Increasing challenges of malaria control in sub-Saharan Africa: Priorities for public health research and policymakers

• Published in: Annals of medicine and surgery 2022-09, Vol.81, p.104366-104366
• Main Authors: Oladipo, Habeebullah Jayeola, Tajudeen, Yusuf Amuda, Oladunjoye, Iyiola Olatunji, Yusuff, Sodiq Inaolaji, Yusuf, Rashidat Onyinoyi, Oluwaseyi, Egbewande Muyiwa, AbdulBasit, Muili Opeyemi, Adebisi, Yusuff Adebayo, El-Sherbini, Mona Said
• Format: Article
• Language: English
• Subjects: Malaria control; Malaria vaccine; Policymakers; Sub-Saharan Africa; WHO
• ISSN: 2049-0801; 2049-0801
• DOI: 10.1016/j.amsu.2022.104366

The ever-increasing cases and mortality due to malaria remains one of the most important public health threats, especially in sub-Saharan Africa—where this burden is considerably high. In 2020, sub-Saharan Africa accounted for about 95% of all cases and 96% of all malaria deaths with about 80% of these deaths reported in children under the age of 5. This review, adopting a public health focus, aimed to understand the challenges of malaria control in sub-Saharan Africa despite ongoing public health interventions. Our review highlights two important findings. First, the increasing resistance of malaria parasites to artemisinin-based combination therapy (ACT) and its partner drugs coupled with increased vector resistance to pyrethroids and insecticides is reversing the progress of public health interventions in keeping malaria under control. Second, the wanning for the efficacy of the WHO-approved vaccine i.e. RTS,S from 60 to 70% following 18 months of observation, and its short-term availability remains an impediment to achieving the WHO target of producing malaria vaccines with more than 75% efficacy by 2030. Our findings underline the need to reassess research priorities with a focus on vaccine production in sub-Saharan Africa. Furthermore, African governments and policymakers must be committed to invest both the political and financial capital in vaccine production and distribution. •Malaria remains a challenging health threat in sub-Saharan Africa despite ongoing public health interventions.•Rising resistance of malaria parasites to Artemisinin-based Combination Therapy (ACTs) and its partner drugs coupled with increased vector resistance to pyrethroids and insecticides have been reported.•Research priorities need to be reassessed with a focus on vaccine production in sub-Saharan Africa.•Investing political and financial capital in malaria vaccine production and distribution by the African government and policymakers is the best strategy for control.