08 / 06 / 2021

Malaria is far deadlier in Africa than the coronavirus

No hospital in this rural community has recorded a covid-19 death. But another menace fills graves on a grimly predictable schedule. The seasonal downpours that soak the red dirt roads here nurture clouds of mosquitoes that spread malaria. Researchers call it a forgotten epidemic: The parasitic disease kills more than 400,000 people each year. Most victims are children in Africa.

The coronavirus pandemic, by contrast, has claimed about 130,000 lives on the continent in the past 15 months, according to World Health Organization estimates. Yet only the coronavirus has commanded a surge of global resources that fast-tracked vaccines, smashing development records and reshaping attitudes toward what is pharmaceutically possible.

Malaria cases worldwide have fallen with the rise of rapid diagnosis, bed nets and better drugs: Global mortality dropped by 60 percent from 2000 to 2019, according to the WHO. Deaths in Africa decreased by nearly a half over that period. But progress since then has ground to a near halt.

Before the pandemic rush, the mumps inoculation held the record for fastest lab-to-authorization time: Four years, achieved in the late ’60s.

The coronavirus shots completed in months were aided by extensive research already conducted on similar viruses, as well as advances in manufacturing. But it was enormous sums of money that got them over the finish line.

The United States alone poured more than $9 billion into coronavirus vaccine development. The world spent $7.3 billion into malaria-related research and development from 2007 to 2018, according to the WHO.

Researchers blame the disparity on market forces: The countries most devastated by malaria tend to be the poorest.

“You’re not going to get malaria in England anymore, or the U.S., so richer countries, which have the research budgets to tackle these tropical diseases, have to spend the right amount of money to make an impact,” said Adrian Hill, director of the Jenner Institute. “It does seem odd that malaria, at least for Africa, is not considered an equivalent priority when there’s this huge number of children dying every year.”

The slowest stage of vaccine creation is what the Burkina Faso team is tackling now: efficacy and safety tests on people. Usually, that involves three phases, each larger and pricier than the last.

The pandemic doses took the same testing journey — just simultaneously. Pharmaceutical companies, flooded with cash, chose to absorb the financial risk of doing so.

“It is crucial to increase funding for diseases like malaria that are far from being controlled,” Potet said. “Yes, there has been some progress. But threats like insecticide resistance, or resistance to medication, are looming.”

Malaria is a notoriously resilient killer. The parasite has been found in mosquitoes preserved in 30-million-year-old amber, meaning the disease has had ample time to mutate. Scientists have struggled for most of the past century to beat that genome puzzle.

Burkina Faso is one of six African nations that account for approximately half the world’s malaria deaths. The country of 20 million counts 11 million cases a year, which, on average, kill 4,000 people.

Cases spike with the wet season, when puddles turn to breeding grounds. Motorcyclists say the air is so thick with mosquitoes, it sometimes feels like they’re driving through rain.

The coronavirus, by comparison, seemed like a mild nuisance. The local hospital has confirmed two cases, and neither were serious. Burkina Faso’s biggest outbreak was in the capital, Ouagadougou, which recorded most of the nation’s 167 deaths.

Poverty is endemic in Burkina Faso, and five years of conflict, mostly in the countryside, has made it worse. Fighters linked to the Islamic State and al-Qaeda have forced more than a million people from their homes.

Many families cannot afford medication or gas money to get to a clinic. Infections deteriorate. Then comes tragedy.