The five-year anniversary of a global pandemic: How Malaria Consortium weathered the storm

This year marks five years since health agencies sounded the alarm that a pandemic was afoot.

In marking the anniversary, Malaria Consortium has been reflecting as an organisation on the biggest lessons of this challenging time, from the perspective of a global health organisation dedicated to combating infectious diseases and ensuring the continued delivery of essential services to communities who need them most.

As concerns began to surface towards the end of 2019 about a novel flu virus emerging in Wuhan, Malaria Consortium was taking note. By the time that the World Health Organization declared COVID-19 a public health emergency in January 2020, we had already begun scenario planning. The organisation’s deep technical knowledge, particularly in outbreak management and infection prevention and control, informed its decisive action, closing the London office two days before the UK government ordered a lockdown.

The immediate pressing concern was the risk that the emergence of COVID-19 could mean other devastating diseases, such as malaria, would fall by the wayside.

A pandemic would cause severe disruptions to the malaria services the organisation carries out, meaning lives would be compromised. The WHO predicted that the disruption caused by the pandemic could lead to double the number of deaths from malaria. The challenge ahead: to continue to carry out those services as much as possible while also limiting the transmission of COVID-19.

Although the organisation was better equipped than most others to deal with a public health emergency, the pandemic was still on a scale no one could ever have predicted. Not only that, but its ever-changing nature required constant agility.

Weathering the storm

Programmes such as our seasonal malaria chemoprevention (SMC) work require delivery on precise timescales, specifically before the rainy seasons, when malaria transmission peaks. A pandemic threatened to throw these delicate plans into chaos, with disastrous consequences for the many lives that depend on them.

Despite this, Malaria Consortium was able to continue to deliver crucial care to the communities with whom we work. Malaria Consortium’s proactive and evidence-based approach during the COVID-19 pandemic ensured that essential malaria services continued despite significant disruptions and uncertainty. Malaria prevention and control services in Nigeria were not only maintained but actually increased in some cases. We helped to develop guidance for countries that advised on how to roll out SMC activities while still aligning with national COVID-19 responses. This ensured the safety of communities and health workers while maintaining essential malaria prevention efforts.

Our well-built systems meant that we could quickly pivot our efforts to COVID-19; for instance, Malaria Consortium helped to lead on the distribution of these crucial vaccines in some of the regions where we work, such as South Sudan, and of personal protective equipment (PPE) to frontline health workers in Uganda. In other areas, operations were able to simply continue as usual, owing to the resilience of the systems that Malaria Consortium had put in place. In Cambodia, mobile malaria workers were already equipped with masks and gloves, as well as sanitisers, and didn’t have to contend with limited stock like so many others. In other countries, such as Mozambique, the organisation adapted upSCALE, an existing digital platform, to help community health workers to respond to COVID-19 alongside case management for other diseases, including malaria and pneumonia.

Lessons learnt

Despite the rapid collective action of the global health community in response, the pandemic laid bare the true reality of global health inequity. Resource-limited countries were often the last to receive the vaccine doses, despite being the most at risk to fallout of the virus.

The situation was a major global wakeup call to the need for better disease surveillance and healthcare systems, particularly in low- and middle-income countries. Malaria Consortium devotes significant resources in supporting national governments to embed robust surveillance, monitoring and evaluation systems within health programmes and infrastructure. Facilitating accurate gathering of disease intelligence empowers decision-makers with timely, actionable health data, making it possible to react quickly and appropriately when a new threat emerges. When the pandemic arose, it was this crucial work that meant the organisation could play a key role in the response.

COVID-19 shone a light on how quickly action can be taken when the need presents itself, driven by political will and global commitment to a common cause. The COVID-19 vaccines were developed and rolled out in record time, illustrating that the same can be true for other infectious diseases.

The pandemic highlighted the importance of close relationships with national health programmes and country health authorities, and of sharing technical knowledge and the use of evidence to adapt quickly to changing circumstances during the pandemic. As our own collaboration with governments, cultivated over many years, demonstrated, we could continue to protect and save lives.

“The pandemic reinforced the power of collaboration and adaptability; it challenged us to rethink our delivery approaches and deepened our commitment to strengthening health systems,” says Dr Kolawole Maxwell, Director of Programmes for West and Central Africa at Malaria Consortium. “Despite the hurdles, we successfully distributed millions of insecticide-treated nets, provided life-saving malaria treatments, and ensured that preventive campaigns reached even the most vulnerable populations. The experience has only fortified the resolve to push for malaria elimination, no matter the obstacles,” he says.

The lessons learnt from this experience have deeply informed our ongoing work, and emphasised the importance of strong infrastructure, such as surveillance, and of the collective action and communication between countries to safeguard their communities against future outbreaks. As the world moves beyond COVID-19, we hope these insights into resilience, adaptability, and leadership in global health crises will continue to inform our own and others’ responses to future pandemics.

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