Experts warn that countries affected by malaria need to learn from Ebola outbreak for coronavirus

Published: 20 March 2020

Experts including Nobel Prize-winner Professor Youyou Tu and St George’s Professor Sanjeev Krishna have warned that malaria-affected countries need to be prepared to deal with the coronavirus (Covid-19) outbreak.  

Published in the Lancet this week, the comment piece states that malaria-endemic regions in Africa need to learn lessons from the Ebola outbreak in 2014-16 in order to take measures to maintain malaria control.  

The global Covid-19 outbreak has been declared a pandemic by the World Health Organisation, and many malaria endemic regions have been affected, including countries across Africa. The paper states: “Africa needs to be prepared to deal with Covid-19, given the infection potential of the disease and its capacity to undermine malaria control effort.” 

The experts urge that measures will need to be taken to avoid similar circumstances to during the Ebola outbreak, where in Guinea alone in 2014, the number of deaths from malaria increased by around ten times according to official numbers. It was also estimated that there were more than 7,000 additional malaria deaths in children younger than five years old in Guinea, Liberia, and Sierra Leone due to the Ebola outbreak. 

The similarity between the early symptoms of Covid-19 and malaria could lead to challenges in early clinical diagnosis, as it did during the Ebola outbreak, and the experts point to preventative measures being needed for both Covid-19 and malaria.  

Pre-emptive measures for malaria control include continued distribution of insecticide-treated bed nets, as well as ensuring malaria tests are carried out for suspected cases of covid-19. The experts also urge that healthcare facilities should be well stocked with combination therapy drugs to treat the disease.  

As with other regions, case and contact tracing, quarantine and screening and education to encourage good hand hygiene practices will be critical for Covid-19 control.  

The clear message from the experts is that any measures will require political will and collaboration in a coordinated effort across malaria-affected countries. They believe preparedness will be key to navigating a potential public health crisis and countries must be set up to handle Covid-19 while minimizing disruption to malaria control.  

Professor Sanjeev Krishna said: “The previous Ebola crisis had many consequences for other treatable diseases like malaria, which went undiagnosed and untreated in the epidemic. People were either too worried to come to healthcare facilities, were advised not to, or the healthcare facilities had disappeared. 

“Many people died because of this and we must avoid this if at all possible for Covid-19."