,S vaccine is an important new tool that can help save tens of thousands of children from malaria, and a powerful example of the role country leadership and multi-sectoral partnerships play in accelerating malaria elimination.
The vaccine will be deployed in selected areas of moderate-to-high malaria transmission through routine immunisation services. This pilot programme will provide crucial information and lessons for the vaccine’s future deployment.
Alonso also affirmed that the new policy of the WHO was to eliminate malaria worldwide by 2030.
On his part, the Executive Director of The Global Fund, Peter Sands accused both the governments of malaria high-burden countries and nations burdened by the disease of failing to invest enough in the fight to eliminate malaria. Sands said: “We must do enough to save lives.”
Together, we must invest enough to eliminate mosquitoes and malaria epidemic. Sands heads The Global Fund, from where 60 per cent of the finance that funds malaria fight is sourced from.
On his part, Dr Abdourahmane Diallo, CEO, Roll Back Malaria (RBM) Partnership to End Malaria, said: “Defeating malaria requires that everyone – government leaders, community health workers, mothers and fathers – takes personal responsibility to achieve zero malaria.”
To this end, he stressed that the RBM Partnership was committed to eliminate the disease from the world and was working to achieve that.

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