Mosquito net distribution could help halve the number of deaths from Malaria during the coronavirus outbreak in Africa, researchers say.

There are concerns that malaria control activities – such as distributing insecticidal nets – could be severely disrupted as a result of the pandemic. Writing in Nature Medicine, Imperial’s COVID-19 Response Team estimate that malaria deaths could more than double in 2020 compared to 2019. But swift action could substantially reduce the burden of malaria and prevent joint malaria and COVID-19 epidemics simultaneously overwhelming vulnerable health systems. In the article the researchers estimate the impact of disruption of malaria prevention activities and other core health services under four different COVID-19 epidemic scenarios.

An estimated 228 million long-lasting insecticidal nets (LLINs) were due to be delivered across Sub-Saharan Africa this year, more than ever before. They estimate that if these mosquito nets are not deployed and preventative chemotherapy and case management is reduced by half for six months, there could be 779,000 malaria deaths in sub-Saharan Africa over 12 months.

If prevention activities were to stop during the outbreak, the team estimates that 200,000 deaths could still be prevented over six months if treatment of malaria is maintained. The researchers recommend that routine distributions of LLINs should be prioritised alongside maintaining access to antimalarial treatment and the use of chemoprevention to prevent substantial malaria epidemics.

 “It is vitally important to get malaria prevention measures out now to reduce the pressure on health systems as COVID-19 cases increase.”

Dr Thomas Churcher, Imperial’s School of Public Health

“In the face of COVID-19 it will still be important to ensure vector control interventions continue to be deployed as much as possible in order to not only sustain the gains already made in malaria elimination but ensure we do not have a resurgence in malaria.”

Okefu Oyale Okoko, Deputy Director/Head Integrated Vector Management Branch National Malaria Elimination Programme (NMEP) Public Health Department Federal Ministry of Health Abuja

“The efforts to maintain net campaigns across Sub-Saharan Africa are absolutely vital. We know how to prevent, track and treat malaria, but the strain Covid-19 puts on health systems risks hard fought for progress. This important modelling is a reminder that efforts to end malaria sit on a knife edge. Protecting people against Covid-19 cannot be pursued in isolation. Governments must see maintaining efforts against malaria as a core part of pandemic preparedness or risk a catastrophic domino effect.”

James Whiting, Executive Director, Malaria No More UK

Read the full article > 

For more information contact:

Stephen Johns
Imperial College London
s.johns@imperial.ac.uk

+44 (0) 20 7594 9531
+44 (0) 7792 657226

In partnership with IVCC, and funded by the Bill & Melinda Gates Foundation, the Liverpool School of Tropical Medicine’s Centre for Capacity Research investigated how Good Laboratory Practice (GLP) certification was achieved by the KCMUCo-PAMVERC trial site in Moshi, Tanzania.

A new paper by Sara Begg identified the enablers and barriers that influenced the development of capacity to achieve GLP certification with the lessons learnt transferable to other African trial sites to accelerate progress towards GLP and strengthen the network of test facilities able to provide high-quality data for the evaluation of vector control products.

IVCC supports a study by North Carolina State University entomologists and Imerys Filtration Minerals Inc. to test an indoor residual spray made by combining a type of volcanic glass with water. In the study Imergard WP – an insecticide created from perlite – was tested. Researchers used the spray in experimental huts in the Republic of Benin to test the effects of the spray on both wild and more susceptible strains of Anopheles gambiae mosquitoes, the primary malaria vector in sub-Saharan Africa. Results showed mortality rates of mosquitoes alighting on Imergard WP treated walls were greater than 80% up to five months after treatments, and 78% at six months. The treatments were effective against both susceptible and wild-type mosquitoes.

Read the full press release on the NCSU website.

Photo credit: Dr. Bidossessi Deguenon, NCSU

“I am very pleased that together we achieved our goal of establishing a sustainable, growing and competitive market for third generation, longer lasting and resistance-breaking insecticides for Indoor Residual Spraying (IRS).”

On December 31st, 2019, the Unitaid funded NgenIRS project came to an end. The NgenIRS team, led by IVCC and made up of colleagues from PATH and Abt Associates, worked in partnership with 16 malaria control and elimination programmes across Africa, the US President’s Malaria Initiative (PMI), the Global Fund and three insecticide manufacturers.

The downward trend in IRS use was reversed and the resulting expansion of use has resulted in significant public health impact, savings in commodity costs and new evidence showing the cost-effectiveness of third generation IRS (3GIRS). What’s more, the foundation has been laid to sustain and expand on these successes, providing malaria programmes with more options for rotation and ultimately more lives saved on the path towards malaria elimination.

