The WHO 2021 World Malaria Report indicates that African countries averted the worst-case scenario, i.e. the doubling of malaria deaths in sub-Saharan Africa (SSA) as projected by WHO. Nonetheless, urgent action is needed to reach global malaria targets.
The report recommends a compilation of tools for tackling the disease stating that no single tool will solve the problem of malaria in SSA. African governments must harness innovation to reach global targets, which will require rapid expansion of new, innovative and impactful tools.
In his foreword in the report, Dr Tedros Adhanom Ghebreyesus, Director-General, WHO, says, “…we continue to need new tools to put an end to malaria, and more investment in research and development. ….malaria has afflicted humanity for millennia. We have the tools and strategy now to save many lives – and with new tools, to start to dream of a malaria-free world.”
To speed the progress against malaria and attain global targets, further investment is needed to accelerate research and development on new diagnostics, vector control approaches, antimalarial medicines and vaccines.
New tools and technologies for malaria control in Africa
In 2021, AFIDEP, through the Platform for Dialogues and Action on Health Technologies in Africa (Health Tech Platform), undertook a Landscape and Political Economy Analysis of Emerging Health Technologies in Sub-Saharan Africa. The analysis found that various tools and technologies are under development and/or testing in different parts of the continent for Malaria control. These include the malaria vaccine, gene drives for control and elimination of malaria, attractive toxic sugar baits, use of drones in larvae control, sterile male mosquito technology, and Ivermectin drug.
Malaria Vaccine
In October 2021, WHO recommended the first-ever malaria vaccine, the RTS, S, also known as Mosquirix, for use in children living in regions with moderate to high malaria transmission. This vaccine, piloted in Ghana, Kenya and Malawi, is a significant boost to the fight against malaria.
Another promising vaccine highlighted by CDC is the whole sporozoite PfSPZ Vaccine. Trials in Western Kenya by CDC and KEMRI showed that the vaccine is safe and well tolerated in infants and young children. CDC and KEMRI also collaborate on a phase II vaccine evaluation in Kenya. Further evaluations to determine its efficacy are underway in different populations in Mali, Gabon, Tanzania, and Equatorial Guinea.
Gene drive for malaria control and elimination
Gene drive is a genetic phenomenon where genetic materials are transferred from parents to unusually high numbers of their offspring due to biased inheritance. The African Union in 2017 committed to investing in the development and regulation of gene drive technology. In 2018, the African Union Development Agency (AUDA-NEPAD) released a report recommending various actions to operationalize the AU recommendation.
The Target Malaria consortium is evaluating several approaches to reduce the number of malaria mosquitoes using genetic modification, in particular gene drive technologies. There is ongoing exploratory work in Burkina Faso, Cape Verde, Ghana, Mali and Uganda led by the Target Malaria consortium. Activities in these countries are still in the preliminary stages.
Attractive Toxic Sugar Baits (ATSB)
Attractive-toxic sugar baits (ATSBs) are a new vector control that kills female and male mosquitoes attracted to sugar feed on a sugary solution containing a mosquitocidal agentix. There are ongoing field trials in Kenya and Mali as well as studies to evaluate its efficacy.
Drones
In malaria control and elimination, drones are piloted for larval control by spraying over vast mosquito breeding sites like swamps. In addition to spraying larvicides, drones are also used to drop larvicide tablets, spread larvicide granules, and in low volume, spray adulticides.
In July 2021, Kenya’s President, HE Uhuru Kenyatta, also the Chair of the African Leaders Malaria Alliance (ALMA), flagged off the use of drones in the larvae control of mosquito habitats.
Sterile Insect Technique
Researchers at the Wits Research Institute for Malaria are working on sterile male mosquito technology as a new tool that has the potential to add value to existing tools for malaria control and elimination in Africa.
The sterile Insect Technique works almost like birth control for mosquitoes, and it relies on sterile male mosquitoes mating with virgin female mosquitoes. This tool is currently under investigation in South Africa.
Ivermectin drug
Ivermectin is an antiparasitic drug that kills mosquitoes exposed to it while feeding on the blood of people (known as blood feeds) who have ingested it. This drug has been tested in Senegal, Liberia, Mali and Burkina Faso. Several studies are currently ongoing to determine the effect of this drug on reducing malaria.
Artificial Intelligence is the automation of human thinking, such as decision-making, problem-solving, and learning. For Malaria control and elimination, Zzapp Company leverages AI to analyze satellite images and topographical maps to identify malaria transmission hotspots and optimizes malaria elimination strategies for each location. Its software system supports the planning and implementation of malaria elimination operations by analyzing satellite images and topographical maps.
Zzapp has implemented and tested this technology in Tanzania with funding from the Gates Foundation, Ethiopia, in collaboration with the International Centre of Insect Physiology and Ecology (ICIPE), Ghana, São Tomé and Príncipe.
Access WHO 2021 World Malaria Report HERE