Egypt makes malaria history, but there's no room for complacency

As an unwanted companion on humanity’s journey through the ages, malaria stands out for its sheer persistence. The mosquito-borne parasite can list prehistoric tribes, kings and queens, peasants and paupers among its victims. Even the disease’s English-language name is taken from antiquity – malus aer, Latin for “bad air”. It is not surprising therefore that malaria also wreaked havoc among the ancient peoples of the Middle East. Cuneiform tablets found in the Iraqi province of Nineveh refer to malaria-like fevers that sickened civilisations in Mesopotamia. Even the pharaohs of Egypt were not immune to what some called “Roman fever” – genetic evidence of the disease has been found in the mummies of famous rulers such as Tutankhamun. Malaria’s resilience is what makes this week’s news that the World Health Organisation has declared Egypt to be free of the disease such an important step forward, not just for one country but for humanity. Almost a century of hard work by the Egyptian people to banish a disease that has plagued the nation from ancient times is no mean feat. However, there is no room for complacency. According to last year’s World Malaria Report, of the 249 million cases recorded in 2022, about 94 per cent were in the WHO’s African Region and the estimated number of global malaria cases in 2022 exceeded pre- Covid-19 levels. That year, well over half a million people died from the disease. Research published by the London School of Hygiene and Tropical Medicine in 2021 has revealed that malaria can leave victims with long-term consequences, such as increased susceptibility to bacterial infection and cognitive impairment. In addition, given that pregnant women, infants and young children as well as refugees and migrants are disproportionately affected by malaria, it is clear that the momentum generated by Egypt’s achievement should be built on. There are realistic grounds to believe that malaria may, like smallpox, one day exist only in laboratories for medical study. The tools and strategies available in earlier times can now be replaced or complemented by increasingly advanced science and technology. In the UAE – a country that itself was declared malaria-free in 2007 after years of hard work – artificial intelligence forecasting tools are being developed that can help health authorities detect malaria outbreaks. The Emirates’ success in curbing the disease at home goes hand in hand with its support for eradication efforts in other nations. The Reaching the Last Mile initiative — a 10-year, $100 million fund launched by President Sheikh Mohamed in 2017 with support from the Bill and Melinda Gates Foundation has achieved much. Such initiatives help humanity move beyond fatalistic assumptions that malaria is just a fact of life that poorer, vulnerable people must put up with. Such innovation and financial support are needed more than ever. In April, the WHO said progress towards meeting targets on case incidence and mortality reduction “is seriously off track”. The organisation added that if current trends persist, its 2030 target for reducing cases will be missed by 89 per cent, while the target for reducing mortality will be missed by 88 per cent. So, while Egypt’s new status as a malaria-free country is undoubtedly good news for its 115 million people, it should also inspire redoubled efforts to consign this illness to the history books forever.