25 April 2020
Since December 2019, the infectious disease COVID-19 has spread across the world. Africa has not been spared, but the delayed arrival of the virus on the continent has provided us with an opportunity to prepare ourselves, though our socio-economic conditions limit our ability to apply the most effective means of prevention; physical distancing.
Physical distancing is not only effective for stopping the spread of COVID-19, but also of other infectious diseases, like malaria. While the former requires that we keep away from people, the latter requires us to remain distant from the mosquito. But for that to happen, we need access to decent living conditions where stagnant water is not a permanent feature, where there is widespread access to clean water and sanitation and the ability to sleep under a net. In the meantime, until that can happen, there are 228 million preventable cases affecting predominantly women and children.
Unlike COVID-19, in which the first African wave has been mild, Africa is home to 93 per cent of malaria cases and 94 per cent of malaria deaths. In their physical proximity with us, mosquitoes infect us and make malaria a huge risk for children under 5 and pregnant women. Malaria is so pervasive that it is viewed as inevitable, yet not lethal when identified and treated early. The speed at which countries react to malaria may suggest that we may have lost our sense of urgency in fighting it. It’s like we’ve come to accept death from a preventable and curable disease as an integral part of life in Africa. But that’s not right. We must stop it from occurring in our communities with the same eagerness demonstrated to beat COVID-19. Indeed, the COVID-19 experience must re-ignite the fact that to reach zero Malaria cases in Africa, it starts with each one of us.
Our environment as well as our health infrastructure need to be made resilient against all forms of health threats. COVID-19 did not only expose weaker health systems, it revealed the narrow focus on health financing in Africa. The ventilators were, portably, never a big issue because most of the usual suspects diseases on the continent did not require it for treatment. But it is now clearer. And COVID-19 put a spotlight on vertical disease funding when faced with acute endogenous or exogenous shock which were under or not funded.
Ebola in West Africa and currently in DRC prompted our communities to enact measures required to preserve life. But the mechanism not to contract Ebola or COVID-19 is clear though challenging in many communities requiring physical proximity for both social and economic sustenance. With malaria, even with physical distancing, hand washing, face masks, all it needs is the bite of an infected female Anopheles mosquito. That bite still translates into one too many deaths in Africa. It remains unbeaten even in times COVID-19. The mosquito prefers physical proximity. It finds you in your home even under lockdown. It will spare you if you sleep under a mosquito net or seek effective timely treatment in case of a fever. It is reassuring that Benin, Chad, the Democratic Republic of the Congo, Niger, and Sierra Leone continue their planned malaria programmes, including mass distribution of ITNs, while taking precautionary measures against COVID-19.
We must come together at a time when lots of resources are allocated to COVID-19, lesser tax collections are expected but national responses to maintain adequate levels of services for malaria and other diseases are capital for the effective economic recovery.
If I were Malaria, I would feel jealous of Africa’s response to COVID-19 and eliminate myself from this continent. I have been factored in by businesses, people self-diagnose for any symptom that they may have, leaders call my name once a year and make promises. Though I thought my statistics were good in terms of death rate, a possible source of concern for business leaders, governments, civil society and citizen, I was mistaken. They may have accepted that death by malaria is part of the experience of living in Africa. That makes me wonder what kind of response they could have given Corona if they had eliminated me and used the billions of dollars invested to strengthen health systems and not just to fight me.
But I will not go away without putting up a fight. Malaria elimination is connected to socio-economic development. As they battle COVID-19, I watch in awe over the promises that have been made and the resources committed to beat it. But just like me, it may just be here to stay unless there is a fundamental change in the way they value the most vulnerable in their slums and rural communities. We need better sanitation (better sewage), access to water for hand washing and better hygiene. These investments must focus on vulnerable communities and will represent investment in communities thus jobs. Decent jobs are a pathway to self-actualization and self-protection from diseases of physical distancing or physical proximity. Of course, I am not malaria, and instead, as a development practitioner, I am hopeful that malaria will be eliminated in Africa. The COVID-19’s response shows that focusing on vulnerable communities and Micro Small Medium Enterprises can pave the way for policymakers to redesign our economies so that endogenous and exogenous shocks face resilient communities. Zero COVID-19 starts with me and on World Malaria Day we must remember that Zero Malaria also starts with me and all of us and that we must act now to save lives.
By Carl Manlan, COO, Ecobank Foundation