The rapid spread of COVID-19 is testing the resilience of robust health systems around the world. WHO and its partners are taking measures to mitigate the potential impact of sustained transmission of the coronavirus in malaria-endemic settings –
particularly in sub-Saharan Africa, which shoulders more than 90% of the global malaria burden.
To date, a small proportion of the global COVID-19 cases have been identified in malaria-affected countries. However, as of 17 March, 25 countries in the African Region had reported cases of COVID-19, and local transmission of the disease had been detected
in 6 countries (Algeria, Cameroon, Kenya, Rwanda, Senegal, South Africa).
“At this point, we still don’t know what the COVID-19 pandemic will look like in sub-Saharan Africa,” said Dr Pedro Alonso, Director of the WHO Global Malaria Programme. “But we do know that when public health emergencies have
hit parts of Africa with weak health systems and high malaria transmission, the impact on malaria disease and death has been very severe.”
The 2014-2016 Ebola outbreak in Guinea, Liberia and Sierra Leone, for example, undermined malaria control efforts and led to a massive increase in malaria-related illness and death in the 3 countries.
Joint action
To support malaria-affected countries, WHO has identified the need for a set of inter-related actions among global partners:
- generating, using and disseminating accurate information;
- mitigating against health system disruptions; and
- ensuring the continuity of routine malaria-specific interventions while also providing, where needed, additional emergency measures, such as mass drug administration, in health systems significantly impacted by COVID-19.
The Organization convened partners on 17 March to discuss areas of collaboration, coordination and next steps.
WHO has begun monitoring the evolving geographic location of COVID-19 cases to understand the extent to which the coronavirus and malaria affect the same target groups. This information will reveal who is likely to be at greatest risk, where and when,
and thus inform the need for malaria-specific interventions to save lives.
In parallel, WHO is working across the 3 levels of the organization to ensure that any advice intended to curb coronavirus transmission and to guide COVID-19 disease management is appropriate in malaria-affected settings.
In recent days, there have been reports of disruptions, as a result of COVID-19, in the production and global supply chains of essential malaria commodities, such as the long-lasting insecticidal nets, diagnostic testing and antimalarial medicines. Coordinated
efforts are required to ensure the availability of key malaria control tools – particularly in countries with a high burden of the disease – and that efforts to limit transmission of COVID-19 do not compromise access to malaria prevention,
diagnosis and treatment services.
Malaria-affected countries may also experience disruptions in health systems in the coming months. A marked increase in febrile patients seeking treatment for COVID-19 at health facilities, for example, would present a significant challenge for a health
workforce that may itself be depleted by the disease.
Policy guidance
WHO is developing guidance for national malaria control programmes and implementing partners to prepare them for the challenges they may face as result of COVID-19. Among other areas, the guidance will address the mitigation of stockouts of
malaria medicines and commodities; the use of preventive malaria therapy for health workers; the deployment of emergency measures in some settings; and the generation of information relating to the geographic distribution and populations affected
by COVID-19 in malaria-endemic settings.
Restrictions around grouping people together – for training, social and behavior change communication activities, fixed-site distribution and clinical care – as well as the restrictions around movement of people in the country, will require
significant adaptations in order to deliver quality interventions and care.
All people living in malaria-affected areas are advised to follow same precautions as the general population, including: frequent hand-washing, respiratory hygiene, social distancing, seeking prompt medical care if symptoms arise (cough, fever,
difficulty breathing), and other WHO-recommended actions.
WHO stands ready to work with countries and other stakeholders to mitigate the negative impact of the coronavirus on malaria responses worldwide and, where possible, contribute towards a successful COVID-19 response.
About COVID-19
COVID-19 is the infectious disease caused by the most recently discovered coronavirus. This new virus and disease were unknown before the outbreak began in Wuhan, China, in December 2019. Essential information on the COVID-19 pandemic can be found in
a dedicated WHO site.
About malaria
Malaria is a preventable and treatable disease caused by parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes. In 2018, there were an estimated 228 million cases of malaria worldwide and
405 000 malaria-related deaths. For more on malaria, visit: www.who.int/malaria
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