Malaria's new challenges, and local approaches to overcome them

Malaria's new challenges, and local approaches to overcome them

A health care worker trains a colleague in Agbowo Primary Health Care Center in Oyo State, Nigeria. Photo credit: Taiwo Olarinde/MSH

Even as we battle COVID-19, there are new challenges in our ongoing struggle to eradicate malaria.

The pandemic is causing major disruptions in health services due to lockdowns, budget crunches, and anxious health workers. Imperial College London estimates that malaria deaths over the next five years may increase by up to 36%. We’re also fighting complacency. In many countries, cases have levelled off rather than declining; in some, the disease is on the rise. 

Meanwhile, as I wrote in Scientific American earlier this year, a new strain of drug-resistant malaria has sprung up in Africa. We must vigilantly monitor its spread and coordinate our response to maintain treatment effectiveness and prevent more deaths on the continent. 

The World Health Organization’s “high burden to high impact” approach calls for a country-driven response to the growing concern about stagnation in the fight to eradicate malaria. At MSH, we’ve seen that supporting local and community leadership is a sound approach to grappling with a vast problem.

In Benin, we supported the development of a mobile app that helps community health workers diagnose and treat cases and feeds general patient information to a national data repository to help track cases and procure supplies. We also supported the National Malaria Control Program in launching an offline app to ease data collection, improve accuracy, and facilitate real-time decision making for seasonal malaria chemoprevention. Using a smartphone and a small solar panel to keep it charged in remote locations, health workers provided preventive treatment to 302,448 children last year, with 95% receiving all four required rounds. 

Another mobile app is helping Madagascar’s community health volunteers properly diagnose and treat suspected malaria cases. Community health volunteers can access digital forms via the app, which feeds into the national health reporting system and quickly relays information to public health officials while simultaneously informing the distribution of essential supplies to prevent shortages. When COVID-19 came to Madagascar’s shores, we added a new module so volunteers can also conduct contact tracing and education activities.

In Malawi, MSH is assisting the National Malaria Control Program in providing high-quality services at the facility and community levels in 10 districts. We also lead implementation on a community program to administer intermittent preventive treatment for pregnant women.

And in Nigeria, we are supporting quality malaria services across eight target states, providing peer-led cascade training to local government health supervisors who then share their knowledge with frontline health workers. Acquired skills include conducting malaria tests, dosing antimalarial medications, and referring severe malaria cases.

We’ve seen that local leadership makes a difference and that we can press forward, even as we battle COVID-19. As we mark World Malaria Day this year, let it be a renewed call to action and engagement and for the resources local leaders need for sustained activities against malaria.

 

Thomas Hall is Senior Principal Technical Advisor for Malaria at Management Sciences for Health