In her small home in Bono East region of Ghana surrounded by her four children, Nsoh Abena, 44, sleeps under a mosquito net she received from the Ghana Health Services two years ago.
She says, “my net has many holes,” she gestures towards the bedroom in the old, run-down building in Kobeda II in the Kintampo North Municipality where she lives, adding, “All the nets have holes.”
She has just recovered from malaria, which also infected the two-year-old daughter she cares for.
She is a farmer and has to pay 150 Ghana Cedis (GHC150) for the medication needed to treat both herself and the child, whose life she feared was at risk.
World Health Organization (WHO) data shows that about 405,000 people died from malaria in 2018, with sub-Saharan Africa accounting for 94% of these deaths. More than two-thirds of the victims were under five. WHO warned in April of 2020 that the number of annual malaria deaths in sub-Saharan Africa could almost double this year because of the coronavirus pandemic, a level last seen 20 years ago.
The spread of COVID-19 has impacted the distribution of insecticide-treated bed nets and access to anti-malarial medication, with people wary of going to a doctor.
Aware of the risks, many countries are pushing ahead with campaigns aimed at reducing the numbers. Uganda is planning a nationwide mosquito net distribution program this year, the _rst since 2017, with about 27 million nets to be given out to 43 million people.
The distribution teams have started work, kitted out in protective gear and supported by a variety of governmental and NGO groups. With 3% of global malaria cases and deaths, Ghana is among the 15 highest-burden malaria countries in the world. Ghana reported the highest increase in absolute case numbers, (500,000 new cases) from 2017 to 2018, which represents a 5% increase versus 2017 levels (from 213 to 224 per 1000 of the population at risk). In comparison to 2015 levels, cases rose by 3%, from 217 to 224 of the population at risk. Deaths, on the other hand, fell by 12%, from 0.42 to 0.37 per 1000 of the population at risk.
As of January 18, there were more than 58,000 confirmed COVID-19 cases across Ghana this includes 1,924 active cases and 352 deaths, Health Experts and the government fear a second wave of the pandemic is raging and spreading like wildfire.
Immunologist and Research Fellow at the West Africa Centre for Cell Biology and Infectious Pathogens (WACCBIP), Dr Yaw Bediako says the new strain of Covid-19 detected at the Kotoka International Airport (KIA) has a higher transmissible rate than the previous strain, he said: “They (the new Covid-19 variant) are transmitted from persons to persons easily than the previous variant. The number of people that a single infected person can infect is significantly more.”
In several health centers across Ghana, outpatient attendance dropped sharply “and you could see that in two ways,” says Dr. Neema Rusibamayila Kimambo, World Health Organization (WHO) Acting Representative for Ghana.
“People were afraid to (see) health services thinking that they might actually be in contact with people with COVID-19. So, because of that fear, even people who needed access to health services were too scared to go.”
At Kunsu – also in Kintampo North, 25-year James Yambor is recovering from malaria. He says, “This time the mosquitoes are too much. We’re contracting malaria every day.”
James says he watch Ghana’s President deliver his 22nd National Update on COVID-19 on Sunday 17th January 2020 and shivered. “Yesterday I almost fainted when the President said he could impose a lockdown again if the cases continue to increase”. He added, “my worry is that we will all continue to talk about this coronavirus and forget about malaria, meanwhile malaria has killed more people in the last nine months than COVID-19’’.
Even before the outbreak of the COVID-19 epidemic, malaria resulted in 10,000 maternal deaths each year, with 11 million pregnant women in sub-Saharan Africa alone in 2018.
Malaria in pregnancy accounts for 11 percent of all newborn deaths and 20 percent of all stillbirths.
Chief Abubakar Mahama is the Chief Farmer at Suronuase. He says: “Mosquitos are not in a lockdown, they are still free. Why survive COVID-19 and die of malaria? If by the middle of the year when the rains are in, and at which time malaria and we are not done with Coronavirus, I believe malaria will kill more people because the country will spend more resources fighting it at the expense of malaria.” He asked: “do you think the government will get money and distribute free mosquito nets again?”.
Insecticide-treated nets (ITNs) are one of the most cost-effective measures for preventing malaria. The World Health Organization recommends both large-scale mass distribution campaigns and continuous distributions (CD) as part of a multifaceted strategy to achieve and sustain universal access to ITNs. A combination of these strategies has been effective for scaling up ITN access.