Malaria Still Wreaking Havoc In Africa 

By: Doreen Ampofo

NEWS COMMENTARY ON MALARIA STILL WREAKING HAVOC IN AFRICA

Monday, April 25, Ghana joined the world to mark the 2022 World Malaria Day, to assess the success and challenges in the global fight against the disease. Despite some significant achievements in the fight, malaria continues to wreak havoc, accounting for about 627 thousand deaths worldwide in 2020. Most of these deaths were recorded in malaria endemic countries including Ghana. Comparing this to 2019, there were 69 thousand more malaria deaths in 2020. Data from the WHO shows that two-thirds of these additional deaths were linked to disruptions in the provision of malaria prevention, diagnosis and treatment during the Covid-19 pandemic with Sub-Saharan Africa carrying the heaviest malaria burden, accounting for about 95% of all malaria cases and 96% of all deaths in 2020. The sad part is that about 80% of these deaths were recorded among children under five years. This calls for innovative measures to reduce the malaria disease burden and save the lives of these innocent children.

In 2019, the first malaria vaccine, the RTSS, which is seen as a breakthrough intervention in the malaria fight was introduced on pilot implementation in three countries, Ghana, Malawi and Kenya. The four dose vaccine was administered in 47 districts in seven regions in Ghana. These are Upper East, Central, Oti, Volta, Bono East, Bono and Ahafo regions. For Ghana, this was welcome news ,considering the country’s malaria burden. Ghana accounts for 2.1 % of global malaria cases and 1.9% of deaths, making it one of the top 10 highest malaria burden countries in the world.  While the entire country is at risk of malaria, two regions – Volta and Western – have the highest malaria burden, with a cumulative  prevalence of 47.04 percent. Over the years, interventions such as the mass distribution of insecticide treated bed nets, indoor residual spraying, larval source management, seasonal Malaria Chemoprevention (SMC) and  implementation of the Malaria Vaccine for Children under two has resulted in a significant reduction in malaria cases in Ghana. In-patient malaria deaths have reduced from 599 in 2017 to 275 last year with proportion of admissions attributed to malaria declining from 22.6% in 2017 to 19.6% in 2021.The introduction of the RTSS vaccine has largely contributed to this feat. Since 2019, more than 1 million children have been reached with at least one dose of the malaria vaccine through the pilot introduction in the three countries.  In Ghana, about 36000 of our children have received at least one dose of the vaccine with uptake around 60%. In Ghana research findings are showing a 9 percent reduction of malaria mortality in children and  significant reduction in severe malaria cases in children under five. The vaccine has proven to be safe and effective with countries already considering adopting the vaccine as part of their comprehensive malaria control plans following a landmark recommendation by the WHO.

With the recommendation, the use of the RTSS will be extended to areas in the pilot regions in the three selected countries which did not benefit from the vaccine. The WHO has already given a grant of $5 million for the roll out to begin by the end of this year. After this, the window will be opened in June this year for countries around the world to apply for the vaccine. While this is extremely good news, there are constantly repeating challenges which may derail the gains. According to the National Malaria Control Programme, the National Strategic Plan currently has a funding gap of $412 million. It predicts that Malaria elimination in Ghana will cost $961 million  between 2020 and 2029. However,  investment in malaria has dwindled especially with the Covid 19 pandemic  which has resulted in the diversion of huge resources to contain its spread. These have resulted in inadequate funding for IRS, SMC, ITN campaigns and expansion of RTSS vaccine implementation. These funding gaps must be addressed urgently because Malaria does not only lead to deaths, but also has a direct impact on the economy. It costs between $10 to $46 dollars to provide treatment and care for a patient. This is money that could have been used to fund other important social needs of citizens.  Households  spend between $5.70 to $48.73 dollars per episode of malaria.  8 to 9 working days are lost by a malaria patient and 5 days by caretakers per episode. Financial productivity lost due to the premature death of children is between  US$ 11,794  and 13,814 per death while it costs businesses $6.6 million  per year. On the national economy, Malaria reduces economic growth in sub-Saharan Africa by 1.3% per person per year and GDP by 0.25 to 6%. We are all affected in one way or the other. This year’s  theme which calls for advancing equity and building resilience to end  malaria is a call to action. A call to mobilise new funding to support the implementation of malaria control activities. Government, stakeholders, partners, and donors must increase investment for malaria control activities to reduce the burden of the disease and ultimately eliminate it. Evidence shows that malaria elimination is feasible and within reach. Invest in malaria control to protect loved ones. Yes, let’s do this together. It can change if we act now