Roselyne Sachiti Features Editor
Today, Zimbabwe joins the rest of the world in commemorating World Malaria Day 2019.
The day comes at a time Zimbabwe, Mozambique and Malawi are coming out of a devastating natural disaster Cyclone Idai which killed and displaced thousands of people.
Cyclone Idai also left behind multiple ponds of stagnant water, which provide a perfect breeding space for malaria parasites.
Natural disasters in the form of tropical cyclones (e.g. hurricanes and typhoons), floods, tsunamis, earthquakes and tornadoes have been secondarily linked to several infectious diseases that include malaria.
This emanates from the fact that natural disasters cause substantial displacement of people and worsens change in the environment, in human conditions and in the vulnerability to existing pathogens for disease transmission.
In Zimbabwe, according to the Ministry of Health and Child Care, National Malaria Control Programme (NMCP), predominant malaria parasite is plasmodium falciparum which accounts for 98 percent of all reported malaria cases.
Plasmodium ovale, P. vivax and P. malariae account for the remainder (2 percent).
The primary vector is anopheles arabiensis and it is widely distributed in the eight rural provinces. Anopheles funestus, resistant to two groups of insecticides — pyrethroid and carbamates, was detected in 2013 in Mutasa and Mutare districts in Manicaland Province.
This efficient vector has also been detected in Karoi District in Mashonaland West.
In Zimbabwe, malaria incidence declined by 84,5 percent from 136/1000 population in 2000 to 21/1000 population in 2016. This has seen the country implementing malaria elimination activities in 20 out of the 47 malaria transmission districts.
The country also received a lot of rain during the 2016/2017 malaria season which increased the mosquito breeding places, resulting in the increased mosquito population density.
This led to an increase in malaria outbreaks experienced in the provinces. Floods also displaced some populations which increased their vulnerability to malaria. By mid-third quarter of 2017, the number of cases had surpassed the cases recorded in 2015 and 2016 for the same period. This is worrying, especially given that cases of malaria have gone up by about 25 percent this year compared to the same period last year.
In 2018, there were 94,533 cumulative malaria cases and 85 deaths. The cumulative malaria cases rose in 2019 with 117 714 and 105 deaths. Manicaland Province contributed 42,2 percent of malaria cases to the national burden, followed by Mashonaland Central at 27,4 percent, Mashonaland East and Masvingo.
There are concerns that Cyclone Idai that ravaged parts of Manicaland Province might cause an upsurge of cases in the affected districts, mainly in Chipinge and Chimanimani.
With malaria lurking, Government has not folded its hands, it has been working over the years to eliminate malaria.
The NMCP, set up in 2001, is the management arm of the Ministry of Health and Child Care (MoHCC) that coordinates malaria control interventions in the country. The NMCP key interventions are vector control and case management underpinned by social and behavioural change communication (SBCC), surveillance, monitoring, evaluation and operational research (SMEO) (including pre-elimination focused interventions), Epidemic Preparedness and Response (EPR), partnerships coordination and integrations and programme management.
In Zimbabwe, legislation, policies and guidelines have also played a pivotal role in the control and management of malaria.
For example, the national Malaria Prevention and Control Policy (2010), National Malaria Strategic Plan (2016-2020), Malaria Communication Strategy (2016-2020) and the Insecticide Resistance Monitoring and Management Plan for Malaria Vectors in Zimbabwe (2016-2020). Malaria remains a global challenge. On World Malaria Day 2019, the RBM Partnership to End Malaria has also mobilised leaders and citizens to work together towards a malaria-free world. The RBM Partnership is the global platform for coordinated action against malaria. It mobilises for action and resources and forges consensus among partners. The partnership is comprised of more than 500 partners committed to end malaria, including malaria endemic countries, their bilateral and multilateral development partners, the private sector, non-governmental and community-based organizations, foundations, and research and academic institutions.
Culminating in events in Paris today, this year’s World Malaria Day seeks to encourage as many people as possible across the globe to make a personal commitment to ending malaria, in line with this year’s global World Malaria Day theme: “Zero Malaria Starts with Me” or “Zéro Palu! Je m’engage”.
To mark the day, a series of events to engage decision-makers, the private sector, scientists and civil society across the city of Paris were announced, including a malaria-themed art installation in the centre of Paris and a football tournament, “Palufoot”, with famous sports personalities. A conference on the progress and the main challenges in the fight against malaria will also be held at the Hôtel de Ville.
