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The Global Fund, 2023
Implementing Partners: The Global Fund, Health Finance Coalition, Malaria No More
Published In: COP28 Prospectus of Climate-Health Solutions, 2023
The Global Fund, 2023
Implementing Partners: The Global Fund, Health Finance Coalition, Malaria No More
Published In: COP28 Prospectus of Climate-Health Solutions, 2023
Globally, there were an estimated 247 million malaria cases in 2021 over 84 countries, an increase from 245 million in 2020. Malaria incidence is highly concentrated, with 29 countries accounting for 96% of malaria cases globally, and 4 countries (Nigeria, Democratic Republic of Congo, Uganda and Mozambique) accounting for almost half of all cases globally.
Malaria is one of the infectious diseases most sensitive to climate change. Malaria transmission increases with small changes in rainfall patterns, temperature, and humidity. A study conducted in western Uganda in 2016 showed that living in a flood-prone area increased chance of catching malaria by about 30% after a flood. The rate and severity of extreme weather events has increased at twice the pace for sub-Saharan Africa than for the rest of the world. Relative to the 1970s, there has been a tenfold increase in floods in Sub-Saharan Africa, partly explaining why malaria transmission has worsened in recent years.
Seasonal Malaria Chemoprevention (SMC) is a proven, cost-effective intervention for preventing malaria cases in highly vulnerable communities living in high-burden countries with strong seasonality of transmission.
Preventive chemotherapy is the use of medicines, either alone or in combination, to prevent malaria infection and its consequences. It requires giving a full treatment course of an antimalarial medicine to vulnerable populations at designated time points during the period of greatest malarial risk, regardless of whether the recipient is infected. Seasonal malaria chemoprevention (SMC) specifically involves giving children under the age of 5 full malaria treatment courses during the malaria season, starting before the onset of rains. In 2022, the WHO endorsed expansion of SMC to new age groups and geographies, creating the opportunity to more than double the population that benefits from SMC. Applying SMC in acute, flood-prone areas could eliminate the risk of malaria outbreaks following extreme weather events.
Suitability of an area for SMC is determined by the seasonal pattern of rainfall, malaria transmission, and the burden of malaria on the community. Historically, SMC has been recommended for deployment in areas:
SMC can be provided at a cost of approximately $1.50 per one person-month of coverage, making it highly competitive from a deaths- and disability adjusted life years (DALYs)-averted standpoint.
Nearly 45 million children were treated with SMC in 15 African countries in 2021, up from 33.4 million in 2020 and 22.1 million in 2019. About 92% of the increased SMC distributions in 2021 were in Nigeria. The project delivered SMC to Uganda and Mozambique for the first time in 2021.
Randomized controlled trials provide strong evidence that SMC reduces cases of malaria by 75%. At full financing (approximately $200 million), the project could annually protect 45 million at-risk people with SMC across central and eastern Africa.
The next steps for the project are to expand the number of rounds of SMC given from 3 to 4 in response to longer transmission seasons; expand to new demographics by treating children from ages 6-10; and reach children in new geographies that are highly flood prone and vulnerable to malaria outbreaks.
Novel seasonal strategies like SMC can protect vulnerable populations from malaria outbreaks in areas prone to flood-risk, lengthening rainy seasons, and variable weather patterns due to climate change.
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