The COVID-19 pandemic has spread across 178 countries around the world. As of April 2020, there are no cures or vaccines available for this highly-contagious viral infection, and most global as well as local healthcare systems are being tested beyond their limits due to this public health emergency.

While such immense pressure on public healthcare systems is quite normal during a pandemic, both in developed as well as developing countries, one must also take into account the existence and outbreak of other diseases that plague the world seasonally. Malaria, a common disease that recurs in parts of Asia, Africa and South America, is a present and constant threat that claims over 800,000 deaths each year.

It’s important to remember during this time that simply because the COVID-19 infection is the major global threat currently, neither the malaria-causing parasite known as Plasmodium nor the female Anopheles mosquito which spreads malaria will take a pandemic into consideration and minimise the threat of malaria. 

Instead, and especially in countries like India, disruptions in healthcare services and preventive measure protocols could lead to an outbreak of malaria during the summer and monsoon months of 2020, as the World Health Organization has already pointed out. Hence, it is important to resume preventive measures for malaria to minimise the risk of adding a malaria outbreak on top of the COVID-19 pandemic.

  1. Why is malaria a cause of concern during the COVID-19 pandemic?
  2. Why is malaria a huge concern for India?
  3. Preventive measures to keep malaria at bay
  4. Takeaways
Doctors for Malaria and COVID-19

The WHO, healthcare professionals and people living in the most at-risk areas are aware of the impact malaria has on susceptible countries every year. This is the reason why the WHO made a special appeal to all nations at risk of malaria outbreaks every year, especially African countries, to not scale back on pre-planned malaria prevention, diagnostics and treatment activities. 

These strategies - which have taken years of dedication and work to implement in most affected countries - are a key step in reducing the strain on health systems, especially during the rapid spread of a pandemic like COVID-19. It’s understandable that these malaria prevention strategies might not be the focus currently because of the COVID-19 pandemic, but efforts need to be made to ensure that these strategies are not completely abandoned because this could be a cause of concern later for the following reasons.

Disruptions in regular healthcare services

The WHO, which has experience in dealing with outbreaks and epidemics across the globe, has underlined the fact that efforts to sustain the preventive strategies against malaria is even more important during a pandemic because healthcare systems - which are anyways strained - would be completely overwhelmed if there was to be an outbreak of a disease like malaria. For example, during the Ebola outbreak in 2014-2016, three African countries were unable to focus on malaria-control measures and this soon led to a massive malaria-related death toll rise in all three nations. 

During a highly contagious and rapidly spreading pandemic like COVID-19, a malaria outbreak in any nation - and especially in a nation which is already struggling to procure enough COVID-19 testing kits, ventilators, personal protective equipment (PPE), etc to  provide care for its population - could be catastrophic and cause even more devastating death tolls than even COVID-19 has. 

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Shutdown of preventive measures like spraying

With most COVID-19 affected countries including India under partial or complete lockdowns, government recommended preventive measures against malaria have been suspended or even postponed. The suspension of insecticide-treated net (ITN) and indoor residual spraying (IRS) can lead to the unhindered growth of vector mosquitoes and lead to a malaria outbreak as summer and monsoon seasons arrive.

This apart, most people themselves are worried about getting infected with COVID-19 and practicing social distancing, handwashing, respiratory hygiene, etc. While taking preventive measures against COVID-19 is urgent and compulsory, family units must also take the regular mosquito-repellent measures used to prevent malaria. This could also help prevent a malaria outbreak at the local level.

Limited scope of routine malaria control approaches

With the entire healthcare system of most affected nations focused on containing the spread of COVID-19, there is a dearth of healthcare workers, protective equipment like masks, long-lasting insecticidal nets, anti-malaria aerosolized sprays, and rapid diagnostic tests. This suggests that regularly or annually conducted malaria control measures, which cannot be conducted without any of these essentials, have a limited scope of actually getting them done while the COVID-19 pandemic continues to spread.

Until a semblance of normalcy is brought back to ascertain a somewhat routine function of healthcare systems, executing malaria control strategies may well be beyond the grasp of developing nations. As the WHO points out, coordinated action is required to ensure the availability of malaria prevention and control tools, and countries with a high burden of malaria need to assure these steps despite the COVID-19 pandemic.

Clinical trials for COVID-19 with malaria medications

There are a number of ongoing clinical trials all over the world to respond to the COVID-19 infection. Some of the key trials are working with chloroquine and its derivative, hydroxychloroquine, to ascertain if these drugs can be used with other existing drugs (or without them) to prevent or cure COVID-19. While there is no conclusive data regarding the use of chloroquine to either prevent or cure COVID-19 yet, the demand for this medication can have potential consequences for a malaria outbreak in any part of the world.

