African countries

After COVID, African countries pledge to fight malaria

Finding holes in a mosquito net at a textile factory in Arusha, Tanzania.Credit: Jim Young/Reuters/Alamy

More than $4 billion in new funding has been pledged by African countries, international donors and pharmaceutical companies at an international summit held in Rwanda to end malaria and neglected tropical diseases.

The commitments were announced at the Kigali Summit on Malaria and Neglected Tropical Diseases, held June 23 in Rwanda. Neglected tropical diseases (NTDs) are a group of 20 diseases including dengue fever, leprosy, yaws and trypanosomiasis, which mainly affect the poorest people, including women and children. According to the World Health Organization (WHO), at least 1.7 billion people worldwide are infected with at least one NTD every year. So far, these diseases have received relatively little attention from donors.

Prior to the summit, total funding for malaria control and elimination stood at $3.3 billion. That’s just under half of the $6.8 billion the WHO says it needs to meet the goal of reducing malaria cases by 90% by 2032.

Increase in cases

Malaria, tuberculosis, HIV and NTDs have increased in recent years, largely due to diagnostic and treatment disruptions caused by the COVID-19 pandemic. In 2020, there were approximately 241 million cases of malaria and 627,000 deaths. African countries accounted for an overwhelming 95% of these cases. This is 14 million additional cases and 69,000 additional deaths compared to 2019. About two-thirds of the additional deaths in 2020 (47,000) were caused by COVID-related disruptions in the diagnosis and treatment of the malaria, according to World Malaria Report 2021.

At the same time, there was encouraging news. “Even during the COVID pandemic, Bhutan and Sri Lanka have remained malaria-free and several Southeast Asian countries have remained on track towards malaria elimination,” said Poonam Singh, Regional Director of the WHO for Southeast Asia, during the summit.

Malaria caused by Plasmodium falciparum is the most severe form, according to the WHO. It is present throughout sub-Saharan Africa and is responsible for more than 90% of malaria cases and deaths worldwide. The most common treatment is artemisinin-based combination therapy.

Some 500 delegates attended the summit, hosted by Rwanda and international public health groups RBM Partnership to End Malaria and Uniting to Combat NTDs. The new funding is intended to get countries back on track by dramatically reducing new cases of malaria by the end of the decade. Since 2015, the WHO has certified 9 countries malaria-free, bringing the total to 40.

“The R&D pipeline is in the best shape it’s ever been,” with new drugs for resistance to malaria and new vaccine technologies, said Philip Welkhoff, director of malaria at the Bill & Melinda Gates Foundation based in Seattle, Washington, at the summit.

Representatives from some 65 African countries attended the conference, and together they pledged $2.2 billion to end malaria and NTDs. The rest has been pledged by high-income countries, philanthropic organizations and pharmaceutical companies.

For big pharma, London-based GSK has pledged research and development (R&D) investments worth $1.23 billion over ten years for malaria, tuberculosis, HIV, NTDs and antimicrobial resistance. Novartis, based in Basel, Switzerland, announced $250 million over the next five years for research into new treatments for malaria and NTDs; and New York-based Pfizer has pledged $1 billion to the International Trachoma Initiative, which fights trachoma, a blinding bacterial infection.

Among philanthropic and charitable organizations, the Bill & Melinda Gates Foundation announced $140 million to support African institutions’ research into malaria and NTDs; London-based Wellcome will provide $80 million for R&D in snakebite treatments and additional NTD research; and UK charity Sight Savers, which works on preventable blindness caused by infections, has pledged $25 million over the next four years.

Some progress has already been made. Benin, Rwanda and Uganda have eliminated some forms of trypanosomiasis, and many other countries have eliminated yaws, Guinea worm and onchocerciasis (river blindness).

Lessons learned

The conference heard how some countries have applied lessons learned from managing the COVID-19 pandemic to control other infections. “COVID-19 has taught us resilience and new ways to maneuver through the pandemic,” as well as how to use existing healthcare systems to fight infections, said Ministry of Health director general Russel Tamata. Vanuatu Health.

Nigeria has leveraged the shift to virtual consultations and digital technology to connect caregivers with doctors during the pandemic to control malaria and NTDs, the country’s Health Minister Osagie Ehanire has said. Despite pandemic restrictions, the country has distributed 17 million insecticide-treated bed nets and expanded NTD chemoprevention to 23 million children, Nigerian President Muhammadu Buhari said at the summit. Rwanda is trying to combine malaria treatment with optical and dental care services, the conference heard.

Corine Karema, who leads the RBM Partnership to End Malaria, said Nature that if malaria and NTDs are not stopped in their tracks, “billions of people around the world will continue to suffer or die from these diseases.” This will “cause greater pressure on health systems,” which, in turn, will hamper their ability to respond to current and future health threats.