Malaria-endemic countries in all WHO have regions have reported cases of COVID-19. In the WHO African Region, which carries more than 90% of the global malaria burden, 45 countries had reported approximately 25 000 cases of the disease as of 30 April 2020. The latest situation reports on the COVID-19 pandemic are available on the WHO website.
As of March 2020, there have been reports of the suspension of insecticide-treated net (ITN) and indoor residual spraying (IRS) campaigns in several African countries due to concerns around exposure to COVID-19. Suspending such campaigns will leave many vulnerable populations at greater risk of malaria, particularly young children and pregnant women.
WHO strongly encourages countries not to suspend the planning for - or implementation of vector control activities, including ITN and IRS campaigns, while ensuring these services are delivered using best practices to protect health workers and communities from COVID-19 infection. Modifications of planned distribution strategies may be needed to minimize exposure to the coronavirus.
WHO commends the leaders of Benin, Chad, the Central African Republic, the Democratic Republic of the Congo, Mali, Niger, Sierra Leone and Uganda for committing to move forward with ITN campaigns during the pandemic. Other countries are adapting their net distribution strategies to ensure households receive the nets as quickly and safely as possible.
Together with partners, WHO has developed guidance to ensure that those suffering from malaria can safely receive the care they need in COVID-19 settings. Tailoring malaria interventions in the COVID-19 response includes guidance on the prevention of infection through vector control and chemoprevention, testing, treatment of cases, clinical services, supply chain and laboratory activities. The document is consistent with broader WHO guidance on how to maintain essential health services during the pandemic.
WHO guidance remains the same. Countries should not scale back efforts to detect and treat malaria; doing so would seriously undermine the health and well-being of millions of people infected with a potentially life-threatening disease.
As signs and symptoms of malaria and COVID-19 can overlap (such as a fever), public health messages will need to be adapted in malaria-endemic settings so that people who have a fever are encouraged to seek immediate treatment rather than stay at home; without prompt treatment, a mild case of malaria can rapidly progress to severe illness and death.
All of the considerations described above apply to malaria-eliminating countries and those preventing re-establishment of the disease: efforts must be sustained to prevent, detect and treat malaria cases while preventing the spread of COVID-19 and ensuring the safety of those who deliver the services. Countries that are nearing malaria elimination must protect their important gains and avoid malaria resurgences. Countries that have eliminated malaria must remain vigilant for any imported cases of malaria that may be occurring to prevent reintroduction of the disease.
Experience from previous disease outbreaks has shown the disruptive effect on health service delivery and the consequences for diseases such as malaria. The 2014-2016 Ebola outbreak in Guinea, Liberia and Sierra Leone, for example, undermined malaria control efforts and led to a massive increase in malaria-related illness and death in the 3 countries.
A new modelling analysis from WHO and partners, published on 23 April, found that the number of malaria deaths in sub-Saharan Africa could double this year alone if there are severe disruptions in access to insecticide-treated nets and antimalarial medicines due to COVID-19. These projections reinforce the critical importance of sustaining efforts to prevent, detect and treat malaria during the pandemic.
In all regions, protective measures should be utilized to minimize the risk of COVID-19 transmission between patients, communities and health providers. WHO and partners have developed guidance on how to safely maintain malaria prevention and treatment services in COVID-19 settings.
Yes. In recent weeks, there have been reports of disruptions in the supply chains of essential malaria commodities - such as long-lasting insecticidal nets, rapid diagnostic tests and antimalarial medicines - resulting from lockdowns and from a suspension of the importation and exportation of goods in response to COVID-19. WHO and partners are working together to ensure the availability of key malaria control tools, particularly in countries with a high burden of the disease, and that efforts to limit the spread of COVID-19 do not compromise access to malaria prevention, diagnosis and treatment services.
WHO is actively following the ongoing clinical trials that are being conducted in response to COVID-19, including studies looking at the use of chloroquine and its derivative, hydroxychloroquine, for treatment and/or prevention. Currently, there is insufficient data to assess the efficacy of either of these medicines in treating patients with COVID-19, or in preventing them from contracting the coronavirus.
Chloroquine is currently recommended by WHO for the treatment of P. vivax malaria. In the context of the COVID-19 response, the dosage and treatment schedules for chloroquine and hydroxychloroquine that are currently under consideration do not reflect those used for treating patients with malaria. The ingestion of high doses of these medicines may be associated with adverse or seriously adverse health outcomes.
For public health emergencies, WHO has a systematic and transparent process for research and development (R&D), including for clinical trials of drugs. The WHO - R&D Blueprint for COVID-19, initiated on 7 January 2020, aims to fast-track the availability of effective tests, vaccines and medicines that can be used to save lives and avert large-scale crises. WHO has also designed a set of procedures to assess the performance, quality and safety of medical technologies during emergency situations.
The WHO Global Malaria Programme is leading a cross-partner effort to mitigate the negative impact of the coronavirus in malaria-affected countries and, where possible, contribute towards a successful COVID-19 response. The work is being carried out in close collaboration with colleagues based at WHO headquarters, regional offices and country level.
In March 2020, before the pandemic had secured a strong footing in Africa, WHO sounded an urgent call for maintaining core malaria prevention and treatment services while protecting health workers and communities against COVID-19 transmission. The findings of a modelling analysis from WHO and partners, published in April, reinforced the WHO call for continuity of malaria services during then pandemic.
In collaboration with partners, WHO developed technical guidance for countries on how to safely maintain malaria prevention and treatment in COVID-19 settings. Tailoring malaria interventions in the COVID-19 response is consistent with broader WHO guidance on how to maintain essential health services during the pandemic.