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Full Malaria Partners International Webinar Q&A Transcript – COVID-19 and the Fight to #endmalaria with the UN Foundation

  1. Malaria Partners International has recently been acquiring and distributing Personal Protection Equipment for Community Health Workers in select areas of Uganda and Zambia so they can maintain their household level malaria efforts. Can you explain and address this problem on a broader scale? Why are most African nations at such a disadvantage in acquiring PPE?

Answer:  All countries have struggled to procure PPE during the pandemic do to a global supply shortage and production challenges during the lockdown period. Many countries around the world already had a moderate stockpile of PPE or have their own production capacity. Some have put in place mechanisms to limit export of PPE. Without a significant stockpile or production capacity, many African countries are competing with wealthier countries for limited PPE.

Several solutions to this issue are being put in place. Along with Rotary, the WHO through the COVID-19 Solidarity Response Fund hosted by UN Foundation, the Global Fund to Fight AIDS, TB and Malaria, UNICEF, Gavi, World Bank, and other partners are working with countries to supply tons of PPE to countries in Africa. At the same time, development partners and national governments are working with apparel manufacturers on the continent to shift production to PPE.

  1. A number of countries, such as Zambia, had planned to conduct mass malaria net distributions this year. Amid the COVID pandemic, are net distributions still taking place, and if so what accommodations are being made?

Answer: Net distributions are still taking place in most countries with modified approaches. The main shift is that nets are being delivered door-to-door rather than from fixed distribution points. This approach will likely be more costly. Updated guidance on this approach, which was created by the Alliance for Malaria Prevention, can be found here.

In the case of Zambia, the net distribution which is planned for August-October is currently on track and has already adjusted to the door to door approach. The status of a variety of malaria interventions is in the RBM Partnership to End Malaria Country Tracker to Mitigate the Effect of COVID-19 on Malaria.

  1. Some epidemiologists believe COVID’s full impact in Africa is simply being delayed. Can you explain why the disease could be so particularly devastating in some of these countries?

Answer:  There are several big picture reasons why the pandemic could be particularly devastating in parts of Africa.

First, countries with already weak health systems will struggle to handle the additional stresses a pandemic will place on their health systems – recall the situation in West Africa during the 2014-2016 Ebola outbreak described during the presentation.

Second, there are serious and deadly infectious diseases that already place high burdens on many African countries. COVID-19 shares symptoms with several of these diseases – for example, fever is a primary symptom of both COVID-19 and malaria. This overlap of symptoms makes it more difficult to appropriately treat a patient unless there is ready access to diagnostic tools. For example, a patient could come in with a fever and if a health care worker doesn’t have diagnostic tests to find out what caused the fever, they could treat them for the wrong disease. This puts them at higher risk of developing severe disease because they are not treated in a timely fashion. This also causes problems because sick people may stop going to seek treatment at health centers (for COVID-19 or any other illness) because they’re afraid they might come into contact with the disease, so they aren’t treated as quickly as they need to be treated to prevent severe disease. On top of that, COVID-19 could interfere with disease prevention efforts (such as vaccination programs, bed net distributions, and seasonal malaria chemoprevention campaigns) because of the risk the disease poses to the health care workers implementing the programs. Those that aren’t totally disrupted will most likely be more expensive to conduct because of adaptations and extra protections needed to keep these implementers safe and healthy. Combined, this overlap creates a situation where we see an increase in the number of cases and deaths not only due to COVID-19, but also of other dangerous infectious diseases already present in the population because sick people aren’t getting the appropriate care and prevention they need when they need it.

Third, global competition for tools to keep COVID-19 at bay is making it difficult for many African health authorities to obtain supplies to fight the pandemic as geopolitically powerful countries mobilize economic, political and strategic power to build stocks for their own populations. This can lead to unequitable distribution of tools needed to fight the pandemic as they are developed, including PPE, treatments and vaccines – which is why the global health community is taking proactive action now to prevent this scenario as much as possible.

