1. Is there any strategy to scale up the high burden high impact approaches against malaria alongside COVID-19 shadow?

Answer:  When we look at the four key elements of High Burden High Impact approach, these elements are being applied during the COVID-19 pandemic. For example, political will is vitally important, to ensure that essential services such as malaria are maintained during the COVID-19 pandemic. We have advocated with Ministers of health to ensure that malaria continues to be prioritized, and the vast majority of the planned mosquito net campaigns, Seasonal Malaria Chemoprevention and IRS are on track to take place in 2020. Indeed, there is every possibility that 2020 will see the highest coverage ever of mosquito nets and SMC! Countries are also using sub national data to better target interventions for maximum impact, and are working to use data in the real time to track any impact of COVID-19 on malaria services in order to take immediate action. The HBHI element around better guidance has been used to modify existing guidance for malaria interventions so that they can be safely implemented during the pandemic. Finally, the RBM partnership to End Malaria has provided technical and implementation support to countries, with countries coordinating their partners to maximize impact, including ensuring that essential commodities are delivered on time.

  1. Should COVID change our ambition to eradicate malaria within a generation?

Answer: Our vision of a malaria-free world is still as relevant as before COVID. The latest pandemic of course represents a significant setback, since we know malaria tends to resurge in times of crisis. Nonetheless, we must keep our sights firmly set on the ultimate goal of ending malaria once and for all. By ending one of humanity’s oldest and deadliest diseases, we will not only save millions of lives—most of them children under 5–but also free up valuable resources to make health systems more resilient and better able to withstand future crises.

  1. Since Rotary is ideally suited to help with local community support and awareness of the treatability of malaria, do you think the public acceptance of the “inevitability” of acquiring malaria can be changed? What individual country’s efforts to change these attitudes might serve as a model for gaining public support for trying to stop malaria?

Answer: Complacency is one of our biggest enemies; because malaria has been around for so long, there is not a sense of urgency around it like with some other diseases—the latest COVID pandemic being a case in point. Through the Zero Malaria Starts with Me campaign, we are working with countries across Africa and beyond to change this very perception that ending malaria is someone else’s job—on the contrary, we can all play a role in preventing malaria. Experiences from countries such as Senegal where the Zero Malaria movement originated show that when communities take ownership of the fight to end malaria, real change can happen. Community champions are a key link between local health authorities and the communities they serve—we must empower them. 15 countries have now rolled out Zero Malaria Starts with Me campaigns and building off the success of Senegal, and organizations such as Rotary have a strong role to play in supporting community level engagement to increase ownership, awareness and action at all levels in the fight against malaria.

  1. How are adapted guidelines for the COVID-19 context being evaluated and documented for lessons learned?

Answer: With the COVID-19 pandemic unfolding and the situation around the world changing rapidly, we are very often learning by doing, and sharing lessons learned with and among malaria-affected countries. For instance, with support from global and in-country partners, Benin conducted the first-ever door-to-door, digitized ITN campaign in late April / early May. In the months that followed, the majority of countries in sub-Saharan Africa have also gone ahead with their planned campaigns, based on a similar approach which is a great achievement. This guidance was based on prior experience gained during the Ebola outbreak in Liberia, when the country distributed LLINs whilst practicing social distancing. Similar approaches are also ongoing in the Sahel, where children under five years of age are receiving Seasonal Malaria Chemoprevention.

  1. How are partners working with countries to ensure that global and national guidance on COVID-19 prevention is incorporated into ongoing malaria prevention and control interventions and health workers training?

Answer: The global malaria community has mobilized early in the pandemic to ensure that life-saving malaria interventions, such as mosquito net distribution campaigns, could go ahead and made COVID-19 safe. This has included switching campaigns to door to door distribution, thus minimizing crowds, and practicing social distancing at all times. We also continue to work with countries and partners to encourage care-seeking behavior in case of fever, which is a shared symptom for both COVID-19 and malaria, recognizing that prompt diagnosis and treatment can literally save hundreds of thousands of lives, especially children under 5. Health workers have been provided with PPE and triaging is taking place at health facilities to separate suspected COVID-9 cases from other patients.

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