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Climate Change Unveiled A New Threat to Malaria Control

An Anopheles stephensi mosquito is obtaining a blood meal from a human host through its pointed proboscis. Note the droplet of blood being expelled from the abdomen after having engorged itself on its host’s blood. This mosquito is a known malarial vector with a distribution that ranges from Egypt all the way to China. Source: CDC
Malaria Resurgence: A Global Health Dilemma

Malaria, a mosquito-borne disease that has plagued humanity for centuries, continues to pose a significant threat to global health. Recent data presented in the World Health Organization’s (WHO) annual malaria report reveals a concerning trend—despite substantial efforts to expand preventive measures, the number of malaria cases is on the rise. In 2022, an estimated 249 million people were affected by malaria globally, surpassing the pre-pandemic level of 233 million in 2019. This surge in cases highlights the complex challenges faced by malaria control programs worldwide, exacerbated by factors such as the ongoing COVID-19 pandemic, drug and insecticide resistance, humanitarian crises, and, notably, the impacts of climate change.

RELATED ARTICLE :WHO’s annual malaria report spotlights the growing threat of climate change

The 2023 World malaria report draws attention to the intersection between climate change and malaria. Changes in temperature, humidity, and rainfall can significantly influence the behavior and survival of the Anopheles mosquito, the carrier of the malaria parasite. Moreover, extreme weather events, including heatwaves and flooding, can directly impact the transmission and disease burden of malaria. For instance, catastrophic flooding in Pakistan in 2022 led to a five-fold increase in malaria cases, demonstrating the immediate consequences of climate-related events on disease prevalence.

Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, emphasizes the substantial risk posed by the changing climate to malaria control efforts, particularly in vulnerable regions. The need for sustainable and resilient responses to malaria has never been more critical. Urgent actions to mitigate the effects of global warming are essential to safeguard progress against this infectious disease. Climate variability is expected to exert indirect effects on malaria trends, leading to reduced access to essential services and disruptions in the supply chain of preventive tools such as insecticide-treated nets, medicines, and vaccines. Furthermore, population displacement due to climate-induced factors result in increased malaria cases as individuals migrate to areas where they lack immunity.

While data on the long-term impact of climate change on malaria transmission remains limited, the varied effects across social and ecological systems underscore the complexity of the challenge. Regions and communities will experience differing magnitudes and directions of impact, necessitating tailored interventions and adaptive strategies.

The global malaria burden and response have been further complicated by the COVID-19 pandemic. The disruption caused by the pandemic led to a surge in both malaria incidence and mortality rates. In 2022, there were an additional five million malaria cases globally compared to the previous year. Notably, five countries, including Pakistan, Ethiopia, Nigeria, Papua New Guinea, and Uganda, experienced significant increases in malaria cases.

However, amidst the challenges, there are grounds for optimism. The phased roll-out of the first WHO-recommended malaria vaccine, RTS,S/AS01, in three African countries is a significant achievement. Rigorous evaluations have demonstrated a substantial reduction in severe malaria and a 13% drop in early childhood deaths in areas where the vaccine was administered. This success builds upon existing interventions, such as insecticide-treated nets and indoor spraying with insecticides, illustrating the potential of comprehensive approaches to disease prevention.

In October 2023, WHO recommended a second safe and effective malaria vaccine, R21/Matrix-M. The availability of two malaria vaccines is expected to enhance the supply and enable broad-scale deployment across Africa, marking a pivotal step in malaria control efforts.

Progress has also been made toward malaria elimination in countries with a low disease burden. In 2022, 34 countries reported fewer than 1000 cases, a significant increase from just 13 countries in 2000. Moreover, WHO certified three more countries – Azerbaijan, Belize, and Tajikistan – as malaria-free in 2022, with several others on track to achieve the same status in the coming year.

To address the current challenges and pave the way for a malaria-free future, a substantial pivot in the fight against malaria is imperative. This requires increased resources, strengthened political commitment, data-driven strategies, and innovative tools. Innovation should focus on developing more efficient, effective, and affordable products to enhance malaria prevention and treatment.

The added threat of climate change underscores the need for sustainable and resilient malaria responses. Integrating efforts to reduce the impacts of climate change becomes paramount in the fight against malaria. A whole-of-society engagement is crucial to build integrated approaches that consider the multifaceted nature of the challenges faced by malaria control programs worldwide.

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In conclusion, the WHO’s annual malaria report highlights the intricate interplay between malaria, climate change, and other global health challenges. While the road ahead is challenging, concerted efforts, innovations, and a commitment to sustainable practices offer hope for overcoming these obstacles and ultimately achieving a malaria-free world.

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