Global health security requires endemic disease eradication:
In 2019, the Lancet Commission on malaria eradication contended that malaria can be eradicated within a generation by improving management, operations, and leadership, developing and deploying innovative tools, and spending an additional US$2 billion per year
WHO released a report in 2020 reaffirming its vision for a malaria-free world.
These reports described the numerous benefits of malaria eradication, including the synergistic nature of eradication, global health security, and the achievement of universal health coverage. Several countries, regions, and global organisations expressed their commitment to an eradication goal, and enthusiasm in the malaria community was high. Then came the COVID-19 pandemic.
Global health experts were quick to warn of the potential negative impacts of COVID-19 on endemic disease programmes. Modelling studies indicated that disruptions to health services and supply chains from the COVID-19 response could set back efforts to control HIV/AIDS, tuberculosis, and malaria by up to 20 years.
In a worst-case scenario, malaria deaths in 2020 were projected to more than double compared with those in 2019.
This extreme outcome did not come to pass given the coordinated action by multiple stakeholders to ensure that more than 90% of planned malaria prevention campaigns, including mass net distributions, indoor residual spraying, and seasonal malaria chemoprophylaxis among children, were undertaken in accordance with COVID-19 safety protocols. Still, irregular access to antimalarial treatment could lead to a considerable increase in malaria deaths in sub-Saharan Africa—even a 10% disruption in access could result in 19 000 additional deaths.
However, COVID-19 has not universally impacted malaria trends. Countries that recently eliminated malaria, including China, El Salvador, and Malaysia, maintained zero transmission throughout 2020, and El Salvador was certified malaria-free by WHO on Feb 25, 2021.
Many of the countries that are nearing malaria elimination stayed on track in 2020, most notably in the Greater Mekong Subregion.
The COVID-19 pandemic is far from over. Malaria programmes will continue to face operational and financial challenges, and the attention and resources of the malaria programme staff and researchers will be stretched to additionally address COVID-19.
The global economy is hard hit and malaria funding, which has been stagnant for the past several years, is poised to decline in the near term as malaria-endemic countries face budget shortfalls and major donors cut their aid budgets.
Existing health inequities within and between countries that exacerbate the spread and severity of malaria are being deepened by COVID-19. Having pre-purchased most of the global COVID-19 vaccine supply through 2021, many high-income countries are expected to achieve vaccine-induced population immunity long before most low-income and middle-income countries, so long as protection from emerging SARS-CoV-2 variants is maintained.
Yet COVID-19 has also brought attention to the importance of resilient and equitable health systems that can respond to routine health needs and health emergencies while contributing to global health security.
Ample evidence exists showing that health emergencies can disrupt and undermine progress against other infectious diseases.
Thus, the goal of global health security must be to ensure that the global population is safe from all infectious diseases, both emerging and endemic, including malaria, tuberculosis, and HIV/AIDS.
Health emergencies should not deter the global community from the ultimate goal of malaria eradication.
Malaria eradication would free up substantial human and financial resources that could then be reallocated to other health priorities, including investment in a systematic approach to disease control and pandemic preparedness based on principles established by successful malaria programmes and repurposed by some countries in the COVID-19 response.
These principles include targeting and tailoring interventions to local circumstances; leveraging efficiency gains to achieve greater impact of interventions with fewer resources; strengthening community-level surveillance, action, and leadership; ensuring access to prevention and treatment in the most vulnerable populations; and prioritising investment in the development and deployment of new diagnostics, drugs, and vaccines. Eradicating malaria would also improve detection of other febrile illnesses, allowing for more rapid response and containment of potential pandemics.
Source : Lancet