The current situation in Africa

In preparation for World Mosquito Day, we sat down with Duncan Kobia Athinya and James Mutunga, entomologist at Vestergaard, to discuss and review the current situation with malaria in Africa.

World Mosquito Day, marked each year on August 20, celebrates the day of the discovery that mosquitoes transmit the parasite that causes malaria. It also allows us to think, reflect, plan, and honour our achievements on mosquito control in Africa.

Between the years 2000 and 2015, the incidence of malaria was estimated to have reduced by 37% and malaria mortality rates by 60%. However, the rate of decline has stalled and even reversed in some countries since 2015. The latest data shows the African region continues to account for more than 95% of malaria cases and 96% of deaths – 80% of all malaria deaths in Africa Region are children under 5 years old. Therefore, it is important to master the current situation of malaria in Africa to see how to better plan its elimination.

The World Malaria Report 2021 has identified insecticide resistance (IR) in malaria mosquitoes as one of the biological threats that could derail efforts towards malaria control and elimination, further setting back the targeted malaria development goals under the WHO Global Technical Strategy for Malaria 2016-2030. Resistance monitoring is therefore key.

Since 2012, IR Mapper, a collaborative effort between the Kenya Medical Research Institute – Center for Global Health Research, and Vestergaard, has committed to consolidating and visualising data on insecticide resistance from peer reviewed published literature, with monthly updates. Data is centralised onto user-friendly, filterable maps to aid in guiding the selection of the most effective insecticidal tools in target geographical areas.

Another key solution resides in partnerships with malaria control programmes and research institutions focusing on malaria. An example is in Ghana, where we partner with the Noguchi Memorial Institute of Medical Research and Ghana’s National Malaria Control Program (NMCP) under the National Insecticide Resistance Monitoring Partnership (NIRMOP). This plays a role in generating insecticide resistance data to inform malaria vector control.

More effective tools that can be rolled out rapidly and equitably, combined with strategic partnerships are key to tackling malaria in Africa. To avoid further back-sliding on control and elimination efforts, there is a need to launch new generations of bed nets to augment insecticide resistance management strategies, faster than mosquitoes can evolve and develop resistance.

The net use average across the continent is close to 50%. Studies have shown an optimal net use level of approximately 80%, would play a substantial role in huge reductions in malaria cases. Considering the gap, it is important to ensure the LLINs in use perform as expected. A full review of the product path to market with faster adoption and better in-field evaluation of bed net performance would help foster this.

There’s an opportunity to have much more strategic supply collaboration and figure out ways and means that manufacturers of malaria commodities can support equitable access to further the fight against malaria. Lessons learned from Covid-19 pandemic has shown that this is possible – the same could and should be done for malaria. We need to unite our efforts to put more pressure on the disease and reduce transmissions.