Further events across the globe are also being organised, including in Bangkok during the Asia-Pacific Malaria Week and also in London, marking a year since Commonwealth leaders made a commitment to halve malaria by 2023.
Several events will also be taking place across Africa, with further countries expected to launch national Zero Malaria Starts with Me campaigns, including Tanzania and the Republic of Congo. Furthermore, Senegal, which pioneered a nationwide Zero Malaria campaign in 2014, will also be launching a joint bed nets distribution campaign with The Gambia. The World Health Organisation’s World Malaria Report 2018 revealed that over half the world’s population is at risk from malaria, with almost half a million deaths in 2017. With progress around the world uneven, World Malaria Day is the highlight of a global commitment to control the epidemic.
RBM Partnership Board Chair Dr Winnie Mpanju-Shumbusho said: “World Malaria Day provides a crucial platform for citizens to call for united action against malaria and renewed political commitment. With a child dying every two minutes from malaria, greater progress and funding is critical.
“Join us on April 25 to step up the fight and demand that malaria is defeated once and for all. Paraguay and Uzbekistan’s malaria-free certification last year and several countries, including China, reaching zero malaria cases can serve as a shining example to others of the progress that we can all make when we work together.”
This year’s World Malaria Day seeks to recognise the importance of Francophone contributions, as well as urging more global action in the fight against malaria.
With more than 300 million people at risk in Francophone countries, the support and contributions of French-speaking nations is integral for progress, although all nations, both those directly affected by malaria and those that contribute towards malaria funding, are being asked to step up the fight.
Later this year, France will also host the Global Fund’s Sixth Replenishment Conference in Lyon on October 10. This meeting will set out to secure commitments of at least US$14 billion in funding. A fully funded Global Fund is critical for progress — saving an additional 16 million lives and preventing 234 million infections of AIDS, tuberculosis and malaria by 2030. Responsible for 60 percent of global malaria funding, it is essential that the Global Fund’s target is met.
World Malaria Day 2019 also comes at a time news of the phased introduction of the RTS,S malaria vaccine in Malawi followed by Ghana and Kenya in the coming weeks broke.
Used alongside bed nets, insecticide spraying, diagnostics, and drugs, the vaccine has the potential to strengthen malaria control efforts in Africa and save tens of thousands of young children.
In a statement, chief executive officer, RBM Partnership to End Malaria Dr Abdourahmane Diallo said: “Global investments in innovation and new tools and strategies to fight malaria have led to tremendous progress and saved millions of lives. The RTS,S vaccine is an important new tool that can help save tens of thousands of children from malaria, and a powerful example of the role country leadership and multi-sectoral partnerships play in accelerating malaria elimination.
Defeating malaria requires that everyone — Government leaders, community health workers, mothers and fathers — takes personal responsibility to achieve zero malaria.
The RBM Partnership commends the governments of Malawi, Ghana, and Kenya for taking ownership of the malaria challenge and committing to protect their communities and countries from this preventable and treatable disease.”
RTS,S is the first and, to date, the only vaccine to show partial protection against malaria in young children. Malaria is disproportionately deadly for young children. While not a perfect vaccine, rigorous clinical testing has shown its potential to boost malaria prevention and save lives. The vaccine will be deployed in selected areas of moderate-to-high malaria transmission through routine immunisation services. This pilot programme will provide crucial information and lessons for the vaccine’s future deployment.
Since 2000, global efforts to expand access, scale up and distribute life-saving bed nets, diagnostic testing, and effective antimalarial treatments has saved seven million lives and prevented more than one billion cases of malaria. Despite this historic progress, malaria remains a significant public health concern threatening half the world’s population.
Greater than 60 percent of the 435 000 people who died of malaria in 2017 globally were children under the age of five.
Therefore, even a partially effective malaria vaccine for young children, when combined with other proven malaria prevention measures, could save thousands of lives and further drive down the malaria burden in the most vulnerable population — children under the age of five. The malaria vaccine implementation programme is a country-led, WHO-coordinated initiative. It is a collaborative effort between Ministries of Health in Malawi, Ghana and Kenya and a range of in-country and international partners, including PATH, a non-profit organisation, and GSK, the vaccine manufacturer.
Financing for the vaccine pilot programme has been mobilised by a multi-sectoral partnership among three key health-funding bodies: Gavi, the Vaccine Alliance, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and Unitaid, with support from the World Health Organisation.