Responding to Malaria Outbreaks During the COVID-19 Pandemic: The Anglican Cross Border Malaria Initiative in Zimbabwe Continues to Fight against Malaria

Shepherd Mahlahleni investigates a breeding site in Negande

It was the first week in March when Shepherd Mahlahleni, a field officer for the Diocese of Matabeleland’s Anglican Cross Border Malaria Initiative (ACBMI) in Zimbabwe first heard news of a possible malaria outbreak in the Negande area of Kariba District. Mahlahleni received phone calls from three village health workers (VHWs) – Tiller Mpofu, Simuguka Siamwiriyo and Sekai Zandu – alerting him of the malaria cases.

VHWs like Mpofu, Siamwiriyo, and Zandu are trained by Zimbabwe’s Ministry of Health and Child Welfare to carryout essential malaria education, rapid testing, and treatment for those who test positive for malaria. Because they are selected by and live in the communities they serve, they are often the first to detect emerging malaria outbreaks.

While it is not uncommon for areas like Negande to experience an increase in the number of malaria cases during March and April (the rainy season), the number of new cases in Negande was a cause for concern for Mahlahleni and the Kariba District Health Office.

As the district began dealing with the urgent needs arising from the COVID-19 pandemic, it became difficult to maintain the normal level of prioritization for malaria activities, Shepherd noted. Routine malaria education and sensitization were not occurring with the same level of intensity as past years, and health staff that typically focus on malaria-related activities were conducting other activities such as food aid distribution.

As fears of COVID-19 spread among rural communities, so did malaria.

In response, Mahlahleni and Muchenje Oswell, the District Environmental Health Officer in Kariba District, visited Negande in March to investigate the malaria cases. They discovered mosquito breeding sites in stagnant bodies of water, which are also a source of water for the nearby communities for household use. They also discovered a shortage of rapid malaria tests in the Negande health clinic because so many more people than normal had presented with fevers.

Those most affected by the malaria outbreak were adults who engage in farming activities along the river soon after the rains, Mahlahleni and Oswell reported. These farmers leave their permanent houses to stay in temporary structures in order to guard their crops from wild animals, therefore exposing themselves to mosquito bites.

Following the trip to Negande, Mahlahleni prioritized the redistribution of rapid tests from a local pharmacy near his office to Negande so that all of Negande’s VHWs and the health centre were fully equipped to test all those who needed a malaria test. VHWs intensified their community education, including encouraging increased prevention measures, such as wearing long sleeves.

Like many countries across Southern Africa, Zimbabwe is under lockdown orders with the goal of preventing the spread of COVID-19. Under the supervision of Zimbabwe’s National Malaria Control Programme and ACBMI, which works in partnership with the J.C. Flowers Foundation’s Isdell:Flowers Cross Border Malaria Initiative (IFCBMI), VHWs in Negande have continued to conduct malaria education within the community while observing COVID-19 social distancing guidelines. They are sharing messages on malaria prevention and encouraging those with fevers to go to a VHW or their local clinic for testing. The number of malaria cases has decreased.

Despite these efforts, Mahlahleni worries that the progress made by ACBMI, in partnership with IFCBMI and Zimbabwe’s National Malaria Control Programme in reducing cases in Kariba district, could be reversed.

​Unfortunately, Negande is one of many communities in Zimbabwe that is experiencing additional challenges during what is already peak malaria season.

As the world struggles to respond to COVID-19, there is a significant risk that prevention and treatment programs for malaria will be disrupted, despite guidance from the World Health Organization that states malaria activities should continue.

As we celebrate World Malaria Day on April 25th, it is important to acknowledge that current investments in malaria are saving almost 600,000 lives and preventing nearly 100 million cases a year. Efforts to limit the spread of COVID-19 are necessary to protect health systems, enabling them to continue to serve the population throughout the crisis. At the same time, these efforts must continue to preserve access to life-saving malaria prevention, diagnosis and treatment services or threaten to reverse decades of hard-fought progress against malaria.

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