As COVID-19 Spreads, Malaria Services Must Stay the Course

By Tarryn Haslam, Director of Malaria, PSI

As we mark World Malaria Day 2020, PSI and the global malaria community of practice face the challenge of ensuring the continuation of essential life-saving malaria services in the face of COVID-19.

On April 23rd, the World Health Organization (WHO) released a new modeling analysis which concludes that severe disruptions to insecticide-treated net (ITN) campaigns and malaria treatment could lead to a doubling in the number of malaria deaths in sub-Saharan Africa in 2020 compared with 2018.

The WHO has urged countries to ensure the continuity of malaria services, such as ITN distribution, seasonal malaria chemoprevention (SMC) and malaria testing and treatment in the context of the COVID-19 pandemic while ensuring the safety of health workers providing malaria prevention and case management services. PSI is working with the WHO, donors, partners and national malaria control programs (NMCPs) to find innovative solutions to heed the WHO’s call for the continuity of these core interventions in the face of the COVID-19 global pandemic.

Supply Chain Disruptions

PSI is currently contributing to five WHO Global Malaria Programme (GMP) workstreams that are addressing a broad range of challenges to the provision of services during the ongoing pandemic. These challenges include supply chain disruptions affecting the availability of commodities as well as modifications to service delivery to ensure the safety of patients and healthcare providers delivering malaria diagnosis and treatment services.

The WHO modeling analysis considers nine different scenarios for potential disruptions to core malaria prevention and treatment services during the COVID-19 pandemic in 41 countries, with each scenario resulting in varying increases in malaria cases and deaths.

Adapting Our Programs

The worst-case scenario includes an assumption that all ITN mass campaigns are suspended in 2020 and that there is a 75% reduction in access to effective anti-malarial medicines. Through global and bilateral mechanisms, PSI is responsible for the implementation of multiple mass campaigns (e.g. ITN and SMC) in 2020. Our teams are working around the clock to pivot mass campaigns to include COVID-19 adaptions, in collaboration with NMCPs, the Alliance for Malaria Prevention, and other key stakeholders to ensure that these campaigns still take place. Likewise, PSI is strategizing with NMCPs and other stakeholders in many countries to ensure ITNs remain available for intended beneficiaries through continuous distribution channels, such as pregnant women through antenatal care clinics, children under one year of age at immunization clinics and students at primary schools.

PSI is providing ongoing support to NMCPs and other stakeholders to ensure the continuation of malaria testing and treatment throughout the COVID-19 pandemic. Through global and bilateral malaria service delivery mechanisms, PSI is also continuing to support care-seeking for fever in malaria-affected countries. The health and safety of health care providers, community health workers and beneficiaries is the number one priority, and PSI is working with NMCPs and other stakeholders to ensure evidence-based infection prevention and control methods are in place. In many malaria-affected countries in sub-Saharan Africa, especially as malaria season nears and the number of confirmed COVID-19 cases remain low, fever is more likely to be caused by malaria than SARS-CoV-2; therefore, it is critical that community members continue to seek care for fever at health facilities and community health workers continue to provide malaria services.

The Time to Act is Now

The number of reported cases of COVID-19 in sub-Saharan Africa is small to-date, however, the number of confirmed cases is increasing every week. As the WHO has indicated, malaria-affected countries in sub-Saharan Africa have a critical window of opportunity to avoid the catastrophic projections illustrated in the recent WHO modeling analysis by ensuring the continuity of malaria services now and throughout the COVID-19 pandemic. PSI’s malaria team is making every effort to support NMCPs and other stakeholders to develop innovative solutions to the challenges faced during these unprecedented times.

Banner image credit: PMI Impact Malaria/Mwangi Kirubi

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