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Our guest is Dr Corine Karema, Acting Executive Director of “Roll Back Malaria”, the partnership to end malaria, which brings together international organizations, the Global Fund, donors, the private sector and countries where malaria is rife. parasite, in all 500 partners.
Malaria killed 619,000 people in 2021, 96% of them in Africa. This is less than in 2020, but we are still above the mortality before Covid-19, which disrupted the fight against this pandemic. Despite everything, the WHO observes that the national health systems for the fight against malaria have resisted. How do you explain it ?
It is true that despite the disruptions in health services, and of course in the fight against malaria due to Covid-19, the countries have really made heroic efforts which have really paid off. First, there is the leadership of the countries, and of course, it is a robust partnership, whether it is the bilateral, multilateral institutions, the NGOs, which have continued to make efforts. 185 million cases of malaria and 997,000 deaths were averted in 2021. And we have also seen that in 2021, many of the countries are within reach of malaria elimination, and this continues to progress, in Africa, we have Cape Verde, we have Botswana.
However, the eradication of malaria faces new challenges. Prevention tools and remedies are no longer as effective, the parasite has become resistant…
Yes, there were nine countries already in Africa which showed that there is resistance to the insecticides which are the pyrethroids, which are the insecticides which are used both for impregnated mosquito nets and for spraying in houses.
And there is also a new mosquito, the Anopheles stephensi, which is spreading in cities ?
The new stephensi mosquito that was seen in Asia is starting to be seen in many countries, Djibouti, Somalia and Nigeria. This is a new problem and that is why the WHO has developed a guideline that allows countries to be able to control this new vector.
Is research on track to find solutions to these problems? ?
Yes, now we are at a level where we really have a large arsenal, innovation tools that are being developed and that have just been developed. For example, when we look for mosquito nets, we have new generation mosquito nets, PBO mosquito nets, so we add to our product the insecticides that are available, to try to boost the effectiveness of the insecticide and of course attack the problems of mosquitoes that are resistant to pyrethroid.
And on the side of drugs and vaccines ?
As far as drugs are concerned, at the moment there are new molecules that are not based on artemisinin, which are in development. You know that there is a first vaccine which has been approved by the World Health Organization (WHO) and which is already implemented in three countries in Africa: Kenya, Ghana and Malawi, and there has about 27 African countries that have submitted their submission to Gavi [l’Alliance mondiale pour les vaccins et la vaccination, NDLR], to be a candidate for the sites that will receive these vaccines. There is also a new vaccine which is the R21 which is in third phase of clinical trial. There are also other vaccines that are in development. There are also anti-monoclonals which are also prevention tools which could be candidates for chemo-prevention in the fight against malaria. That is why, I am optimistic, these are tools that will allow us to eradicate malaria.
Rolling out all these new tools against malaria is going to take money. WHO estimates needs at $7.8 billion per year and funding, although increased in 2021, is half that. Here too, you are optimistic ?
We have just had the conference in September for the replenishment of the Global Fund, to fight against HIV, tuberculosis and malaria. I think it’s a great achievement, especially in the present context of Covid-19, the socio-economic impact, the war with Ukraine, climate change, because it’s the first time that the Global Fund was able to mobilize $15 billion. The Global Fund is a very important partner in the fight against malaria, now with Covid-19, the costs of malaria interventions have increased, the supply costs have increased. So it will also depend on endemic steps, the third most important contributor, primary health care.
►Also read: Malaria: the situation is stabilizing, but new risks are emerging, according to the WHO