Suddenly, why am I among the generation to not end malaria?

By Esther Nakkazi

The world over, on this day, April 25, 2018, it is World Malaria Day. Today is also the tenth World Malaria day ever after a decade when it started being celebrated and maybe the saddest ever because malaria is on the rise again.

With not much time to waste we should know that the gains we sang about and thumped our chests over about conquering malaria for the past decade have reversed. In 2016, malaria cases rose for the first time in a decade and there were 216 million cases of malaria, 5 million more than the previous year.

There were also 445,000 deaths in 2016 as well human migration is continually importing the disease from high burden areas to lower burden areas. In some high burden countries, the annual number of deaths from malaria has increased. Those with the greatest burden of disease and death are those caught up in a humanitarian crisis where conflict remains the greatest challenge like Burundi, Chad, DR Congo and South Sudan.

Sadly, this treatable disease, malaria, still kills a child every two minutes.

I have not suffered from malaria in about five years and I think it is because I try to prevent it. I often spray my inside and outside my house twice a year. I sleep under a mosquito treated bed net and when I stay out of Uganda for long, I take my medication days before I return.

But it is not only me who has achieved some feat, some countries have even bigger gains. Egypt and Morocco have been malaria-free since 2000, and Algeria since 2016. Others are following suit, Botswana, Cape Verde, Comoros, South Africa and Swaziland, will most likely eliminate malaria by 2020.

Algeria, Comoros, Madagascar, the Gambia, Senegal, and Zimbabwe have also been honored this year by the African Leaders Malaria Alliance for leadership in scaling down malaria cases. In total forty-four countries are reporting less than 10,000 cases.

But even with my own prevention success and for the countries mentioned, malaria is back and with a vengeance. Suddenly, the target of reducing malaria cases by at least 90% by 2030 looks bleak.

Dr. Tedros Adhanom Ghebreyesus, Director-General of the WHO says the malaria fight is at crossroads. But he is hopeful this generation could be it but wants urgency.
“We could be the generation to end the disease for good. If we don’t seize the moment now, our hard-won gains will be lost,” says Dr. Ghebreyesus and cautions, "if we continue along this path, we will lose the gains for which we have fought so hard."

Anti-malaria campaigners say we have become complacent in dealing with malaria. Funding has also flatlined. However, if ONE of the actions to revitalize the fight against malaria is funding then we have hope after the London Malaria Summit.

The UK Prime Minister Theresa May and other Commonwealth leaders made a commitment to halve malaria burden across 53 member countries by 2023 in response to the London Malaria Summit.

There was renewed leadership and energy in the fight to end malaria or “Ready to Beat Malaria” and resource commitments - worth over £2.9bn ($4bn) - to catalyse progress towards beating malaria at a time when efforts to end the preventable disease have stalled.

In addition, the Multilateral Initiative on Malaria (MIM) conference in Dakar brought together scientists and researchers from across Africa to share the latest innovations in the fight against the disease.

Specifically, over the next five years, the Wellcome Trust committed more than £100 million to understand the parasite genome, designing more effective vaccines, developing new treatments, insecticides, and diagnostic tests, and tackling the emergence of a "super strain" of resistant malaria in Southeast Asia before it spreads to Africa. 

Zenysis Technologies has a software platform to help governments identify potential malaria outbreaks ahead of time and they committed in-kind technical support worth $6 million to other malaria-endemic countries in Africa and elsewhere.

Also, five crop protection companies, BASF, Bayer, Mitsui Chemicals, Sumitomo Chemical Company & Syngenta, launched ZERO by 40, a joint initiative supported by IVCC and the Bill & Melinda Gates Foundation, to accelerate development of innovative vector control tools and extend their commitments to help eradicate malaria by 2040.

Australia announced an investment of AUS $56.25 million from their Health Security Initiative to support the development of new resistance beating malaria prevention, diagnosis, and treatment tools 2018-22. They also committed up to AUS $700,000 to support the July 2018 Malaria World Congress in Melbourne and finance new Health Security Fellowships for professionals working in the Greater Mekong Sub-Region.

The Kingdom of Eswatini pledged to get rid of malaria by 2020 and to double domestic financing for indoor residual spraying and also committed to mobilize more domestic resources from the private sector.

Ghana agreed to be one of three countries to pilot the new malaria vaccine, RTS, S, and one of the first to introduce next-generation resistance beating insecticides for indoor residual spraying. RTS, S, the first approved malaria vaccine, will be used in the field starting later this year. The Gate Foundation is working with GSK and other partners to find ways to make RTS, S more durable.

Guyana committed to a targeted response, technology transfer and the need to introduce new tools to accelerate their efforts to defeat malaria. Kenya said it would ensure at least 80% of people living in malaria risk areas are using appropriate malaria preventive interventions and that all malaria cases are treated in accordance with the National Malaria Treatment Guidelines. 

While Malawi committed to reduce malaria incidence and deaths by at least 50% by 2022 and to eliminate malaria entirely from the country by 2028.

With all this renewed commitment and my own success am hoping that this generation does end malaria.