This is simply because chloroquine and hydroxychloroquine are WHO-approved medications used to treat Plasmodium vivax malaria worldwide. If the medicine on which the current treatment of malaria depends on is short on supply due to excessive demand, or misused, it can make a potential malaria outbreak much more difficult to handle - especially when healthcare systems are already dealing with a public health emergency in the shape of a pandemic.

According to a study published in the Indian Journal of Medical Research in 2018, India has had a positive link with malaria ever since Dr Roland Ross of the Indian Medical Service announced in 1897 that the malaria parasite was carried and transmitted by mosquitoes - leading health scientists to figure out ways to prevent and cure malaria in subsequent years. Still, malaria outbreaks are common in present-day India, especially due to the tropical climate, heavy monsoons and water-logging. 

In 2015, India joined 17 other countries in the Asia Pacific region to endorse a plan to eliminate malaria from the world by 2030. India further pledged to make this plan a reality by eliminating malaria by 2027 - three years ahead of the regional and global target. 

This was a daunting task to begin with, given that India still carries a huge burden for malaria every year. According to India’s National Health Portal, India was able to control the burden of malaria to a large extent with the number of cases declining from 2.08 million in 2001 to four lakh in 2018. This was done through the rigorous pursuit of the National Framework for Malaria Elimination (2016-2030) and the National Strategic Plan (NSP).

Given that India is one of the countries to be affected by COVID-19, and is currently in the second stage of transmission, it’s important for the nation’s healthcare system and government to make sure that this pandemic does not diminish the efforts to contain a recurring disease like malaria. Not only would this overwhelm the healthcare system and claim more lives, but it would also render useless all previous attempts made to eliminate malaria for good.

Despite the rapid spread of COVID-19, it’s important to continue all possible preventive measures and strategies against a malaria outbreak in India as well as other countries with a heavy burden of the disease. The following are some vital steps you must take to prevent malaria:

  • Avoid stagnating water or water logging around in and around your homes.
  • Eliminate all breeding grounds of mosquitoes in and around the house.
  • Use mosquito repellent creams, sprays, liquids, coils, etc to prevent mosquito bites.
  • Screen your houses, especially doors and windows, with wire meshes and nets.
  • Use bed nets or mosquito nets while sleeping at night.
  • Call your local councillor or municipal department if you see mosquito breeding in and around your home.
  • If you observe any symptoms of malaria in yourself, a loved one, or anybody in the neighbourhood, call the doctor or emergency health services.
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While healthcare workers and medical staff all over the world ramp up their efforts in the battle against containing the spread of COVID-19 that has claimed several lives across the globe, it is important to keep in mind other diseases and infections plaguing a certain region. Malaria, for instance, is a common occurrence in tropical countries, including India.

The ongoing trials to treat COVID-19 patients also includes medications used to treat patients suffering from malaria, and an increased load to treat the current global pandemic may also result in a shortage for the disease it is originally meant for. Governments and authorities, at this time, must focus their attention on not only containing the COVID-19 pandemic, but also prepare themselves adequately for all possible eventualities, including a malaria outbreak in the coming summer months and the monsoon.

Dr Rahul Gam

Dr Rahul Gam

Infectious Disease
8 Years of Experience

Dr. Arun R

Dr. Arun R

Infectious Disease
5 Years of Experience

Dr. Neha Gupta

Dr. Neha Gupta

Infectious Disease
16 Years of Experience

Dr. Anupama Kumar

Dr. Anupama Kumar

Infectious Disease

Medicines / Products that contain Malaria and COVID-19


  1. World Health Organization [Internet]. Geneva (SUI): World Health Organization; Malaria and the COVID-19 pandemic
  2. World Health Organization [Internet]. Geneva (SUI): World Health Organization; WHO urges countries to ensure the continuity of malaria services in the context of the COVID-19 pandemic
  3. Kumar, A. et al. Burden of Malaria in India: Retrospective and Prospective View. In: Breman JG, Alilio MS, White NJ, editors. Defining and Defeating the Intolerable Burden of Malaria III: Progress and Perspectives: Supplement to Volume 77(6) of American Journal of Tropical Medicine and Hygiene. Northbrook (IL)
  4. Narain, Jay Prakash and Nath, Lalit M. Eliminating malaria in India by 2027: The countdown begins!. Indian J Med Res. 2018 Aug; 148(2): 123–126. PMID: 30381533
  5. Das, Aparup. et al. Malaria in India: The Center for the Study of Complex Malaria in India. Acta Trop. 2012 Mar; 121(3): 267–273. PMID: 22142788
  6. World Health Organization [Internet]. Geneva (SUI): World Health Organization; World malaria report 2019
  7. National Health Portal [Internet] India; World Malaria Day 2019
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