Malaria is a complex disease with an intricate web of interactions involving the Plasmodium parasite, a female Anopheles mosquito and a susceptible human. As explored in previous webinars of the End Malaria series by the Platform for Dialogue and Action on Health Technologies in Africa (Health Tech Platform), there is no one-size-fits-all solution for eliminating the disease.
Each setting demands a multifaceted and comprehensive approach, considering the whole lifecycle of transmission (from mosquitoes to humans) and backed by robust health systems, policies, and community engagement. In this blog, we explore how Africa’s research and technical capacity can support the delivery of this comprehensive approach.
While delivering her keynote speech, Prof. Faith Osier, Co-Director of the Institute of Infection and Chair of Malaria Immunology and Vaccinology at Imperial College London, emphasised that a comprehensive and system-wide approach is essential if we stand any chance of eliminating malaria. Asymptomatic malaria keeps the disease alive and perpetuates its transmission.
Therefore, while it is crucial to concentrate research and development efforts on population groups such as children under the age of five years that are most vulnerable to malaria, countries must consider tools and interventions that involve multiple academic disciplines to address its transmission across the entire population, seeking out the asymptomatic malaria infections to completely eliminate the disease.
Investing in a diverse research environment
A diverse and multidisciplinary research environment is critical to inform policy and programme implementation. As highlighted by Dr Susan Imbahale, Senior Lecturer at Technical University of Kenya, the success of higher learning institutions in producing quality malaria research encompasses the entire research environment, including infrastructure, multidisciplinary collaboration, and government support. The current research landscape therefore needs to move from individual research projects to large-scale, multidisciplinary endeavours to address the complexity inherent in eliminating the disease.
To this end, sustainable and adequate funding to institutions of higher learning is essential to support long-term malaria control efforts in Africa. Furthermore, creating effective incentives, beyond financial rewards, can motivate researchers to continue producing impactful work that addresses real-world challenges. This involves strengthening research infrastructure by establishing state-of-the-art laboratories and research centres, ensuring they are well-equipped to conduct innovative research on malaria control and elimination.
This innovation is necessary, according to Dr Donnie Mategula, Deputy Group Head, Infectious Disease Epidemiology Group at Malawi Liverpool Wellcome Programme. Mainstay malaria interventions deployed over the past decade need to be updated to address emerging threats such as climate change and malaria vectors which are spreading beyond their range limits. Innovations through research would consider the heterogeneity of transmission within locales, and maximise the effective delivery of existing malaria control tools while providing new tools to supplement current elimination efforts.
Dr Sessinou Benoit Assogba, a Postdoctoral Research Scientist at the London School of Hygiene & Tropical Medicine further noted that a core focus should be on investing in the training, mentorship and empowerment of young scientists who will serve as catalysts for ground-breaking innovations that can reshape the landscape of disease control. Enabling young minds to develop and implement novel malaria control strategies bolsters local capacity and resilience, driving positive change from within communities.
Research-to-policy infrastructure
Research findings should ideally directly inform policy decisions. However, while research organisations generate a substantial amount of evidence, there is a notable lack of effective translation of this data into policy and legislative action to support malaria elimination. Bridging the gap between research and policy implementation remains a critical concern. This can be achieved by enabling a supportive environment that encourages the flow of information and utilisation of research findings from academic to government corridors.
Prof. Charles Mbogo, a public health entomologist, Chief Research Scientist, and President of the Pan-African Mosquito Control Association (PAMCA) expounded that the elimination of malaria should be treated as a development issue, and not just as a health problem. This would allow African governments to establish broader mechanisms in relation to malaria interventions, for instance including considerations of urban housing and irrigation schemes.
African governments should also have mechanisms in place to foster collaboration among researchers, between researchers and national malaria control programmes, and with international partners. This will facilitate the exchange of knowledge, resources, and expertise – technical and non-technical, and accelerate the reinvention and development of tools and strategies for malaria control that considers local contexts and challenges.
Ultimately, the responsibility of malaria eliminations lies with Africans whose continent bears the greatest burden of the disease. Enhancing the African research and technical capacity expands the tool box for malaria control, and it is through united action that we can harness the power of research, advocacy, policy, and public awareness to end the burden of malaria on the continent.
Read summaries of the previous webinars:
Webinar 1 Zero Malaria Is Possible: Ending the Malaria Burden in Africa
Webinar 2 Navigating Africa’s Journey to Malaria Elimination: Threats and Opportunities
Webinar 3 Closing the Gap in Financing Malaria Control Strategies
Webinar 4 Advancing Malaria Elimination with Emerging Health Technologies