  1. Can COVID-19 be contacted through mosquito bite?

Answer: The CDC and WHO have stated that there is no scientific evidence that mosquitoes can carry and/transmit COVID-19

  1. Are mosquitoes’ carriers of COVID-19?

Answer:  No! While mosquitoes are known to carry arboviruses like Yellow Fever, Chikungunya and Zika, there is no evidence that they can transmit COVID-19 and there’s no biological reason to suspect they might.

  1. Currently, there are increased cases of malaria in Uganda due to the rainy season and much of the emphasize is geared to sensitizing the masses on COVID-19.  What will be done so that malaria given much attention during this time?

Answer: The malaria program in Uganda is still operating and working to ensure the continuation of essential malaria services. There is also guidance for countries which has been developed on Malaria Social and Behaviour Change Program Guidance in the Context of COVID19 Pandemic. To help countries sensitize people about malaria during this time. It’s important to support the sensitization of malaria especially this time as the attention of the health system has shifted majorly onto COVID-19. Essential services must be actively promoted by:

  • Assure people that hospitals are safe to visit
  • Ensure that hospitals disinfect more often in these times
  • Provide clients who visit hospitals with nose mask, hand washing facilities, hand sanitizers etc
  • Provide health workers with PPEs to motivate them to deliver essential services without fear of putting their lives in danger

Additional information on Uganda’s approach is also included in the answer to the next question.

  1. Due to COVID-19 many patients are treating themselves at home because they are afraid to go to hospital, worried to be mixed with COVID-19 patients while Uganda still has low cases about 280 as of now and no deaths. What measures will be done to stop the rising malaria cases?

Answer:  People with fever in malaria endemic countries are encouraged by WHO to seek care. Community health workers, who work outside of facilities will play an essential role in providing this care and decreasing the number of people who have to seek care in facilities.

It is challenging for countries to balance the public health approaches to malaria and COVID-19, but most countries are learning how to do so. You can find more information on the status of country responses to malaria during COVID, including Uganda, on the RBM Partnership to End Malaria Country Tracker to Mitigate the Effect of COVID-19 on Malaria. While there are some delays in the indoor spraying campaign in Uganda, the net distribution campaign has moved forward with an adapted approach. There are concerns about the malaria situation due to flooding, so these preventive measures will be essential.

  1. Can you suggest any advocacy tools and or success stories to raise our voices above the current COVID noise?

Answer: Nothing But Nets“Raise Your Voice” portal of our “Take Action” webpage provides a number of advocacy tools, materials and immediate actions you can take from signing a petition, to tweeting your elected officials, to preparing for a meeting (or call) with your Member of Congress. If you’re interested in learning more about our leadership/advocate/spokesperson development program, which we refer to as the Champions Council, please contact Margaret McDonnell (mmcdonnell@unfoundation.org) or sign up here.

We find that it’s very effective to share 1) individual stories of people affected by malaria (some of which can be found here: https://nothingbutnets.net/ourimpact/) and about why you are passionate about the issue; 2) the tremendous impact and success of malaria-fighting programs such as the Global Fund and PMI (such as the tremendous reductions in malaria cases and deaths, the strong ROI, etc); 3) the impact that malaria has on the U.S. military and global health security; and 4) the importance of continued strong bipartisan U.S. leadership and investments in global health as to combat diseases from malaria to COVID-19. We provide talking points, materials, trainings, webinars and events that go into this in detail

We are very interested in NBN and Rotary joining forces to raise further awareness and our voices to ensure we continue making progress against malaria so please reach out to mmcdonnell@unfoundation.org if you’re interested in partnering or learning more.

  1. Are there any side effects from internal spray to prevent mosquitoes?

Answer: Chemicals which are used for IRS must undergo rigorous safety testing. If IRS is conducted properly according to global guidelines – including appropriate use of PPE by sprayers and families appropriately preparing their home for spraying and allowing time for the pesticide to dry – then no! If these guidelines are not followed appropriately and a person comes into direct contact with the pesticide, it can cause skin rash or eye irritation.