Dr Benji Pretorius, founder of Erada Technology Alliance and malaria survivor, shares an insight into why the next 12 months will see significant strides forward in the global mission to eradicate malaria
2020 will be remembered largely because of the Covid-19 pandemic and the disruption to ‘normal’ life which came with it. While efforts to contain the virus featured prominently in world headlines, malaria prevention programmes ensured that more lives were not lost.
In the most challenging of circumstances, malaria prevention has remained resilient. Vital measures and prevention programmes have largely continued, preventing the World Health Organisation’s ‘worst case scenario’ of malaria deaths doubling from becoming a stark reality. However, according to the latest World Malaria Report, published in November 2020, we as a global community have strayed off course from current eradication goals.
It is easy to look back at 2020 in a negative light, especially with the picture painted by the World Malaria Report, but there have been some silver linings.
For instance, insecticide treated nets (ITNs) deployment programmes have continued across Africa. One area which has seen a notable success is in Benin, which not only undertook its fourth mass distribution of nets in 2020, but also adopted digital tools to gather vital insights into the size of the country’s population and to ensure that ITNs were deployed in the areas in greatest need. Digitalisation also ensured that households had the correct number of ITNs, thereby affording the local authorities the ability to plan in greater detail the level of distribution.1
The digitalisation of the programme was made possible through the use of smartphone data, which gathered insights into the size of individual households, ages, and genders. Each household was granted a unique QR code, which allowed authorities to confirm the right number of ITNs had been distributed and no households were missed. The data also revealed that, from around 3m registered households, 14.5m persons needed access to a net. Consequently, Benin’s authorities have been able to bring in a sufficient quantity of ITNs, with the aid of international partners.
The Benin case study has shown what is possible with strong government support and the use of data in fighting malaria. Given that Benin’s digitalised ITN deployment took place during the Covid-19 pandemic, it also further highlights that it is not only possible for malaria prevention to continue amongst other pandemics, but programmes are continuing to evolve and adapt.
Perhaps the most encouraging sign that we have turned a corner came at the end of 2020 with the announcement that a malaria vaccine set to enter the final stages of testing this year could be available by 2024. While this is, undeniably, welcome news and which should be celebrated, the speed in which a vaccine for Covid-19 has been developed does raise the question of why one for malaria – a disease which could claim ten times more lives – is still some way off being ready.
The answer to this question is that malaria is often one step ahead. New research to understand the genetics of the Plasmodium parasite is released on a regular basis, highlighting everything from the impacts of climate change to specific mutations which could render some antimalarial drugs ineffective.
While a vaccine for malaria would be the pinnacle of preventing the disease, it must be the result of careful research. Malaria is, after all, one of the oldest diseases in the world, yet we are still finding out the best way to fight it effectively.
In the absence of this definitive answer, our focuses should remain on educating vulnerable communities, maintaining support for prevention programmes like in Benin, and ensuring access is granted to frontline workers carrying out remote testing and treatment ‘in the field’.
Rapid diagnostic tests (RDTs) will be essential in providing early intervention, especially with technology playing its part in making tests increasingly accurate. It has been encouraging that RDTs continued to be deployed even in the face of Covid-19, especially as our own test is close to beginning the next stage of its practical field trials. As figures in the 2020 World Malaria Report3 show, nearly 2bn RDTs have been distributed throughout the last two decades, including 348m in 2019 alone.
Steps have been taken to position RDTs in community facilities as more affordable tests become available. The foundations have been laid in bringing malaria tests to the communities most at risk, as has also happened for Covid-19. We now need to ensure that tests translate into treatment at an earlier stage.
It may have been overshadowed by Covid-19, but make no mistake, the global fight against malaria is one that we are both in control of and taking forwards. The collaboration between frontline health workers, medical professionals, and governments has not only continued during the pandemic, but has led to critical discoveries and developments, all of which will be essential as we fight for a malaria-free world.