WHO Urges Increased Use Of Recommended Malaria-Fighting Tools

The World Health Organisation (WHO) has issued a call for increased implementation of new and existing malaria interventions to save lives on World Malaria Day. Thanks to an ongoing pilot programme coordinated by WHO, nearly 1.5 million children in Ghana, Kenya, and Malawi at high risk of illness and death from malaria have now received their first dose of the first malaria vaccine, RTS,S/AS01 (RTS,S). Malaria vaccine pilots, which began in 2019, are increasing equity in malaria prevention for the most vulnerable people and saving lives. Malaria vaccines, if widely used, could save the lives of tens of thousands of children each year, according to WHO.

"We have the tools to drive down malaria, a package of interventions that includes vector control, preventive medicines, testing, and treatment," said WHO Director-General Dr Tedros Adhanom Ghebreyesus. "These are complemented by a safe and effective malaria vaccine, which has the potential to save the lives of tens of thousands of children each year." Malaria elimination in many countries is within reach with sustained investment and increased efforts to reach those most vulnerable." The theme for World Malaria Day 2023 is "Time to Deliver Zero Malaria: Invest, Innovate, Implement." Within this theme, WHO advocates for more effective use of available tools and strategies for malaria prevention, diagnosis, and treatment, particularly among marginalised populations.

Countries have made some progress in expanding access to malaria services for most-at-risk populations. Despite some progress, many people at high risk of malaria still lack access to services that can prevent, detect and treat the disease. Challenges in expanding access to malaria services have been compounded, particularly in sub-Saharan Africa, by the Covid-19 pandemic, converging humanitarian crises, restricted funding, weak surveillance systems, and declines in the effectiveness of core malaria-fighting tools.

To address these threats and support countries in building more resilient malaria programmes, WHO recently published new strategies and frameworks, including: a new strategy to contain antimalarial drug resistance in Africa; a new initiative to stop the spread of Anopheles stephensi in urban environments; a new framework, developed jointly by WHO and UN-Habitat, to guide city leaders in urban malaria control; a new toolkit to help countries assess their malaria surveillance systems and identify areas for investment. WHO has also increased the transparency, flexibility and access to its malaria recommendations.

The consolidated WHO Guidelines for malaria are now available through two digital platforms: MAGICapp and the “Malaria Toolkit” app. WHO encourages countries to tailor the recommendations to local disease settings for maximum impact. Continued investment in the development and deployment of new malaria vaccines and next-generation tools will be key to achieving the 2030 global malaria targets. A second malaria vaccine, the R21/Matrix-M (R21) vaccine, if approved, could help close the sizable gap between supply and demand and further reduce child illness and death from malaria.

It is a priority for WHO to continue the thorough and efficient expert review of the R21 malaria vaccine once additional key safety and efficacy data from the ongoing R21 phase 3 trial are available and provided to WHO. The RTS,S malaria vaccine will be introduced gradually in additional African countries beginning in early 2024. There are 28 new vector control products in the R&D pipeline. New types of insecticide-treated nets, targeted baits that attract mosquitoes, spatial repellents, lethal house lures (eaves tubes), and mosquito genetic engineering are among the tools being tested. Due to the emergence and spread of partial artemisinin resistance, researchers are prioritising the development of non-ACT treatments in the field of antimalarial medicines. To reduce the risk of drug resistance, researchers are working on next-generation medicines such as "triple ACTs," which combine artemisinin with two partner drugs.