We have lived with the reality of COVID-19 as a global pandemic for over 12 months and it has been a year of intense public health efforts. As Malaria Consortium remains committed to disease burden reduction across all of our programmes, we have sought to mitigate the risks of transmitting COVID-19 whilst continuing to help ensure access to essential services for malaria, pneumonia, diarrhoea and dengue. We have continued to collaborate with ministries of health and civil society partners, to adapt the delivery of key interventions and help ensure essential health services are not disrupted.

There have of course been challenges; ensuring adequate personal protective equipment (PPE), adapting to remote training, supply chain issues, a shifting of health staff from existing areas of the health system to a pandemic response, to name only a few. But there have also been extraordinary positives. It has been encouraging to see that key malaria interventions have continued to be viewed as essential services in many countries and interventions at scale, like that of seasonal malaria chemoprevention (SMC), were able to continue. In practical terms, this means that an estimated 20 million children under the age of five received the necessary drugs to significantly reduce their risk of contracting malaria.

As an organisation, we have sought to respond to these extraordinary set of circumstances by drawing on our technical and research expertise, our experience delivering interventions at scale and our integration of surveillance and data that enables us to maximise our ability to respond, innovate and facilitate decision-making. Our work over the last year has looked to meaningfully contribute to the solutions that are needed to reduce disease burden, improve health outcomes and strengthen health systems – solutions that can and will emerge as positives from this pandemic.

Some of this work has included research to understand the burden chiefly of malaria among patients with COVID-19 and to assess the clinical consequences of potential interactions, our findings will be released very soon. Research like this is crucial in countries in sub-Saharan Africa that carry a disproportionately higher share of the global burden of malaria and other infectious diseases. The potential impact of COVID-19 on the diagnosis, prevention and treatment of endemic diseases is of even greater concern.

In light of this, we have also adapted our work with frontline health workers (FLHWs) who play a critical role in managing infectious diseases and for whom the COVID-19 outbreak has made this work even more challenging. In Uganda, we are developing the capacity of FLHWs to screen for symptoms associated with COVID-19 while continuing to provide community case management services safely, accurately and with the right tools and support. In Mozambique, we have similarly supported the country’s community health workers, known locally as agentes polivalentes elementares (APEs), to respond to the pandemic by providing COVID-19 health messages and resource allocation information. This was made possible through adaptations made to Mozambique’s existing upSCALE digital platform – a digital health app created as part of a previous Malaria Consortium-led project that all APEs are able to use in the remote settings they live and work in.

The pandemic has highlighted the potential of digital health tools to provide solutions to improve diagnosis, treatment and prevention of disease, information exchange, real-time data capture, effective management of resources and more integrated health systems with robust monitoring, surveillance and interventions. Our projects demonstrate how digital health solutions can be used in low resource settings to help strengthen pandemic response, making health systems stronger and more resilient and we hope the momentum and investment in these kinds of solutions will be continued.

COVID-19 has been an unavoidable reminder of the importance of resilient health systems that are able to provide equitable health outcomes and help underpin social, economic and political stability. The pathway to universal health coverage is both complex and context-driven and the development of a number of COVID-19 vaccines will now fundamentally shape this pathway. COVAX, the global initiative to ensure rapid and equitable access to COVID-19 vaccines for all countries, regardless of income level, have begun shipments of life-saving vaccines to a small handful of countries in Africa. We welcome this initiative and hope to see the number of available vaccines in low-income countries continue to grow. We must look to this vaccination roll out as an opportunity to strengthen primary health care across the board, to ensure that rapid and equitable access is possible and ensuring that front line health workers and the most vulnerable are prioritised.

The availability of an effective vaccine and developing the necessary mechanisms to appropriately distribute it to whole communities are however, not the only challenges. Overcoming potential vaccine hesitancy, particularly amongst those who perceive the risk of illness as distant to themselves, will be vital. Through Malaria Consortium’s research and implementation, we have found that social and behaviour change activities at a community level have a significant role to play in increasing awareness and understanding of disease prevention and interventions. Integrating these activities into existing health systems and utilising existing human resources, such as community health workers, to undertake these activities is critical to the success of the any effective vaccination programme.

What has been achieved so far has been extraordinary. We are both thankful to our implementing partners and supporters and committed to improving health outcomes for the communities we serve. As we continue to respond to the impact of the pandemic, we’ll do our best to support wherever we can. Whether this be in providing our expertise to assist with planning and roll out of vaccines in the regions that we work, or in supporting health care workers to protect themselves and their communities from COVID-19 and from other infectious diseases. If we can leverage our existing distribution networks to be of help or provide guidance on risk-based approaches, we will. Ultimately, we will continue to support communities, health teams and governments to build resilience into their health systems, ensuring they are equipped to respond in the future.

All of latest COVID-19 updates and resources can be found here.