COVID-19 Must Not Roll Back Progress on Malaria

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A Q&A with Nothing But Nets’ Margaret Reilly McDonnell

What is the value of engaging with outside experts? External experts can provide a channel for knowledge sharing, offer deeper insights, hone expertise, and strengthen community and society goals. We believe private-public partnerships are incredibly important in the fight against malaria.

Nothing But Nets is a global grassroots campaign to raise awareness, funds, and voices to fight malaria. In our first Q&A, Margaret McDonnell, Executive Director of Nothing But Nets, addresses the growing concern COVID-19 may have on malaria progress, why we must continue to step up the fight against both and what can be done to safeguard the gains thus far made to eradicate the disease.

Disclaimer: The viewpoints expressed by the author do not necessarily reflect the opinions, viewpoints and official policies of Vestergaard PermaNet®.

 

Why is it important that we fight both malaria and COVID-19?

It’s absolutely critical that we simultaneously fight malaria alongside COVID-19 or we risk losing ground on the twenty years of progress we’ve made against malaria. Recent modeling by WHO suggested that severe disruptions to malaria programs- specifically long-lasting insecticide-treated net campaigns and access to antimalaria medicines- due to COVID-19 could lead to a DOUBLING of deaths from malaria in 2020 to nearly 800,000 deaths. All of us – from country and community leaders to donors to private sector partners to implementers- must act NOW to adapt and execute programs as to ensure lives are not lost.

More information, including links to WHO’s detailed guidance for how malaria-endemic countries should tailor malaria interventions and case management in light of the COVID-19 response can be found here.

 

How are countries adapting their net (LLIN) distribution?

WHO has urged countries to NOT scale back their core malaria prevention, diagnostic, and treatment activities but to proceed with some adapted and new approaches in light of COVID-19 as to protect health workers and community members. Similarly, as reflected in the guidelines co-created by the Alliance for Malaria Prevention and the RBM Partnership to End Malaria, “while flexible and innovative approaches will be required to distribute ITNs (nets) in the context of the COVID19 pandemic, it is important that national malaria programmes and partners do not suspend the planning or implementation of vector control activities, including ITN campaigns.” The guidelines encourage programs to adhere to recommendations in place prior to COVID-19 relating to best practices for logistics and supply chain management and accountability for ITNs.

That said, in light of COVID-19, net distributions are being adapted in several ways to adhere by COVID-19 safety protocols including to avoid large gatherings of people by distributing door-to-door rather than at central distribution points, such as was done in Benin. While such mitigation measures will likely be more expensive than traditional approaches, the cost of significantly delaying malaria interventions all together would be catastrophic.

Nothing But Nets, Margaret McDonnell in Tanzania in 2017.
What are you hearing from the field?

The Global Fund to Fight AIDS, TB, and Malaria (Global Fund) recently completed a survey, which showed that the COVID-19 pandemic has led to widespread disruption in service delivery impacting approximately three-quarters of HIV, TB, and malaria programs. The results of this qualitative survey indicate challenges to testing and case finding for malaria; canceled or delayed prevention activities; and reassignment of medical and laboratory staff to the fight COVID-19 resulted in a 73% disruption to malaria service delivery (19% with high or very high disruptions). These interruptions are largely due to lockdowns, restrictions on gatherings of people, and transport slowdowns.

While this news is troubling, we also know programs are continuing to adapt so that many scheduled net distributions are moving forward. The status of a variety of malaria interventions can be found in the RBM Partnership to End Malaria Country Tracker to Mitigate the Effect of COVID-19 on Malaria.

 

What role do partners/funders like the Global Fund and PMI play in the fight against COVID-19 and malaria?

