Malaria will likely kill more people in sub-Saharan Africa in 2020 than COVID-19 as the pandemic causes disruptions to established public health initiatives and health care treatment protocols, according to the World Malaria Report published Monday by the World Health Organization (WHO).

There could be up to 100,000 excess malaria deaths, primarily among children under the age of 5, in the region in 2020 due to COVID-19-related disruptions, Reuters reported.

The World Malaria Report notes that COVID-19 has spread to all countries threatened by malaria, causing at least 22 million cases of the virus and 600,000 deaths. As these countries impose restrictions on the movement of people, malaria prevention services such as the dissemination of mosquito nets have been limited. Public health campaigns advising people with COVID-19-like symptoms to stay at home, meanwhile, may have inadvertently deterred people with malaria from seeking treatment. 

“The global health world, the media, and politics are all transfixed by COVID … and yet we pay very little attention to a disease that is still killing over 400,000 people every year, mainly children,” Pedro Alsonso, director of the WHO’s malaria program, told reporters at a briefing on Sunday, according to Reuters.

“And to remind you, this is a disease we do know how to get rid of — so it is a choice that we don’t,” he added. 

Malaria is transmitted by female mosquitoes carrying the parasite. When one of these mosquitoes bites someone, they can become infected with the disease and experience a range of flu-like symptoms. The report notes that children under the age of 5 are the most vulnerable to the disease, accounting for 67% of malaria deaths in 2019. The vast majority of cases — roughly 94% — occur in Africa. 

The World Malaria Report looks at the state of the disease, progress that has been made over the past two decades, and recent setbacks. 

In 2000, 239 million people became infected with malaria and 736,000 people died from it. Around this time, funding for malaria initiatives greatly increased — including for the Global Fund to Fight AIDS, Tuberculosis, and Malaria — leading to steep declines in malaria deaths over the next several years. 

By 2019, there were nearly 2 billion additional people on Earth compared to the turn of the millennium. Despite this explosive population growth — concentrated mainly in countries affected by malaria — cases of the disease declined to 228 million in 2019, and annual deaths plummeted to 409,000. The mortality rate among threatened populations halved during this period and 21 countries managed to eliminate the disease within their borders. 

Starting around 2016, however, progress against malaria began to plateau as funding dried up. Since then, annual deaths have remained virtually unchanged. Countries achieved a sort of grim stalemate with the disease until COVID-19 arrived.  

While the pandemic has worsened the global malaria crisis, it has also exposed the complacency surrounding the disease and could usher in a resurgence of attention and funding for malaria prevention and treatment, the report argues.

After all, scientists know how to stop malaria — countries must distribute mosquito nets and spray insecticide; provide anti-malarial drugs; conduct surveillance campaigns to pinpoint malaria hotspots; expand testing and treatment availability; and scale up funding for the first malaria vaccine.

The WHO calls on all countries to fund these efforts to achieve a 90% reduction in malaria prevalence globally by 2030. In other words, the WHO wants to bring annual malaria deaths to under 40,000 a year within a decade — a monumental public health achievement that would improve the lives of hundreds of millions of people. 

“It is time for leaders across Africa – and the world – to rise once again to the challenge of malaria, just as they did when they laid the foundation for the progress made since the beginning of this century,” Dr. Tedros Adhanom Ghebreyesus, WHO director-general, said in a statement. 

He added: “Through joint action, and a commitment to leaving no one behind, we can achieve our shared vision of a world free of malaria.”