In response to mounting concerns around the impact of COVID-19 on malaria elimination efforts across the African continent, the African members of the End Malaria Council have released a joint statement and a four-pronged action plan calling on African and global leaders to act quickly to: protect the decades of gains against malaria; boost African purchasing power and local manufacturing of critical medical supplies; continue investments in building an essential health workforce; and, use data to maximize limited resources to save lives.
The End Malaria Council is a committed group of global public sector and business leaders that sees malaria eradication as a critical health and development priority and that drives progress toward eradication by focusing on three key areas: leadership, financing and technology. The signatories of the statement are:
Uhuru Kenyatta, President of Kenya and Chair of the African Leaders Malaria Alliance
Jakaya Kikwete, former President of the United Republic of Tanzania
Ellen Johnson Sirleaf, former President of Liberia
Aliko Dangote, President and Chief Executive of the Dangote Group
Graça Machel, Founder, The Graça Machel Trust and Foundation for Community Development
The World Health Organization (WHO) and its partners recently published a modelling study which shows that deaths from malaria could double in 2020 if access to life-saving malaria prevention, diagnosis and treatment services are disrupted. This finding becomes especially concerning as we reach the rainy season in the highest malaria endemic countries across Africa and in India.
“I am committed to working with fellow heads of state and government on a coordinated and harmonized response to COVID-19 that stamps out this pandemic while continuing to provide essential health services to our citizens. Nothing is more important than protecting our women, children and men from preventable and treatable diseases like malaria. These efforts will help us to sustain the significant gains that we have made driving down malaria cases and deaths over the past twenty years.” – 
Uhuru Kenyatta is the President of Kenya, the Chair of the African Leaders Malaria Alliance and a member of the End Malaria Council.
“To fight COVID-19 effectively and ensure hard-won gains in malaria are not lost, African nations must strengthen essential regional partnerships to develop coordinated and collaborative approaches to support public health systems.” – 
Jakaya Kikwete, former President of the United Republic of Tanzania was the founding Chair of the African Leaders Malaria Alliance. Currently President Kikwete is an ambassador and advocate for regional approaches to health and development on the African continent and a member of the End Malaria Council.
“Prioritizing frontline health worker safety is a critical investment in the COVID-19 response that will provide short- and long-term benefits. Ensuring these health workers are equipped with the necessary protective equipment, diagnostics and data tools will protect health workers and empower them to interrupt the virus while maintaining life-saving services against existing diseases like malaria.” – 
Ellen Johnson Sirleaf was President of Liberia during the Ebola outbreak in 2014 is the former Chair of the African Leaders Malaria Alliance. Currently President Sirleaf is the World Health Organization’s Goodwill Ambassador for the Health Workforce and a member of the End Malaria Council.
“African governments face challenging resource constraints as they seek to control and respond to COVID-19 but must avoid diverting funds from essential health campaigns that protect the most vulnerable populations, including children and pregnant women. By prioritizing the mobilization of new funding to combat the pandemic, African nations can address the needs of the pandemic without interrupting vital delivery of other life-saving health programs.” – 
Aliko Dangote, President and Chief Executive of the Dangote Group, created a private sector coalition to support Nigeria’s COVID-19 response that has mobilized over 25 billion Naira. He is a member of the End Malaria Council.
“Pregnant women and young children are among the most vulnerable to infectious diseases, including malaria. It is imperative that we African leaders ramp up our work to sustain safe access to essential health services during this pandemic to support our communities and protect the lives of Africa’s future.” – 
Graça Machel, Founder, The Graça Machel Trust and the Foundation for Community Development and a member of the End Malaria Council.
Statement: Meeting the Challenge of COVID-19
Five years ago, we drafted Agenda 2063: the Africa We Want, to share our optimism about a prosperous future for Africa’s people, society and economy. Critical to achieving this vision was a sustained focus on ending preventable and treatable diseases, like malaria, within a generation.
For the malaria community, we started off the decade energized by historically low levels of malaria deaths and cases. The Lancet Commission on malaria eradication report released in September 2019 concluded that malaria eradication “is a bold but attainable goal, and a necessary one.” This sharpened our focus on the challenging, but achievable ambition of driving malaria cases and deaths down by 90% by 2030. Our optimism was well-founded, but not without challenges.
However, the COVID-19 pandemic puts our vision in jeopardy.
The World Health Organization (WHO) and its partners recently published a modelling study which shows that deaths from malaria could double in 2020 if access to life-saving malaria prevention, diagnosis and treatment services are disrupted. This finding becomes especially concerning as we reach the rainy season in the highest malaria endemic countries across Africa and in India.
