Malaria claims the life of an African child every two minutes. Sub-Saharan Africa accounts for 95% of global malaria cases and 96% of malaria-related deaths, with six of the 16 Southern African Development Community (SADC) countries – Angola, Democratic Republic of the Congo, Madagascar, Malawi, Mozambique, and the United Republic of Tanzania – contributing significantly (~26.2%) to the region’s malaria burden. These statistics are alarming; but underscore a profoundly urgent call to action.
“Time to deliver zero malaria: Invest, innovate, implement” was the theme for World Malaria Day on 25 April. Now on 6 November, as we observe SADC Malaria Day, the theme continues to guide our efforts in creating awareness, mobilising communities, showcasing progress, and encapsulating the path towards a malaria-free SADC region and world.
There were remarkable achievements and progress in the fight against this relentless disease between 2000 and 2015, but also persistent challenges. The good news is that malaria is preventable through awareness and education to prevent people being bitten by malaria-carrying female Anopheles mosquitoes. It is also treatable if diagnosed early.
The bad news is there are new challenges. These include Plasmodium parasite resistance to the artemisinin in artemisinin combination therapy antimalarial drugs; resistance of the Anopheles mosquito vectors to insecticides used for vector control; and the ability of the most deadly and prevalent malaria parasite, Plasmodium falciparum, to evade the commonly used point-of-care diagnostic tool in rural endemic areas. There is also a change in mosquito-biting behaviour from indoors to outdoors in certain species; and the impact of climate change on the spread of malaria into previously malaria-free areas, or increase of transmission rates in existing malaria areas as temperatures rise.
Collaboration and research support
The extreme interconnectedness in the SADC region, with shared populations, economies, ecologies, and patterns of disease, presents challenges of its own, but also collaboration opportunities. Cross-border efforts provide a critical advantage, addressing the movement of people and disease across borders, enabling coordinated efforts to control malaria in border regions, preventing the spread of the disease, and ensuring consistent and effective interventions. This is essential for achieving regional and global malaria elimination goals. All 16 SADC member countries signed the Windhoek Declaration in 2018 pledging their commitment towards eliminating malaria in the region. They agreed on the importance of regional collaboration, data sharing, increased funding, research support, and leadership training for data-driven decision-making in a dynamic environment.
The University of Pretoria Institute for Sustainable Malaria Control (UP ISMC) coordinates and promotes transdisciplinary research across different departments in the University. The Institute creates a platform for diverse experts to bring their unique skills and knowledge to the table and join forces to address malaria holistically. Their collective efforts mirror the SADC countries’ regional collaboration, aiming to bridge gaps and maximise impact, ultimately advancing the fight against malaria. Since its inception in 2011, the Institute has contributed important research to the development of tools, strategies and technologies to help us get ahead of the ever-evolving malaria parasite and the mosquitoes that transmit it.
Invest: Mobilising resources
Investing in malaria control is the foundation of all disease elimination efforts. It requires significant financial commitment to secure the necessary resources for control programmes to procure essential antimalarial drugs, distribute or apply vector control tools, and strengthen healthcare systems. In addition, investing in research and development is crucial as it supports control programmes. Beyond finances, investment reflects the dedication of governments, organisations, the private sector, and individuals to save lives. It also includes capacity-building, educating the next generation of researchers, healthcare professionals, and leaders in malaria-focused programmes and institutions.
Innovate: Cutting-edge research
Innovation is the driving force behind progress in the fight against malaria. Researchers continuously seek new ways to block malaria's evolving challenges. Research that fosters innovation must be encouraged, whether it's developing more effective antimalarial drugs, advanced diagnostic tools, or innovative mosquito control methods and new insecticides. It also extends to data management and surveillance, where digital technologies like data analytics and artificial intelligence can provide real-time insights into malaria transmission, predicting outbreaks, optimising resource allocation, and targeting interventions where they are needed most. We need discoveries, whether simple or ground-breaking, to adapt to the ever-changing landscape of malaria and to achieve elimination.
Implement: Research with impact
Investment and innovation must lead to effective implementation. Effective malaria control relies on strategies that turn research and innovations into real-world solutions. Implementation, from field trials to education campaigns, and learning from both success and failure, bridges the gap between scientific knowledge and tangible impact. Robust healthcare systems are essential for ensuring universal access to these life-saving measures. Community engagement and awareness campaigns are vital to encourage participation in malaria control efforts. Community-driven programmes drive behavioural change and instil ownership, empowering individuals to protect themselves and their families. Community support is crucial; without it, interventions are likely to fail.
The UP ISMC researchers invest their expertise to identify innovative approaches with actual impact. Some research includes the discovery of compounds for new antimalarial drugs, e.g. the indigenous succulent Aloe malothii, which can disrupt the parasite’s lifecycle, and the discovery of powerful chemical compounds that could be developed into multistage and transmission-blocking drugs; conducting mosquito vector surveillance to better understand changes in mosquito behaviour; innovative methods such as bio-art for public awareness and education; and the development of new nets to use against insecticide-resistant mosquitoes. In the flagship Remote Sensing for Malaria Control in Africa (ReSMaCA) programme, researchers use satellite technologies to investigate the driving factors of malaria within hotspot areas, and the potential impacts of climate variability on the disease. The programme is assisting in the development of a climate-modelling system that will provide access to tools such as risk maps and forecasting models to monitor and predict epidemics. Researchers train citizen-scientists who play a role in the research, thereby benefitting it and the community. The Institute also builds leadership and management capacity in malaria control programmes, to enable managers to make effective data-driven, informed decisions.
A malaria-free SADC region is attainable with unwavering dedication and cooperation. Malaria respects no borders, emphasising the need for a united approach among SADC countries and support from the research community. Achieving this goal requires investment in malaria control, effective strategies, and strengthened cross-border collaboration. Through concerted efforts, education, and innovative solutions, we can end this preventable and treatable disease, and ultimately save lives.
Professor Tiaan de Jager is Director of the University of Pretoria Institute for Sustainable Malaria Control (UP ISMC). Dr Taneshka Kruger is a researcher at the University of Pretoria and UP ISMC project manager.
Disclaimer: The opinions expressed in this article are solely those of the author and do not necessarily reflect the views of the University of Pretoria.