World Malaria Day 2024: Meeting Zero Malaria Targets amidst Climate Change and the Looming Parasite Resistance!

Climate change is worsening this burden, and the detection and expansion of artemisinin- (the main component in the antimalarial combination therapy) resistant strains in the East and Horn of African countries (Eritrea, Ethiopia, Uganda, Tanzania, Rwanda, and South Sudan) throw the goal of malaria elimination further than previously anticipated.

“Malaria is among the very climate-sensitive diseases. The temperature has risen for over 1.5 centigrade over the past few decades. The rise in temperature increases the transmissibility of the mosquitoes considerably, we need to come together to save our planet and our communities from malaria”.

The long rainy seasons and floods increase water stagnancy, thus giving mosquitoes longer breeding time. Subsequently, hot and dry spells cause ponds, lakes, and swamps to dry into small stagnant water bodies where mosquitoes breed. For example, malaria surges have been observed after cyclones that have hit Mozambique recently (MMV report Climate change and malaria).

These changes are expected to increase the number of people exposed to Malaria in Africa from 427 Million to 461 Million in 2040 (Ermet et al., 2013).

Also, these climate changes tend to disrupt health infrastructures, making accessible areas inaccessible and the inaccessible ones even more inaccessible due to disrupted roads, hospital buildings, etc. Health financing dedicated to malaria is shifted to address adverse climatic disasters.   All these are expected to add 60,000 malaria deaths yearly.

In response to these climatic shifts and the looming drug resistance, African nations are refining their approach towards malaria elimination.

Efforts are being intensified to improve surveillance systems, strengthen health infrastructure, and promote community-based initiatives.

Recently, DHIS2, a widely used data system in healthcare settings worldwide, announced a new application that is considering integrating climate-health-related data, which will be vital in responding to malaria. DHIS2 has also been tested to support genomic surveillance of resistant strains in South Africa.

Some African countries, such as Mozambique, Rwanda, and Malawi, are already in the pilot stage of including climate-health-related data in DHIS2, and hopefully, more, including Tanzania and others, will follow.

Innovations in vector control, like genetically modified mosquitoes and using drones to map and treat high-risk areas, are promising. Moreover, expanding malaria vaccine trials offers a glimmer of hope for a more robust preventive mechanism.

Recently, the WHO also approved two vaccines, RTS,S, and R21, for rollout in malaria-endemic countries. More than 2 million children in pilot implementation countries, namely Ghana, Kenya, and Malawi, have already been vaccinated with the RTS,S and Cameroon became the first country to start the large-scale rollout of the approved vaccines. In October 2023, WHO said there is an overwhelming demand for the vaccines, and the available supply is still limited.

However, the journey is fraught with challenges. The threat or vector, diagnostic and antimalarial resistance, which are exacerbated by the current climate crisis, threatens the reversal of much of this progress. Limited resources and the need for greater international cooperation and funding are significant barriers.

Nonetheless, there are opportunities for synergistic efforts that combine malaria control with climate adaptation strategies, ensuring more resilient health systems and communities.

To address the challenges posed by climate change in the fight against malaria, it is important to consider, among other things, the following: