5 Lessons Malaria Offers on Transitioning from Pandemic to Endemic

As we enter Year 3 of the Covid-19 pandemic - and the media and experts increasingly discuss the likelihood of transitioning to the endemic stage - malaria, the world’s oldest and deadliest disease, can offer insights on what to expect.

Lesson #1: Endemic doesn’t mean less deadly

85 countries are today in the endemic stage of malaria, meaning the disease exists in communities but it has become more manageable as immunity builds up. But endemic doesn’t mean malaria is any less deadly. The World Health Organization’s latest World Malaria Report estimates there were 241 million malaria cases and 627 thousand malaria deaths worldwide in 2020. Sub-Saharan Africa alone accounted for about 95 of the world’s malaria cases and 96 percent of all malaria deaths. “We’re all tired of living in a pandemic but transitioning to the endemic stage of Covid-19 doesn’t mean our work is done. As the fight against malaria shows, without adequate prevention, testing and treatment, an endemic disease still poses a persistent, deadly threat, particularly to those most vulnerable,” says Martin Edlund, Malaria No More CEO.

Lesson #2: Endemic doesn’t mean we can drop our guard

Bed nets continue to protect up to one million people each year. In addition, a new study in The New England Journal of Medicine suggests that children who sleep more often under insecticide-treated bed nets are at 43 percent lower risk of death than those who do not use treated nets.

Lesson #3: Endemic doesn’t mean more testing isn’t needed

Through the President’s Malaria Initiative (PMI), health workers in sub-Saharan Africa tested approximately 267 million fever cases with malaria rapid diagnostic tests in 2019, resulting in 190 million people being treated with anti-malarial drugs, helping to cutting the number of child deaths from malaria in half since 2000. Yet, an estimated 40% of fevers in sub-Saharan Africa still go undiagnosed, creating dangerous risks that outbreaks will go undetected. Over the next 5 years, investments in the U.S. President’s Malaria Initiative (PMI) aim to save 4 million additional lives and prevent 1 billion more malaria cases over the next five years with the latest innovations and additional funding.  

Learn more: Malaria No More & Covid Collaborative - Leveraging U.S. Malaria Platforms

Lesson #4: Endemic doesn’t mean we’re equally vulnerable

Malaria is among the leading causes of death in many developing countries, and young children and pregnant women are most at-risk. Children under age five accounted for 80% of all malaria deaths in Africa in 2020, given they are more susceptible as their immune systems are still developing. And pregnant women are at an increased risk of malaria infection because of their decreased immunity (maternal women are at a 2-fold increased risk of malaria).

Lesson #5: Endemic doesn’t mean more research and innovation aren’t still needed

After more than 35 years of research, the WHO formally recommended the world’s first malaria vaccine for roll out in sub-Saharan Africa as of October. Regardless of this significant progress, this month, the fight against malaria took a step backward as the latest UN Climate Report warned that two decades of progress against the world’s oldest disease could be reversed due to rising temperatures, changing rainfall patterns, and extreme weather events. As a result, the report also called for better “understanding seasonal shifts” and working toward a “deeper understanding” of climate change’s impact on changing mosquito seasons, goals Malaria No More has been working toward through our Forecasting Healthy Futures initiative. In January, the new Institute for Malaria and Climate Solutions (IMACS) was launched to help countries use exciting new climate data and artificial intelligence to improve the precision of forecasts that predict when and where malaria outbreaks will occur before they do.

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