Can Commonwealth countries eradicate malaria by 2030?

Although malaria is a preventable and curable disease when diagnosed and treated promptly and correctly, it continues to be a major public health threat. It has disproportionately spiked mortality in low-resource communities worldwide, with Africa losing more people to it, according to the World Malaria Report. In 2020, an estimated 241 million people had malaria, and 627,000 of them died, an increase of 69,000 deaths over the previous year. Africa was home to 95 percent of malaria cases and 96 percent of malaria deaths. Children under five accounted for about 80 percent of all malaria deaths in the Region, according to the World Health Organization (WHO). One of the key resolutions from the Commonwealth Heads of Government Meeting (CHOGM) that convened in Kigali last week was halving malaria in Commonwealth countries by 2023, and working towards ending the epidemic of malaria by 2030, in line with global, regional and national commitments. One of the global commitments known as the Global Technical Strategy (GTS) for malaria was adopted by the World Health Assembly in May 2015. Besides providing a comprehensive framework to guide countries in their efforts to accelerate progress towards malaria elimination, it also sets the target of reducing global malaria incidence and mortality rates by at least 90 percent by 2030. The recommendations to achieving the targets are grouped in three pillars; to ensure universal access to malaria prevention, diagnosis and treatment, to accelerate efforts towards elimination and attainment of malaria-free status, and to transform malaria surveillance into a core intervention. However, the 2022 annual Commonwealth Malaria Report showed that the Covid-19 pandemic disrupted malaria services, leading to an increase in malaria incidence and mortality rates. The data from the report also indicates that the Commonwealth is currently not on track to halve malaria cases and/or deaths by 2023. Rwanda, which is also grouped in the countries which are not currently on track to achieving the targets recorded a tremendous drop in malaria cases from 4.8 million cases in 2017 to 1.8 million in 2020. Malaria deaths also decreased from 700 in 2016 to 148 deaths in 2020. While harmonization of the WHO recommendations was expected to be a game changer when the commitment was signed, the country suddenly had a sharp rise in malaria cases the following year which called for special measures in addition to what was already pledged. Although Rwanda had achieved significant progress in reduction of malaria over decades, malaria incidence rate increased every year from 112 per 1,000 in 2013 to 2014 to 308 per 1,000 in 2015 to 2016. Health data from 2015 show that malaria became the second cause of morbidity in Rwanda representing 7.4 percent of outpatient consultations and the sixth cause of mortality representing 4.3 percent malaria proportional mortality, according to WHO. At that time, malaria was also number four in leading causes of death among children under the age of five, while it was the leading in 2005. “There are different measures taken by the country to fight malaria. The major ones include prevention by supplying mosquito nets every two to three years to the general population. We also supply them to pregnant mothers and children below the age of five because they are the most affected by malaria. “Another method of prevention is Indoor Residual Spraying (IRS) in the most affected regions which are the eastern province, five districts of the southern province, and other sectors that have high malaria cases, such as in Rusizi, Nyamagabe and Nyaruguru,” Dr Aimable Mbituyumuremyi, the Head of the National Malaria Control Programme, other Parasitic Diseases and Neglected Tropical Diseases Division at Rwanda Biomedical Centre (RBC) told The New Times. He added that for treatment, Community Health Workers (CHW) test and treat malaria, besides health centres and hospitals. Mbituyumuremyi also noted that there is constant research on emerging resistance to insecticides among Anopheles mosquitoes and malaria’s resistance to available treatment so that both can be changed as soon as it is discovered. Asked whether the 2023 and 2030 targets to eradicate or reduce malaria cases are attainable, he said that consistency in implementing already available measures is needed, together with inclusiveness in prevention. “There needs to be focus on groups of people who seem to have been left behind when it comes to prevention. For instance, there are people who are not targeted when we are supplying mosquito nets, not because we don’t have them, but because they are rarely where they are used (beds). “Mosquito nets and Indoor Residual Spraying protect people inside houses, but people who spend nights outside houses like gatekeepers, drivers, security personnel, fishermen/women, mineworkers, sex workers and more who do not benefit from existing methods of prevention need to be given mosquito repellent body creams, and spraying, especially in wetlands should be introduced as well,” Mbituyumuremyi said. During the launch of the 2022 annual Commonwealth Malaria Report that was held in Kigali ahead of CHOGM, Patricia Scotland QC, the Secretary General of the Commonwealth said that ending malaria is not one country’s problem. “It is for all of us to tackle. And in doing so, we will make our whole community healthier, safer and more prosperous. “I urge our Commonwealth family to continue to prioritise the fight against malaria, especially in the face of the other challenges facing our nations’ health systems. It is now time to truly commit to ending the epidemic of malaria and ensure we hold ourselves to mutual accountability for the commitments made so far,” Scotland added.

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Can Commonwealth countries eradicate malaria by 2030?