We have an urgent opportunity now to learn from previous disease outbreaks—such as the Ebola outbreak in West Africa in 2014-2016— and take swift action to save precious lives, especially children under 5 and pregnant women who are disproportionately impacted by malaria. Taking action now will protect hard won gains to improve standards of health and access to essential health services that have been achieved over the last two decades.
Combatting COVID-19 will require keeping people safe from malaria and maintaining investments that further strengthen health systems, particularly at the sub-national and community levels. Last week, world leaders showed global solidarity in raising more than $8 billion USD to combat the pandemic. We encourage leaders to use this funding in an integrated approach to control COVID-19 while maintaining malaria services as part of essential health packages, routine health services and campaigns. Failing to do so may create a double jeopardy: new deaths from malaria could dwarf the impact of COVID-19, and an upsurge in malaria cases could overwhelm already taxed health systems –compounding the human and economic toll.
To protect millions against COVID-19 and preventable, infectious diseases like malaria, we call on leaders to:
1. Protect the Gains on Malaria
The decades-long effort to increase access to malaria prevention and treatment tools has saved more than seven million lives and continues to save nearly 600,000 lives every year compared to levels in the previous decade. However, these lives are at great risk if anti-malaria campaigns – like mosquito net deliveries, insecticidal spraying initiatives and distribution of seasonal malaria chemoprevention treatment – are discontinued, or if routine testing and treatment services are disrupted.
Partners such as the WHO and the RBM Partnership to End Malaria have recently issued new guidelines on how to safely continue providing life-saving preventive treatments, case management services and on developing social and behavior change programs in the face of COVID-19. We applaud countries that are currently using these guidelines to reach thousands of people at risk with life-saving insecticide-treated mosquito nets, seasonal malaria chemoprevention and indoor residual spraying campaigns. We continue to urge manufacturers of essential malaria commodities, including rapid diagnostic tests and treatments to maintain production to ensure the consistent availability of products. These guidelines are helping our countries to maintain robust malaria programs and encouraging our citizens to seek diagnosis and treatment for malaria at the first sign of symptoms.
It will also be critical to sustain the nearly $3 billion USD in funding provided by countries invested in the global malaria fight to ensure these efforts progress without disruption.
2. Boost African Purchasing Power and Local Manufacturing of Critical Medical Supplies
The WHO estimates that as many as 940 billion pieces of medical grade personal protective equipment (PPE) are needed to respond to COVID-19 in major countries in Sub-Saharan Africa. Recent analysis suggests that less than one third of clinics and health posts in sub-Saharan African have access to PPE and other vital medical supplies they need to address COVID-19. Ten African countries have no ventilators and most face dangerous scarcity.
We are committed to fostering an environment where African countries can produce more of the lifesaving interventions and equipment needed to support response efforts in our nations. Africa needs to move urgently to pool its procurement capacity to increase its buying power on the international market and ensure that African countries aren’t competing with one another, but working in tandem to support mutual efforts. In the medium term, we must boost domestic production capacity and expand national stockpiles to ensure we have the critical equipment we need. This is not just a health security issue, it is a national security issue.
We are pleased to see various international stakeholders – including the WHO, UNICEF, the World Bank and the Global Fund to Fight Aids, Tuberculosis and Malaria – coming together to develop and implement plans to coordinate procurement across Africa and to address the significant problems with the supply chain. These efforts must be accelerated to equip our continent with an integrated and collaborative approach to ending this global pandemic.
3. Build an Essential Health Workforce
Just like COVID-19, malaria does not respect borders and is a disease of poverty that presents as fever, shaking chills, headache and gastrointestinal issues. To effectively fight malaria, many African nations have adopted a regional approach and extended health systems by establishing a network of community health workers (CHWs).
CHWs are often the only access to care for malaria and routine health services and will continue to play a consequential role in saving lives during the response to COVID-19. We urge governments and donors to prioritize these essential frontline health workers, specifically through measures that both protect CHWs, and empower them to interrupt the virus, maintain existing services and shield those most at risk.
In addition to these measures, countries invested in the malaria fight have also been engaged in strengthening primary healthcare clinics and building surveillance and data networks to quickly diagnose and provide treatment. We encourage partners to leverage these capacities to detect and fight COVID-19 on the front lines.
4. Maximize Limited Resources to Save Lives
Malaria does not affect all places equally. Countries should prioritize data and sub-national data analysis to inform how to utilize resources most efficiently. In geographies where malaria is seasonal and COVID-19 cases are increasing, there is a narrow window of time to intervene. Immediate action is necessary to ensure campaigns not only continue, but are targeted to the populations at highest risk. This will help alleviate pressure on health resources that may be needed to treat COVID-19.