Written by Delphine Thizy, Stakeholder Engagement Manager at Target Malaria
The World Health Organization (WHO) released its World Malaria Report 2019 today. The good news is that the number of malaria cases continues to decline. In 2018, there were 228 million cases of malaria worldwide, compared to 231 million in the previous year. The number of deaths has also decreased from 416,000 in 2017 to 405,000 in 2018. In the last decade, 23 countries have been certified malaria-free and the number of countries with less than 10,000 cases continues to increase.
Global investments and actions to fight the disease are making a difference. However, we need to do more. The report stresses that progress is coming at a slower pace. In 2010, the number of cases per 1,000 population was 71 but, since 2014, it remains at 57. Moreover, malaria is increasingly becoming a disease of poverty and inequality, with only five countries in sub-Saharan Africa registering 50% of the cases in 2018. The situation is not likely to get better, as a recent study about climate change effects on health indicates. Women and children are the most vulnerable groups. Children under five are at particular risk, accounting for two-thirds of malaria deaths in 2018 worldwide.
Beyond those numbers, those facts, we need to realize that there are families who are not sure if their kids will survive, there are farmers who will miss the key moment to plant their crop because they will be in bed with fever, there are children who will get behind at school because they have missed lessons due to diseases. There are many lives, many communities whose opportunities are affected by one of the oldest diseases, caused by a parasite transmitted by small insects, the Anopheles mosquitoes.
Current tools used to combat the disease, such as indoor residual spray, bed nets and improved diagnostics, are not enough to eradicate malaria. These tools are not reaching all the populations at risk. Even when they do, there is no guaranteed that they will be correctly and frequently in use. Besides, mosquitoes’ resistance to insecticides is another increasing challenge. To make malaria elimination a reality by 2050, innovation and new tools are essential. This is not a debate anymore, it is a fact, as WHO and the Lancet Commission notably pointed earlier this year.
Gene drive technology is one of the avenues to explore. Gene drive mosquitoes, for example, could become a more cost-effective, sustainable and long-term solution tool, complementing methods already in place. More research is needed to understand whether using gene drive mosquitoes would be feasible and appropriate to enter the public health toolkit against malaria. We should not be intimidated by the unknowns and potential impacts of emerging technologies, but ensure that research is conducted responsibly. Gene drive mosquitoes should be part of the integrated worldwide anti-malaria effort, as defended by WHO. Moreover, it should be an essential aspect of further investments in research, development and in scaling up transformative tools - usually listed as critical steps if we really want to eradicate malaria in one generation.
Eradication of malaria is a commitment that we ought to make to the young generation. We need to explore all potential tools that can contribute to this goal. Together with researchers from endemic countries, communities and policymakers, we need to raise to this challenge. Because Zero Malaria Starts with us.