Public Health Solutions Africa

Advancing Malaria Control in Africa: Which Interventions Work Best?

PH

Apr 04, 2025By Public Health Solutions Africa

Context

Malaria continues to be one of Africa’s most pressing public health challenges, causing hundreds of thousands of deaths annually, especially among young children and pregnant women. With limited resources, it's critical to choose interventions wisely. Let's explore current malaria strategies and compare their cost-effectiveness to guide smart investments.

Effective Malaria Interventions in Africa
1. Vector Control
Long-lasting Insecticide-treated Nets (LLINs) are simple yet powerful, reducing malaria by nearly half when properly used. They remain one of the most reliable interventions, protecting families for 3–5 years.
Indoor Residual Spraying (IRS) involves spraying insecticides inside homes, significantly reducing mosquito populations. It's especially effective in areas of high transmission.

2. Chemoprevention

  1. Seasonal Malaria Chemoprevention (SMC) provides preventive medicines to children during high-risk months, reducing malaria cases by about 75% in eligible regions.
  2. Intermittent Preventive Treatment in Pregnancy (IPTp) uses safe medicines during antenatal visits to protect pregnant women and unborn children, dramatically improving birth outcomes.

3. Rapid Diagnosis and Treatment

Rapid diagnostic tests (RDTs) combined with prompt treatment using Artemisinin-based Combination Therapies (ACTs) offer swift, life-saving care at low cost, significantly reducing severe illness and death.

4. Malaria Vaccines

  1. RTS,S (Mosquirix), the first WHO-approved malaria vaccine, provides modest protection (~36%) and has been rolled out in pilot programs across Ghana, Kenya, and Malawi.
  2. R21/Matrix-M, a newer vaccine, offers higher protection (~75%) at a lower cost and is already being distributed in Nigeria, Ghana, and other African countries.

Comparing Cost-Effectiveness
Making smart choices about interventions is critical. Here's how they stack up:

  1. Highly cost-effective interventions include prompt diagnosis and ACT treatment, seasonal chemoprevention (SMC), and preventive treatment for pregnant women (IPTp), often costing under $50 per life-year saved.
  2. LLINs remain a robust and cost-effective option, particularly in rural or widespread transmission settings, with costs typically around $30–$60 per life-year saved.
  3. IRS, while effective, can be more expensive ($60–$120 per life-year saved) but remains essential in high-risk or insecticide-resistant areas.
  4. Vaccines are promising additions, with R21/Matrix-M significantly more cost-effective ($30–$80 per life-year saved) than RTS,S ($60–$200 per life-year saved), offering improved protection at a lower price.

The Power of Integrated Strategies
The greatest impact comes from combining these strategies. Countries experiencing high malaria transmission benefit significantly from integrating LLINs, IRS, SMC, IPTp, rapid diagnostics, effective treatments, and the new vaccines. Tailoring these interventions based on local transmission dynamics and community needs ensures resources are optimized and lives are saved.

Looking Ahead
Continued investment, community engagement, and vigilant monitoring of resistance and efficacy will determine future successes. As we move forward, strengthening local health systems and community participation will remain key in the fight against malaria.
Together, strategic intervention choices and integrated approaches hold the promise of significantly reducing malaria’s toll across Africa.