The potential public health consequences of COVID-19 on malaria in Africa

Ellie Sherrard-Smith, Alexandra B. Hogan, Arran Hamlet, Oliver J. Watson, Charlie Whittaker, Peter Winskill, Fatima Ali, Audu B. Mohammad, Perpetua Uhomoibhi, Ibrahim Maikore, Nnenna Ogbulafor, Jamilu Nikau, Mara D. Kont, Joseph D. Challenger, Robert Verity, Ben Lambert, Matthew Cairns, Bhargavi Rao, Marc Baguelin, Lilith K. WhittlesJohn A. Lees, Sangeeta Bhatia, Edward S. Knock, Lucy Okell, Hannah C. Slater, Azra C. Ghani, Patrick G.T. Walker, Okefu Oyale Okoko, Thomas S. Churcher*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

34 Citations (Scopus)


The burden of malaria is heavily concentrated in sub-Saharan Africa (SSA) where cases and deaths associated with COVID-19 are rising1. In response, countries are implementing societal measures aimed at curtailing transmission of SARS-CoV-22,3. Despite these measures, the COVID-19 epidemic could still result in millions of deaths as local health facilities become overwhelmed4. Advances in malaria control this century have been largely due to distribution of long-lasting insecticidal nets (LLINs)5, with many SSA countries having planned campaigns for 2020. In the present study, we use COVID-19 and malaria transmission models to estimate the impact of disruption of malaria prevention activities and other core health services under four different COVID-19 epidemic scenarios. If activities are halted, the malaria burden in 2020 could be more than double that of 2019. In Nigeria alone, reducing case management for 6 months and delaying LLIN campaigns could result in 81,000 (44,000–119,000) additional deaths. Mitigating these negative impacts is achievable, and LLIN distributions in particular should be prioritized alongside access to antimalarial treatments to prevent substantial malaria epidemics.

Original languageEnglish
Pages (from-to)1411-1416
Number of pages6
JournalNature Medicine
Issue number9
Publication statusPublished - 1 Sep 2020
Externally publishedYes

Bibliographical note

Funding Information:
This work was supported by funding from the UK Medical Research Council under a concordat with the UK Department for International Development (no. MR/R015600/1 to M.B, L.O, P.W., A.G. and T.C), the Wellcome Trust (no. 200222/Z/15/Z to T.C.) and the Bill and Melinda Gates Foundation (to A.G.). We thank all those who facilitated collation of the data provided by the NMEP in Nigeria. The maps in the figures were prepared using GADM v.3.6.

Publisher Copyright:
© 2020, The Author(s), under exclusive licence to Springer Nature America, Inc.


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