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Has the world turned its back on malaria? 

Mother and child getting treatment for malaria in a health care facility in Kisumu, Kenya.

Mother and child getting treatment for malaria in a health care facility in Kisumu, Kenya. Image: WHO/S. Torfinn

Lutz Hegemann
President, Global Health and Sustainability, Novartis International AG
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  • The World Health Organization's (WHO) 2021 World Malaria Report states 14 million new cases of malaria from 2019 to 2020.
  • Approximately 93% of those deaths occurred in Africa among children under five.
  • Data shows we have the tools to eliminate what some call "the forgotten epidemic," yet progress is stalling and emerging threats could reverse the hard won gains of recent years.

While the world's focus has been on COVID-19, 14 million new cases of malaria emerged in 2020, and the number of cases and deaths in the new WHO malaria report are the highest since 2012. Yet, in some parts of the world, such as El Salvador and China, were declared malaria-free by the World Health Organization in 2021.

The fight against malaria has stalled, with emerging threats, like COVID-19 and complacency -- there's good reason why malaria is sometimes referred to as the "forgotten epidemic." However, this deadly disease can be eliminated with the right focus and resources.

Since 2000, 23 countries have achieved zero malaria cases. These gains of recent years are within reach but hard-won.

Have you read?

Globally, malaria is on the decline

Malaria deaths declined steadily from 2010 to 2018 worldwide. Cases fell 70 percent in Asia and 22 percent in Africa, thanks, in large part, to partnerships between governments, non-governmental organizations and leading health care providers.

But declines began slowing even before the COVID-19 pandemic, and the disruptions the pandemic caused erased a great deal of progress. The number of cases and deaths in the new WHO malaria report are the highest since 2012, with the majority of those deaths, approximately 93%, in Africa among children under five.

We must recommit to this fight against malaria with great urgency.

Each year’s warm season brings new mosquitoes breeding and biting. The stakes are especially high for children across the African continent who may be infected at a critical time in their development. What’s more, climate change is expected to alter the mosquito's growth cycle and enhance the transmission rates of mosquito-borne diseases and widen its geographic distribution.

Malaria vaccine has the potential to save lives

Fortunately, there’s good news on the horizon. A vaccine endorsed by the WHO has been shown to be efficacious against the Plasmodium falciparum species of the parasite that causes the most severe infections. The vaccine will not be a silver bullet, but it has the potential to save many lives when used as part of a comprehensive elimination approach using every tool at our disposal.

In the short term, our efforts will require more efficient and equitable use of the tools we already have, including existing anti-malarial drugs, bed nets, and insecticides to target malaria-carrying mosquitoes. It will also require that health officials strengthen epidemiological surveillance and national capacity to deliver interventions. With this approach, we’ve seen dozens of countries reduce and ultimately eliminate malaria across broad areas. However, countries must prepare to introduce new tools, like the vaccine and new medicines.

Fighting malaria in today's world

Given today’s unique challenges, we need better collaboration. According to this year’s Global Fund Results Report, strong partnerships helped national malaria programs in the hardest hit regions in sub-Saharan Africa sustain much of their work over the past year. Ensuring steady supplies of medicines, training new medical practitioners and improving timely diagnosis helped those programs keep malaria cases from rising even further during the pandemic.

Lessons learnt from this experience should be widely applied.

Finally, we need to play the long game. A recent study conducted in Uganda and published in the New England Journal of Medicine was merely the latest to document how the malaria parasite has mutated to resist artemisinin—the key medicine we’ve used for decades. The growing prevalence of artemisinin resistance demonstrates the risk of relying too heavily on a single medicine. Instead, what’s needed is innovation to build a fuller arsenal of tools, including second-generation vaccines and new treatments.

For instance, Novartis, my employer, and Medicines for Malaria Venture, a public-private
partnership established to reduce malaria in developing countries, recently completed a clinical trial of a new antimalarial treatment that combined ganaplacide, a novel agent with a new mechanism of action, with lumefantrine, and showed a cure rate of up to 94.9% in children under 12 in six African countries and India. This drug combination requires further evaluation, but its success to date shows there’s reason for hope.

Over the past two years, COVID-19 has taught us that we are capable of agility and action against the world’s deadliest diseases if we commit the resources and the will to get it done. We’ve seen how companies, academia and countries can work together to produce life-saving innovations and get them out to patients. And we’ve seen how regulatory authorities can cut red tape to accelerate technology that can save lives.

We must do the same for malaria, a disease that has killed millions of people over centuries is finally within our power to be eliminated for good.

Now is the time to get back on track.

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