Imperative for Malaria Elimination in Africa: Addressing Challenges, Advancing Solutions

Against the backdrop of global economic challenges, achieving malaria elimination goals and addressing other health issues, such as Neglected Tropical Diseases, encounters various impediments. Despite strong political commitment and a range of interventions, progress toward malaria elimination has slowed.

The sixth annual Africa Malaria Progress Report underscores the imperative of pivotal achievements to combat malaria effectively. The report identifies a significant financial gap, projecting a US$1.5 billion deficit in Member States’ budgets by 2026 to maintain current, albeit inadequate, coverage of essential malaria interventions.

This shortfall, influenced by the global financial crisis and elevated costs of essential commodities to counter resistance threats, may lead to a doubling of malaria deaths, akin to worst-case scenarios anticipated at the onset of the COVID-19 pandemic.

Additionally, an annual funding increase of $5.2 billion is deemed necessary for the continent to make substantial progress towards elimination and enable countries to fully execute their national strategic plans. Member States, in collaboration with national and global multisectoral partners, must swiftly bridge these gaps and fully fund national malaria strategic plans.

His Excellency President Umaro Sissoco Embaló, Chair of the African Leaders Malaria Alliance (ALMA), addressed concerns about the precarious situation facing Africa regarding malaria services during a recent announcement. Africa currently confronts a confluence of challenges, including financial deficits in malaria programs exacerbated by global economic instability, climate change effects, insecticide and drug resistance, and humanitarian crises. These multifaceted issues necessitate urgent attention to prevent a surge in malaria cases and fatalities.

The report also underscores the escalating threat of climate change on health, including malaria and Neglected Tropical Diseases. Despite Africa’s minimal contribution to global carbon emissions, the continent faces disproportionate impacts from climate-induced disasters, exacerbating malaria and other vector-borne diseases.

A comprehensive agenda is essential to address these emergent threats, positioning malaria as a pivotal avenue for health systems strengthening, primary healthcare, pandemic preparedness, and illustrating the nexus between health and climate change. The global community is urged to bolster support for mitigation and adaptation measures, while Africa must take proactive measures and contribute additional resources to eradicate the disease definitively.

President Embaló emphasized the potential rise in malaria-related deaths due to funding shortages, biological threats, and climate disruptions. This message was conveyed through a speech delivered by His Excellency Carlos Pinto Pereira, Minister of Foreign Affairs, International Cooperation and Communities, Republic of Guinea Bissau. President Embaló further highlighted the opportunity for a comprehensive approach involving all sectors to build robust and sustainable health systems while addressing malaria challenges to champion malaria elimination by 2030.

Acknowledging the enduring investments and heroic efforts by countries, partners, and community health workers across Africa, the report emphasizes the continent’s continued burden, with 94% of all malaria cases and 95% of all malaria deaths recorded. Children under the age of five remain the most vulnerable demographic, comprising approximately 78% of all malaria deaths in the region.

Commissioner for Health, Humanitarian Affairs, and Social Development at the African Union Commission, Her Excellency Amb. Minata Samate Cessouma stressed the impact of resistance threats on existing tools against malaria and advocated for the integration of new, more effective tools. She highlighted the potential for local manufacturing and market-shaping efforts to mitigate costs and enhance accessibility, thus maximizing impact.

The 2023 African Union Malaria Progress Report highlights advancements in malaria control and health sectors through the strategic utilization of health scorecard tools. Real-time data-driven programming has facilitated significant actions, including resource mobilization, training, procurement strategies, and enhanced community engagement across more than 40 African countries. These data-driven tools enable countries to identify bottlenecks promptly and drive effective action.

The report advocates for the accelerated rollout of national ‘Zero Malaria Starts with Me’ campaigns, with 29 countries already engaged. Establishing multisectoral End Malaria and NTD Councils and Funds at the country level is deemed critical for advocacy, action, resource mobilization, and accountability. These councils have mobilized over US$50 million across Africa in seven countries to date, with 15 more countries aiming to establish their councils and funds in 2024.

Lastly, the recent World Health Organization certification of the Republic of Cabo Verde as a malaria-free nation serves as a testament to the attainable outcomes with steadfast commitment and collective action in Africa. This milestone positions Cabo Verde alongside 43 other countries and territories that have attained successful malaria elimination, showcasing the transformative potential of concerted efforts encapsulated in ‘Zero Malaria Starts with Me’

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