Today we launch a collection of evidence materials, consisting of a video, a project overview and evidence slides (available in both English and French). These materials are available for free download on the NgenIRS web page and IVCC resource library. These materials have been prepared to show the impact of the NgenIRS project and are intended for use by partners and stakeholders who need to communicate the contribution of 3GIRS products to the reduction of malaria. We hope that these are useful to you and advice on use can be found within the materials.

I would like to extend my heartfelt thanks to the NgenIRS team and our many other partners who worked tirelessly and selflessly to make this project such a huge success. Although we have achieved great things together, we must maintain this commitment to enhancing and smartly deploying the vector control toolbox if we are to reach our shared goal of malaria eradication.

View all evidence materials > 

As the world grapples with the COVID-19 pandemic, there is a renewed awareness of the devastating effects of infectious diseases and the need for robust health and surveillance systems. COVID-19 is testing the resilience of these systems around the world and is now moving into resource-limited settings, where its impact could be even more devastating. Malaria-endemic countries across the globe have reported cases of COVID-19 and 37 countries in Africa (which carries more than 90% of the global malaria burden) had reported cases by 5^th April 2020. Efforts to limit the spread of COVID-19 are necessary to allow health care systems to continue to serve their communities during this crisis.

At the same time, these efforts must not compromise access to life-saving malaria prevention, diagnosis and treatment services or threaten to reverse decades of hard-fought progress against malaria. Experience from previous disease outbreaks has shown the disruptive effect on health service delivery and the consequences for already vulnerable populations. COVID-19 is not the first reminder of the potentially delicate balance of global health challenges (Swine influenza in 2009, Ebola in 2014 and Zika virus in 2015) and it won’t be the last, although somehow it seems we forget and move on so quickly. Recognising this balance, the World Health Organization (WHO) has underlined the critical importance of continuing malaria prevention at this time. Ensuring access to vector control tools and products is an important strategy for reducing the strain on health systems. These vital tools include insecticide-treated nets (ITNs) and Indoor Residual Spraying (IRS) – which have been responsible for more than three quarters of averted clinical cases of malaria in the past 18 years.

In recent days, there have been reports of the suspension of vector control programmes in several African countries due to COVID-19. The WHO strongly encourages countries not to suspend the planning for or implementation of vector control activities, whilst, of course, taking all necessary precautions against spreading infection. There are also disruptions in the supply chains of essential vector control interventions, resulting from lockdowns and from a suspension of the importation and exportation of goods in response to COVID-19. Coordinated action is required to ensure the availability of these tools for the people who need them most and we are committed to contributing our expertise and networks to this end.

At IVCC, our vision is a world free of insect-borne disease, where lives are saved, and prosperity increased. Our strategy to reach this goal is to deliver a comprehensive toolbox of resistance-breaking vector control tools and to maximise their impact through market access interventions. During this time, we will continue to work in partnership with colleagues across the global health community to see this happen. The COVID-19 pandemic has demonstrated once again that we do not have all the tools needed to tackle infectious diseases and so, if anything, more innovation than ever is essential. Current investments in malaria are saving hundreds of thousands of lives and preventing millions of cases per year. This is significant progress but too many people continue to suffer and die. In 2018, there were an estimated 228 million cases of malaria worldwide and an estimated 405,000 deaths – of which two thirds were children under five in Africa. As long as malaria exists, it threatens the poorest and most vulnerable and has the potential to resurge in times of public health crises – like the one we are facing now.

Against the backdrop of COVID-19 it could be easy for malaria to be forgotten by the international community and for vital resource allocation to suffer, so we are incredibly grateful for the continued support, guidance and work of all our funders and partners. In recognition of the importance of not taking our foot off the pedal with malaria eradication, our funders have encouraged us to continue to support partners through the challenges of COVID-19. It is difficult to apply blanket rules but we are taking a flexible and pragmatic approach to adjusting workplans and contracts to ensure the continuation of delivery of programs; supporting reasonable costs to ensure that essential resources and expertise remain in place; and considering, in good faith, requests to re-profile and revise project budgets, timelines and milestones. It is due to this commitment by us all to stay the course, even in these unprecedented times, that we will reach a malaria-free world.

Our thoughts remain, always, with people in malaria-endemic countries, our partners globally and our colleagues – we hope that you stay safe and well, and remain committed to playing our part in that.