Despite the progress recorded, “swamp fever” continues to kill more than 600,000 people each year. The vast majority of victims of malaria, which is transmitted to humans through the bites of certain mosquitoes, are found on the African continent.
“76% of victims are children under 5 years old, they are the ones who pay the heaviest price,” recalls Sylvie Manguin, research director at the Institute of Research for Development (IRD), attached to the university. from Montpellier. On this World Malaria Day, 20 minutes looks at the three main avenues for eliminating this disease also called malaria.
Impregnated mosquito nets
As the mosquitoes that transmit malaria bite at night, mosquito nets are powerful allies against the disease. “In the 1980s, the French Pierre Carnevale had the idea of impregnating mosquito nets with pyrethroid-based insecticides », recalls Sylvie Manguin who adds “this idea saved a lot of lives”. Between 2019 and 2022, the New Nets project delivered millions of mosquito nets soaked in two insecticides to combat the resistance of certain mosquitoes to pyrethroid.
“These are mosquito nets with one type of insecticide at the top of the fiber and another at the bottom of the fiber in order to kill even mosquitoes resistant to one of these products,” explains the research director. According to the backers of the New Nets project, this initiative helped prevent around 13 million cases and nearly 25,000 deaths in three years. “Technologies have evolved a lot,” notes Sylvie Manguin. Before, we had tablets and buckets of water and we soaked the mosquito nets in them. Today, at the heart of their very fiber, they have insecticide molecules. » Enough to allow more and more people to protect themselves from mosquito bites.
Heading towards vaccination
But to protect yourself, nothing beats vaccines. “We have been talking about a vaccine against malaria for a hundred years but we managed to design it very recently,” emphasizes Sylvie Manguin. In 2021, the very first malaria vaccine, “RTS, S”, was finally recommended by the WHO. Then at the end of 2023, the organization gave the green light for a second “safe and effective” vaccine for children, R21/Matrix-M. “As a malaria researcher, I dreamed of the day when we would have a safe and effective vaccine against malaria. Now we have two,” marveled the head of the WHO, Tedros Adhanom Ghebreyesus.
Especially since “these two vaccines have very satisfactory levels of effectiveness, around 75%”, welcomes Sylvie Manguin. However, it is difficult to imagine eliminating malaria by relying solely on these injections. “Production capacity is relatively limited at the moment. In addition, children must receive three doses each then a booster,” notes the research director. Enough to slow down optimal vaccination coverage. Especially since “having a vaccine is great”, it is not “the panacea” however, recalls Sylvie Manguin. “We saw it with Covid-19, people do not necessarily adhere to vaccination,” she slips.
Educate for better care
While almost every minute a child dies from malaria around the world, prevention remains essential. To administer the vaccine, we obviously need to work on getting the population to support it. “Trust, religion… For a thousand different reasons, many people refuse to be vaccinated or to have their child vaccinated,” recalls Sylvie Manguin.
However, many African countries are very involved. In March, eleven of them pledged to “end malaria deaths” by 2030. At the end of January, Cameroon – one of the most affected countries, implemented the first global malaria campaign. large-scale vaccination. “I worked in Angola and it is the adults who sleep under mosquito nets, not the children, even though they are the ones who risk dying,” remembers Sylvie Manguin. They believe that they must be protected from mosquito bites to avoid getting sick and thus continue to work. »
It is therefore essential to raise awareness among the population when “nearly half a million children die each year in sub-Saharan Africa, their immune systems not being developed enough to fight the parasite,” she recalls. The IRD research director, however, highlights the progress made over several years: “Algeria, Argentina, Belize… Since 2015, thirteen countries have been certified malaria-free by the WHO! » The organization hopes to reduce the global burden malaria by 90% by 2030.