Chijioke Iremeka
Despite strides in expanding access to insecticide-treated nets and medicines to prevent and treat malaria in young children, pregnant women, and other vulnerable Nigerians, public health physicians say more people are coming down with malaria due to climate change.
The physicians said there is a nexus between climate change and malaria, insisting that changes in temperature, humidity and rainfall due to climate change influence the behaviour and survival of the malaria-carrying female Anopheles mosquitoes responsible for transmission of malaria.
Citing the 2022 deadly flooding in Pakistan, which led to a five-fold increase in malaria cases in the country, experts said extreme weather events, such as heat waves and flooding can directly impact transmission and disease burden.
The 2023 World Malaria Report by the World Health Organisation spotlights the growing threat of climate change to the global progress against malaria, especially in the vulnerable regions of Africa and others.
The report, which provides a comprehensive up-to-date assessment of trends in malaria control and elimination across the globe, described climate change as one of many threats to the global response to malaria.
According to the Director-General, WHO, Dr Tedros Ghebreyesus, “The changing climate poses a substantial risk to progress against malaria, particularly in vulnerable regions. Sustainable and resilient malaria responses are needed now more than ever, coupled with urgent actions to slow the pace of global warming and reduce its effects.”
He noted that climate variability is expected to have indirect effects on malaria trends through reduced access to essential malaria services and disruptions to the supply chain of insecticide-treated nets, medicines and vaccines.
Ghebreyesus added that population displacement due to climate-induced factors may also lead to increased malaria as individuals without immunity migrate to endemic areas.
In 2022, according to the WHO, there were an estimated 249 million malaria cases recorded globally, exceeding the pre-pandemic level of 233 million in 2019 by 16 million cases.
In addition to the disruptions caused by COVID-19, the global malaria response has faced a growing number of threats, such as drug and insecticide resistance, humanitarian crises, resource constraints, climate change impacts and delays in programme implementation particularly in countries with a high burden of the disease, WHO said.
The UN health agency said, “The COVID-19 pandemic significantly disrupted malaria services, leading to a surge in both incidence and mortality rates, exacerbating already stalled progress against the disease.
“Meanwhile, in the 11 countries that carry the highest burden of malaria, rates of new infections and deaths have levelled off, following an initial upsurge during the first year of the pandemic. These countries, supported by the WHO’s ‘high burden to high impact’ approach, saw an estimated 167 million malaria cases and 426,000 deaths in 2022.
“In view of current trends, progress towards critical 2025 milestones of the WHO global malaria strategy is off track by a wide margin.”
Speaking on this, the Regional Director for Africa, WHO, Dr Matshidiso Moeti said it was crucial to recognise the multitude of threats that impede the global response efforts towards elimination of malaria globally.
“Climate variability poses a substantial risk, but we must also contend with challenges such as limited healthcare access, ongoing conflicts and emergencies, the lingering effects of COVID-19 on service delivery, inadequate funding and uneven implementation of our core malaria interventions.
“To forge ahead toward a malaria-free future, we need a concerted effort to tackle these diverse threats that foster innovation, resource mobilisation and collaborative strategies,” she added.
Moeti said an additional five million malaria cases were recorded in 2022 and over the previous year, and that five countries bore the brunt of the increases.
“Pakistan saw the largest increase, with about 2.6 million cases in 2022 compared to 500,000 in 2021. Significant increases were also observed in Ethiopia, Nigeria, Papua New Guinea and Uganda,” she added.
Speaking on how climate change leads to the behaviour and survival of anopheles mosquitoes responsible for the spread of malaria, a Family Physician with Anambra State Ministry of Health, Dr Chidumeje Okafor said, “We know that malaria is carried by a parasite known as plasmodium falciparum which is carried by vector known as anopheles gambiae female mosquitoes.
“These anopheles female mosquitoes thrive more in warmer climates. So, it is usually more in Africa because Africa is in the tropics and in subtropical regions. These mosquitoes thrive more there. Then, the parasite is able to regenerate and multiply more in warmer climates.
“Coming to temperate regions, the colder climate, like in the US and Europe, though some parts of these countries still have seasonal warm climates, they also have a very harsh winter. When that happens, it wipes off all the anopheles mosquitoes.
“Climate change means that the earth is getting warmer, the temperature is increasing and ice caps are melting. It means that these initially cold climate regions are becoming warmer like Africa and anopheles mosquitoes will now start thriving more in those areas thereby, leading to malaria spread in the regions that malaria was initially wiped away from.
“Yes, the more the climate changes into warmer climates, the more malaria spreads everywhere because the victors and the parasites are able to thrive more in those initially cold areas, which have become warmer by the making of climate change.”
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