The Fight Against Malaria is Stalling

[This article has been published in Spanish in Big Vang - La Vanguardia]

Photo: Alfons Rodríguez. http://trackingmalaria.isglobal.org

For the first time in 10 years, the scientific community is gravely concerned about an upswing in the number of cases of the disease reported in various parts of the world

While the last decade has seen unprecedented progress in the control of malaria worldwide, today, for the first time in 10 years, the scientific community is gravely concerned about an upswing in the number of cases of the disease reported in various parts of the world.  It is true that there has been only a marginal increase in the number of malaria cases between 2015 and 2016 (from 211 to 216 million); however, an increase of 5 million cases, albeit with no apparent change in the total number of deaths (445,000 in 2016), is a trend that must be viewed with great concern. The upswing is worrying not only because it represents a return to the number of cases reported in 2012, but also because it has occurred simultaneously in around 25 countries situated in a variety of different geographical locations. Another significant datum is the year-on-year increase in autochthonous cases in 11 of the 21 countries currently committed to the goal of completely eliminating malaria from their national territory by 2020. In the words of Dr Pedro Alonso, head of the World Health Organisation’s Malaria Control Programme, “the global fight against malaria is at a crossroads”.

There are many reasons why progress towards malaria elimination has stalled, but all of them are, to some degree, the result of a certain complacency engendered by the excellent results achieved in recent years by a global strategy that has, to some degree, been working on autopilot. Over the past two decades, sustained injection of international funds into interventions targeting malaria control and prevention has driven rapid and remarkable advances, despite the absence of new tools or even good global coverage of the strategies developed. The increase in funds, which currently amount to some €2 billion per year, has plateaued in the last two or three years, and funding now appears to be clearly insufficient in a global context in which experts estimate that current annual investment needs to be tripled until at least 2030 if we are to achieve the ambitious goal of malaria eradication. To make matters even worse, the task of controlling malaria has been further complicated by a series of biological challenges because the parasites that cause the disease and the mosquito vectors that transmit them have developed resistance to the most commonly used drugs and available insecticides. However,  the specific role of this resistance in the increased number of cases worldwide is still unknown.

Photo: Alfons Rodríguez. http://trackingmalaria.isglobal.org

We need new drugs and new insecticides; without them we may continue to see a rollback of recent advances

What is the best way, at this crossroads, to move forward with confidence? Research is paramount at this stage. Its objective must be to provide, in the short term, effective new tools to replace or complement those currently in use. We need new drugs and new insecticides; without them we may continue to see a rollback of recent advances. We must learn how to combine the tools we have optimally. We must be able to integrate into those strategies the much delayed vaccine we have been waiting for so long as well as new and better prevention measures. Finally, we need to improve our ability to implement these interventions equitably, to ensure that they reach the people who need them the most, who are often those most likely to be excluded from innovative initiatives.

However, all these efforts will be in vain if we fail to achieve the financial stability that can guarantee continuity on all fronts of this battle. The British government has just announced its intention to invest £500 million sterling per year for the next three years in the fight against malaria. The Bill & Melinda Gates Foundation, an organisation famed for its ability to shake up awareness about global health issues in our society, has promised to invest of $1 billion over the next five years. Good news, undoubtedly, but predictably insufficient unless these contributions have a catalysing effect on investment.

Photo: Alfons Rodríguez. http://trackingmalaria.isglobal.org

Every year on April 25—World Malaria Day—we have an obligation to remind everyone that malaria continues to represent a huge challenge for humanity

Every year on April 25—World Malaria Day—we have an obligation to remind everyone that malaria continues to represent a huge challenge for humanity, even though, it has fortunately been many years since we have had any cases of the disease within our own borders. For the 91 countries around the world where the malaria  parasite continues to be transmitted, it is a source of concern, disease and death requiring much more than an annual reminder on a particular day. In the globalised world we live in, last year's upswing in the number of malaria cases is a bad portent, a warning signal we cannot afford to ignore if we do not want to regret in the future that we were incapable, just when we were getting somewhere, of controlling this age-old plague. 

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To mark World Malaria Day this year, the photographer Alfons Rodríguez travelled to Mozambique to create a record of the life of Rosa, who works at the Manhiça Health Research Centre (CISM). His aim was to show us how Rosa is contributing to the elimination of malaria in the southern region of her country. You can view his photo reportage here.