This post is part of our Unite To Fight series, which supports the Global Fund to Fight AIDS, Tuberculosis and Malaria's efforts in calling attention to the critical need to maintain the gains the world has made towards malaria elimination.
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In Zambia, threats of COVID-19 have coincided with peak malaria season – a time when vulnerable communities are most at risk for malaria outbreaks. This situation presents unique challenges for malaria program coordinators and field staff who are part of the Anglican Diocese of Lusaka Cross Border Malaria Initiative.
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Monica Mvula, a program coordinator based in Mongu district, has facilitated the distribution of soap and PPE for malaria volunteers in Simulumbe, together with health facility staff. These items will help protect the volunteers from COVID-19 and will reduce the risk of community spread in the case that COVID-19 reaches Mongu. At the same time, Monica is doing all she can to address a malaria outbreak and stock outs of rapid malaria tests. 

Monica shared information about a particularly concerning situation in Simulumbe in late April, where 195 malaria cases were diagnosed in just one week. After confirming these cases, the clinic ran out of rapid tests. Therefore, the actual number of cases was likely higher.

With support from the Isdell:Flowers Cross Border Malaria Initiative, Monica was able to urgently step in and provide the clinic with 225 rapid tests to ensure suspected malaria cases could be tested according to protocols.

Though malaria is spreading, it is being confronted by Monica and a team of trained malaria volunteers. As of today, Monica is continuing to follow up on untreated cases within her program areas in Mongu. 

Emmanuel Mutoya is a Community Health Worker in Liuwa Plain National Park – located in Western Province, Zambia. Liuwa park is home to tens of thousands of wild animals which live alongside a population of approximately 10,000 people, all of whom are at risk of malaria.

According to Emmanuel, much of his malaria work continues even as the COVID-19 pandemic threatens communities like his. During a conversation on May 7th, Emmanuel shared that he is still testing people with suspected malaria and treating those who are positive. In addition, Emmanuel still does active follow up of index cases; If someone tests positive for malaria, those living within 140 meters of the positive case are tested for malaria and treated if positive.  
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This photo, taken before the COVID-19 pandemic, shows Emmanuel conducting a rapid diagnostic test in the Salunda health facility catchment area.

Emmanuel shared that COVID-19 has introduced fear into his interactions with clients.

“When people come to us, especially people who we don’t know where they are coming from, they bring fear to us,” he explained. “But we test them.”
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CHWs like Emmanuel now have PPE and soap. Emmanuel wears a mask when he tests a client, and the client wears a mask as well.

Emmanuel explained that the way he provides malaria education to his community has changed drastically since the COVID-19 pandemic began. He used to bring large groups of people together to provide malaria education, but now this is done on a person-to-person basis, and fewer people are being reached.

“We still sensitize those who come to us who are sick – so we talk to them and give them education about how they can prevent malaria,” he explained. “But it is not like the way we used to do it where we can bring a lot of people together.”  
 
 
 
Funding from the J.C. Flowers Foundation’s Isdell:Flowers Cross Border Malaria Initiative (IFCBMI) supported the training of a cadre of Community Health Workers (CHWs), including Emmanuel, in 2017. These CHWs are trained by Zambia’s National Malaria Elimination Centre, and are supported and supervised by IFCBMI’s partner, the Anglican Diocese of Lusaka Cross Border Malaria Initiative.  ​

In the midst of our efforts towards malaria elimination, COVID-19 has grasped our attention as a new, dangerous, and still poorly understood threat.
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We collectively seek to end COVID for the same reasons we seek to end malaria. We fight both COVID-19 and malaria because they limit development at the family, community, and national levels. We fight both COVID-19 and malaria because they squelch economic opportunities for families and nations. Ultimately, we fight both COVID-19 and malaria because they steal our precious and rich lives, and even one life lost prematurely is one life too many.
 
Though COVID-19 is still poorly understood, we know how to prevent, diagnose, and cure malaria. The loss of 430,000 people each year to malaria is not inevitable. Now, more than ever, we must not let ourselves become distracted from the efforts that we know contribute to malaria’s elimination.
 
Worryingly, a modelling analysis from the World Health Organization shows that a de-prioritization of malaria interventions could lead to a doubling of malaria deaths. Under the worst-case scenario, in which all insecticide-treated net campaigns are suspended and there is a 75% reduction in access to effective antimalarial medicines, the estimated tally of malaria deaths in sub-Saharan Africa in 2020 would reach 769,000, twice the number of deaths reported in the region in 2018. This would represent a return to malaria mortality levels last seen in the year 2000.
 
Now is a time for malaria partners to unite to fight. We’re joining the Global Fund to Fight AIDS, Tuberculosis and Malaria in calling attention to the critical need to maintain the gains the world has made towards malaria elimination.
 
Led by The Global Fund, The Unite To Fight campaign highlights the critical role health workers in saving lives. 

As part of this campaign, we will be sharing insights and brief stories from communities where the Isdell:Flowers Cross Border Malaria Initiative is working in partnership with national malaria control and elimination programs to defeat malaria.

In the coming weeks, we will share the efforts of malaria activists and health workers like Emmanuel Mutoya from Western Province, Zambia, who continue to fight each and every day for malaria elimination.