Partners such as the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) have stepped up in significant ways to assist countries’ efforts. They’re offered immediate funding of up to US$1 billion to help countries fight COVID-19, mitigate the impacts on lifesaving HIV, TB and malaria programs, and prevent fragile health systems from being overwhelmed. Under the WHO’s leadership, the Global Fund is using its experience working with partners and governments in more than 100 countries to coordinate the response on a massive global scale. The Global Fund’s response to the pandemic makes available up to US$1 billion through two main mechanisms: 1) US$500M available vis-à-vis grant flexibilities, which allow countries to use up to 5% of existing GF grants and 2) US$500M available via the COVID-19 Response Mechanism, which allows countries to access funding to reinforce the response to COVID-19, mitigate its impact on HIV, TB and malaria programs and make urgent improvements in health and community systems.

Similarly, the U.S. President’s Malaria Initiative (PMI) is on the frontlines of the COVID-19 response and plays a critical role. PMI’s close partnerships with countries to prevent and control malaria through core interventions such as nets, indoor residual spraying and anti-malarial medicines, help reduce the overall strain on health systems. PMI’s efforts to strengthen health systems to combat malaria helps build countries’ capacity to respond to other health threats and emergencies, such as COVID-19. As stated by Dr. Ken Staley, the U.S. Global Malaria Coordinator, in his World Malaria Day statement,  PMI created technical guidance for partner countries and programs to innovate and evolve their approaches to continue delivering proven malaria interventions during the COVID-19 pandemic; they spearheaded the development of global guidelines; and are working with the Global Fund, the RBM Partnership to End Malaria, and others to ensure robust and coordinated assistance for countries.

Further, in response to the supply chain impact of COVID-19, PMI and Global Fund are working closely together to identify impacted products and orders, prioritize country needs, and work with suppliers to ensure countries continue to receive life-saving malaria products. Recognizing that many systems used to deliver malaria prevention and treatment are the same systems needed to control COVID-19, PMI and the Global Fund are leveraging malaria platforms to bring additional support to countries that will protect health workers, patients, and communities from the risks of COVID-19.

 

A truck delivers mosquito nets to the schools of Chato district. Photo courtesy of PMI.
What is Nothing But Nets doing to ensure that nets are being distributed?

The United Nations Foundation’s Nothing But Nets campaign is proud to be long-time supporters and partners of the agencies providing technical, adaptation and implementation guidance for malaria programs, including net distributions, in light of COVID-19 such as WHO’s GMP, the Global Fund, PMI, AMP, and the RBM Partnership to End Malaria. We’re stepping up our direct and constituent-led advocacy work in the U.S. to help secure robust and increased funding levels for the Global Fund and the U.S. President’s Malaria Initiative in the US Government’s COVID-19 relief supplemental bills as well as the Fiscal Year 2021 appropriations process as to ensure that malaria programs such as net distributions can adapt, continue, save lives and strengthen health systems overall.

We engage with private sector partners like Vestergaard who have a long-time commitment to bringing innovative tools to the malaria fight. We work to facilitate and encourage private sector partners to join or stay in the fight and to offer their areas of expertise as to strengthen programs. We continue to work with our WHO and UN partners (such as UNHCR, UNICEF, and PAHO) and others to support programs that protect the most vulnerable populations- including refugees and internally displaced persons, such as an upcoming project that we’re working on with the Mentor Initiative and SC Johnson to provide disinfectant kits to health facilities in Borno State, Nigeria to ensure they can continue essential health services such as malaria case management in light of COVID-19.

 

What can private companies and individuals do to sustain momentum and effort?

Private sector partners have a critical role to play in ensuring that we can continue to make progress against malaria and don’t get further off track due to COVID-19 by committing to developing and producing innovative products, by sharing their knowledge and expertise regarding supply chain and logistical management, and by sharing their company’s commitment with their policymakers and key decision-makers so that they’re aware of the private sector role and business case of investing in the fight to end malaria.

As individuals, you can take action to raise awareness, donate, and advocate to your policymakers so that they know this is an important issue to you. For more information on how you can take action, check out RBM Partnership to End Malaria, Zero Malaria Starts with Me, and Nothing But Nets.

 

 

Margaret McDonnell
Executive Director, Nothing But Nets

 

Banner image courtesy of Nothing but Nets.