Table 1 Policy summary

Background

The COVID-19 pandemic and the measures put in place to reduce its spread could severely impede malaria prevention activities, such as bed net distribution, as well as reduce access to malaria treatment if health systems become overwhelmed. We use transmission dynamics models of COVID-19 and malaria to investigate how different levels of malaria service interruption could influence malaria disease control and deaths in SSA, which accounts for more than 90% of malaria deaths globally, and disproportionately affects children

Main findings and limitations

If malaria control activities are severely disrupted as a result of the COVID-19 pandemic, we find that malaria deaths could more than double in 2020 compared with 2019. If mosquito nets are not deployed and case management is reduced by half for 6 months there could be 779,000 malaria deaths in SSA over 12 months. The projected effect varies according to how long services are interrupted, if the disruption coincides with the malaria transmission season and whether routine vector control interventions such as the mass distribution of mosquito nets was due in 2020. Reducing malaria transmission has additional benefits in reducing the presentation of fever cases in the health system at a time when they may be overwhelmed with COVID-19 cases. The projected effect on malaria services and mortality is highly uncertain because these estimates are heavily dependent on how countries respond to COVID-19

Policy implications

Swift action now could substantially reduce the burden of malaria and prevent joint malaria and COVID-19 epidemics simultaneously overwhelming vulnerable health systems. Routine distributions of mosquito nets should be prioritized alongside increasing access to antimalarial treatment and the use of chemoprevention to prevent substantial malaria epidemics