Robust health systems could stem climate-related rising cases of malaria

By Dauda Abbas

Over the past few decades, remarkable strides have been made to end Africa’s burden of malaria. Frontline tools, such as insecticide-treated bed nets (ITNs) and artemisinin-based combination therapies (ACTs), have played significant roles in saving countless lives by reducing deaths and curbing the spread of the disease.

Between 2000 and 2021, concerted efforts and the implementation of these frontline tools have averted over 11 million deaths and two billion malaria cases, mostly in the African region.

However, the decreased effectiveness of these tools, the challenge of climate change, and poor health systems continue to pose a threat to the lives of millions of people in Africa, particularly pregnant women and children under five who are the most vulnerable.

Scientific evidence shows that rising temperatures create favorable conditions for the proliferation of malaria-carrying mosquitoes, which thrive in warm environments.

As temperatures increase, mosquito reproduction rates accelerate. Extended periods of warmth lengthen the breeding season, leading to a rapid increase in mosquito populations and a surge in malaria transmission.

Higher temperatures also expedite the development of the malaria parasite within mosquitoes, resulting in an expanded geographic range for malaria transmission and making previously low-risk regions more susceptible.

Altered rainfall patterns caused by climate change contribute to the creation of mosquito breeding sites. Areas experiencing increased rainfall may see the formation of stagnant water bodies, which serve as ideal breeding grounds for mosquitoes.

Conversely, areas affected by prolonged drought may experience a decline in mosquito populations. However, when rainfall follows a drought, the sudden availability of water can trigger a rapid increase in mosquito populations and lead to malaria outbreaks.

These unpredictable shifts in rainfall patterns disrupt traditional malaria control measures, necessitating adaptive strategies to mitigate the impact of the disease.

Since World Malaria Day in April, AFIDEP has been facilitating a series of webinars on various aspects of malaria through the Health Tech Platform. Experts from across Africa have provided insights into the topic. The growing resistance of the Anopheles mosquito and Plasmodium parasite to insecticides and drugs, respectively, is among the threats impeding the global goal of a 90% reduction in malaria incidence and deaths by 2030.

Governments continue to use treated bed nets and indoor residual spraying as primary tools for combating malaria, but mosquitoes can now survive exposure to insecticides, allowing them to continue transmitting the disease.

Furthermore, the increasing resistance of the Plasmodium parasite to drugs used for treatment is leading to treatment failures, necessitating the discovery and development of new chemotherapeutic agents.

This resistance has led to the declining effectiveness of insecticides and ACTs. According to WHO figures highlighted by Dr. Michael Okal, Director of Research and Development at Vector Health International Ltd, countries are currently 48% off track in eliminating malaria by 2030.

 Dr. Chris Barasa, Chief of Party at Amref Health in Kenya, emphasized the need for African countries to streamline public health functions, particularly primary healthcare, to build resilience in efforts to improve, promote, protect, and restore the health of all people.

Resilience in healthcare planning involves proactive measures, crisis management, and post-crisis learning to enhance future preparedness, considering the uncertainty of future health threats.

To address these challenges, countries can implement various measures, including identifying potential threats and developing strategic health information systems, diversifying primary healthcare services to manage a broad range of health challenges, establishing effective data collection and utilization for evidence-based decision-making, and fostering collaboration and coordination between healthcare entities to enable a comprehensive and effective response to health threats. The threats posed by drug and insecticide resistance, climate change, and fragile healthcare systems highlight the complex challenges that need to be addressed in order to end malaria in Africa.