Krystal Birungi, a field entomologist from Uganda and an advocate for investment in fighting malaria, spoke about the release of the World Health Organisation’s World Malaria Report 2024, In December, Krystal visited the House of Commons to call for increased funding to combat the disease, which claims the life of one child every minute in Africa.
Malaria remains one of the leading causes of death on the African continent, which bears the heaviest burden of the disease. In 2023, Africa accounted for an estimated 94% of global malaria cases and 95% of malaria-related deaths.
Here she shares her thoughts on the new World Malaria Report.
Malaria continues to be a huge public health threat
Malaria claims a lot of lives and mostly young lives. In 2023, the number of deaths was estimated at 597,000 globally. In Africa, where most of the cases and registered deaths occur, 76% of lethal cases were among children aged under 5 years.
Although there have been breakthroughs, such as the WHO-recommended malaria vaccine, which 17 countries have introduced through childhood immunisation programmes, figures show we are not on track for malaria elimination by 2030.
Additionally, mosquito resistance to insecticide-treated nets, antimalarial drug resistance, and the spread of Anopheles stephensi among others are growing concerns in malaria-endemic countries.
That is not to say that what we’ve done so far has been futile. Far from it – since 2000, malaria control efforts have helped avert 2.2 billion cases and 12.7 million deaths worldwide. In 2023 alone, more than 177 million cases and 1 million deaths were estimated to have been averted globally.
80% of averted cases and 94% of averted deaths were in the WHO African Region, highlighting the huge gains we make from targeted policy and investment in this region.
Many countries with a low burden of malaria, such as Rwanda and Liberia in the WHO Afro region, continue to move steadily towards the goal of elimination. These two countries demonstrated impressive reductions in malaria cases, with an 85% decrease in Rwanda since 2019 and a 44% decrease in Liberia since 2017. In 2023, more than half of the 83 malaria-endemic countries worldwide reported less than 10,000 cases of the disease.
However, many challenges such as funding gaps, poverty, climate change, humanitarian emergencies such as conflicts, and lack of access to essential health services jeopardise the progress already made.
Although the findings from this year’s report lay bare the heavy burden of malaria in Africa, they also paint a hopeful picture around the opportunities to accelerate progress. With the right investment, research and development, community engagement and political will, it is possible to reverse the trends and accelerate progress towards malaria elimination. Now is the time to act.
Advocating for Africa
As someone who has experienced malaria firsthand, I wanted to share my personal story of growing up in Uganda, a malaria-endemic country, to stakeholders in the UK. Malaria remains a leading cause of death and illness in Uganda, responsible for 14% of all hospital deaths, 25% of hospital admissions, and up to 40% of outpatient visits.
It disproportionately affects the poorest, least educated, and most vulnerable – especially children, pregnant women, adolescent girls, and those in remote areas.
I’ve personally faced some of these challenges or known people who have, and I feel it’s crucial to raise awareness. As a spokesperson for Target Malaria, I wanted to emphasise the need for continued investment in malaria research and innovation, as well as the development of bold approaches to fight this disease.
When I’m not speaking at events on malaria and campaigning, I work as an entomologist with Target Malaria at the Uganda Virus Research Institute, in Entebbe. We are developing a promising genetic technology called gene drive in collaboration with research institutions like Imperial.
Our aim is to engineer mosquitoes that to bias the rate of inheritance and pass on a genetic modification – in our case female sterility – to all their offspring.
Over time, we hope our gene drive mosquitoes would lead to sufficient reduction of the malaria mosquitoes to stop the transmission of the disease.
During my week in the UK, I met with my colleagues from the Imperial’s Department of Life Sciences, at the Crisanti Lab in South Kensington to discuss the latest developments of our work at Target Malaria Uganda.
Last May, the team in Uganda imported for the first time a non-gene drive genetically modified mosquito that we call “male bias”. This strain was originally developed at Imperial. So, it was fascinating to share our experience studying this strain in our lab in Entebbe while the team in London still has it in their insectary.
On that note, I recently participated in a fascinating campaign called The Zero Malaria Experience. Using data on malaria provided by Imperial (Professor Azra Ghani’s modelling team), the campaign visualised the progress made in combating malaria, showing how prevention measures and treatments have saved lives. Since 2000, malaria control efforts have averted 2.2 billion cases and 12.7 million deaths worldwide.
It was a privilege to be part of the campaign, lending my voice to the film alongside figures like David Beckham, WHO’s Dr. Tedros Adhanom Ghebreyesus, RBM’s Dr. Michael Charles, and other inspiring members of the malaria community.
Krystal Birungi, Entomologist at the Uganda Virus Research Institute, Target Malaria Uganda & Global Fund Advocates Network Speaker