Uganda Grapples With Malaria Burden Amidst Promising Innovations

The latest World Malaria Report released by the World Health Organization (WHO) paints a vivid picture of the global battle against malaria, with Uganda standing out as one of the high-burden countries. Despite decades of interventions, malaria stubbornly remains the leading cause of illness and death in Uganda, particularly among children under five years old and pregnant women. The disease, transmitted by the unapologetic female Anopheles mosquito, continues to challenge public health, economic development, and social progress.

The Malaria Burden in Uganda

According to the report, Uganda, with a population of close to fifty million people, accounts for 5% of the world’s malaria cases and 3% of malaria-related deaths. Astonishingly, according to page 151 of the report, Uganda leads the East and Southern African countries with 23% of malaria cases and high transmission rates, beating even Mozambique, which comes in second at 19%. It’s not exactly the kind of competition anyone wants to win.

Malaria’s economic toll is just as staggering. Families lose loved ones, and resources that could have contributed to building roads, schools, create jobs are diverted to fight malaria. Children – the main victims of malaria – lose access to education and young children often die (80% of malaria deaths are children under five). Pregnant women are at high risk of losing their babies and their lives because malaria in pregnancy puts them in grave danger.

Current Intervention

Uganda’s government, together with partners like WHO, has declared a fight against malaria. This includes distributing insecticide-treated mosquito nets (ITNs), spraying homes with indoor residual insecticides (IRS), and ensuring early diagnosis through rapid diagnostic tests (RDTs). Treatment relies heavily on artemisinin-based combination therapies (ACTs), which remain a mainstay in the battle against the disease.

While these measures have shown results–malaria prevalence has declined slightly over the last decade–progress is hampered by challenges like insecticide resistance, inadequate healthcare in remote areas, and insufficient funding. Not to mention the eternal struggle of getting children to sleep under the mosquito net and fishermen not to use it as one of their equipment to trap silverfish locally known as “Mukene”.

Gene Drive Technology: A Game-Changer?

Amid these challenges, hope emerges in the form of a genetic technology called “gene drive”, currently under development, and championed by Target Malaria at the Uganda Virus Research Institute in Entebbe. This cutting-edge approach involves genetic modifications to the Anopheles gambiae mosquito, the main malaria carrier in Uganda.

Gene drive aims at disrupting the mosquito population by ensuring genetic changes–like female sterility or an abundance of male offspring–are passed on disproportionately. Over time, this could drastically reduce the population of malaria-carrying mosquitoes and, with it, malaria transmission. Excellent scientists, biologists and or mosquito-specialists, recognised in their field, are working hard at Uganda Virus Research Institute, to one day make this tool available after it has one a full range of field evaluations. Gene drive is a promising tool which, combined with existing interventions, could strongly decrease malaria cases as one of our recent studies suggests. Dr. Kayondo Jonathan, Principal Investigator with Target Malaria Uganda, explains, “Gene drive technology is not a standalone solution but a complementary tool. Combined with existing interventions, it could bring us closer to a malaria-free Uganda.”

Community at the Forefront

Target Malaria Uganda recognizes that groundbreaking technology means little without community buy-in. Stakeholder engagement is central to the project’s work, and it is important for us to ensure that people understand the project’s mission, values and objectives. We were honoured to recently receive the visit of stakeholders from Lwazi Jaana, Kansambwe, and Lwazi Bubeke islands on Lake. It was an opportunity to discuss Target Malaria activities and phases of research and deepen the relationships between the project and local communities.

The Road Ahead

The fight against malaria requires continued investment, innovation, and community involvement. Traditional interventions like ITNs and ACTs remain crucial, but integrating novel tools such as gene drive technology could prove transformative.

The World Malaria Report calls for global solidarity and increased funding to eliminate malaria, a call that Uganda cannot ignore. While the dream of a malaria-free Uganda might sound ambitious, innovative interventions offer a glimmer of hope for high-burden countries such as Uganda.

If all stakeholders–governments, researchers, and communities–rally together, we can work towards making that dream a reality, for us or the next generation.

By Independent (Kampala).