From Pandemic* to Endemic*…

Written by Samantha O’Loughlin, Target Malaria

As I write, here in the UK we are in lockdown to try to stem a disease pandemic that is causing global suffering and deaths. We are all unsure about what the future holds.

Imagine a world where Covid-19 is endemic. Scientists are still struggling to develop an effective vaccine. Imagine if we all know we will have to take two or three weeks off work sick every year. We feel the familiar start of a fever and know that we are in for a rough few days – again. We hope that this time will not be worse; we won’t end up in hospital like our brother, or will never come home from hospital like our grandmother. Imagine that the health care system in your country cannot cope, and that there are not enough hospital beds to go around or doctors to treat you.

If you replace the words ‘Covid-19’ with ‘malaria’ in the paragraph above, this is the sad reality for most people living in sub-Saharan Africa. When I am working with my colleagues in Burkina Faso or Uganda it is common for someone to start looking unwell. ‘Don’t worry’ they say, ‘it is just malaria’. Usually, they stay home for a few days, but sometimes it develops into something far worse.

On 25th April it was World Malaria Day, a day set aside for us to remember the ongoing battle against malaria across the world, and to celebrate the successes. Between 2000 and 2014, the number of malaria-related deaths fell by 40% worldwide, from an estimated 743,000 a year to 446,000. But since then, the rate of reduction in cases and deaths has stalled, and in some countries has started to increase again. It is worth emphasising that these deaths are happening every single year: in most countries where it occurs, malaria is an endemic disease, not an epidemic or a pandemic.

The emergence of Covid-19 is likely to make the death toll from malaria much worse. A new study from the World Health Organisation predicts that in Africa deaths may jump from a projected 386,000 without coronavirus to 769,000.

One big difference between Covid-19 and malaria is that malaria cannot be transmitted directly from person to person. Malaria is transmitted from the bite of an infected mosquito. This means that reducing the numbers of mosquitoes can have a dramatic effect on the disease. In fact, most of the progress in reducing malaria cases so far has been due to preventing mosquito bites.

Reducing the numbers of mosquitoes using gene drive may be a game-changing addition to the current toolbox of methods that we have to fight malaria. It is important for us to continue to research whether it can be deployed effectively and safely.

Stay home and stay safe.

*Pandemic: A pandemic is defined as an epidemic occurring worldwide, or over a very wide area, crossing international boundaries and usually affecting a large number of people.

*Endemic: An endemic disease circulates in society at a fairly constant level; it is an everyday occurrence.