Covid-19 could set fight against malaria back by 20 years, top UAE disease expert says

Simon Bland, head of Abu Dhabi’s Global Institute for Disease Elimination, says hundreds of thousands could die if tropical diseases are forgotten

Bill Gates and Sheikh Mohamed bin Zayed, Crown Prince of Abu Dhabi, pictured with frontline health worker Rahane Lawal at the Last Mile Forum in Abu Dhabi in November, 2019. The event raised $2.6 billion for preventable diseases. Victor Besa / The National

The UAE has donated and raised billions for diseases such as polio and river blindness, which are little known outside Africa and Asia, but which afflict communities in the developing world. Hamad Al Mansoori for the Ministry of Presidential Affairs

Syrian refugee children line up to receive vaccinations against polio at a camp in Lebanon. Mohammed Zaatari / AP

A health worker administers a polio vaccination to a child in Raqqa, eastern Syria. Public health researchers say missing vaccinations contributed to the re-emergence of polio in the area. Nour Fourat / Reuters

Health workers tackle the Ebola outbreak in Liberia in 2014. Simon Bland said Africa's experience in tackling such outbreaks left it relatively well set up to tackle Covid-19. Wade Williams / AP

A Sinovac Biotech researcher holds a potential vaccine for coronavirus at the 2020 China International Fair for Trade in Services in Beijing, on September 5, 2020. Experts fear diverting resources to Covid-19 will have long-term implications for exotic diseases. EPA

The UAE is central to the broad effort to eradicate polio in Pakistan. Wam

Afghan female health workers mark a child’s finger on February 24, 2014, after administering polio drops outside her house in Jalalabad in Nangarhar province. Wakil Kohsar / AFP photo

A health worker administers a polio vaccine to a child in Karachi, Pakistan, on February 23, 2014, during a three-day nationwide campaign to eradicate polio. Afghanistan, Pakistan and Nigeria are the only three countries in the world where the disease is endemic, according to the Global Polio Eradication Initiative. Shahzaib Akber / EPA

An Emirates Red Crescent worker with a tiny patient in Pakistan. The UAE charity is ready to start rebuilding the country’s crisis-hit health system. Wam

Asseta Rouamba (L) stands with her daughter who receives malaria treatment at a health centre in Kaya, Burkina Faso on September 13, 2020. Kaya, the capital of the Centre-Nord region, has been overwhelmed with a massive influx of people forced to flee their homes by an Islamist insurgency. AFP

Diba Cisskho, 70, lost his eyesight to river blindness. His translucent eyes are the telltale sign of the disease, which is transmitted by black flies. Courtesy Ed Kashi

The burden of Covid-19 could set back the fight against malaria by 20 years and lead to hundreds of thousands of deaths, a former top UN official said.

Simon Bland, chief executive of the Abu Dhabi's Global Institute for Disease Elimination, said the impact of the pandemic has already set back eradication programmes for other diseases.

In the case of malaria, "the worst-case scenario is you get a doubling of deaths ... from about 400,000 now to almost 800,000", he told The National.

He estimated the fight against the disease, which kills thousands of children each year, could be set back two decades.

Progress against tuberculosis, HIV and polio, which is close to eradication, could also be lost.

The potential good news is Africa understands infectious disease. It's had community health, test and tracing - it's done a lot of things that we haven't done in the West

Researchers, governments and labs around the world have rallied to find a vaccine for coronavirus, diverting resources to tackle a disease that has killed at least a million people and left many with lasting symptoms.

Mr Bland, who held senior positions in the UN’s Aids-fighting agency and the British government before leading Abu Dhabi’s new research institute, said his great fear was that disruption caused by Covid-19 will last far longer than predicted.

“That disruption is likely to lead you to higher cases and higher deaths from malaria, tuberculosis, HIV and those other diseases that are that are a problem across Africa,” he said.

The lesson of Covid-19 is that “pandemics come and go, and there will be another one, and eventually, there’ll be one that is a real disrupter”.

“Honestly, this could be much worse – this could be a disease that has a higher mortality rate,” he said.

Scientists are still modelling the impact of the virus on other illnesses. These include what are known as Neglected Tropical Diseases, which despite being little known in western countries have brought ill-health and hardship to millions.

Simon Bland fears progress in the fight against malaria, TB and other diseases will be set back for years. Pacific Press

The Bill and Melinda Gates Foundation and the UAE have brought donor conferences to Abu Dhabi to raise cash to tackle them.

In November 2019, Mr Gates, businessman and former mayor of New York Michael Bloomberg and Sheikh Mohamed bin Zayed, Crown Prince of Abu Dhabi and Deputy Supreme Commander of the Armed Forces, were among those to pledge $2.6 billion in the fight against "forgotten diseases".

The NTD Modelling Consortium at the University of Oxford predicted that anti-disease efforts could recover from a short delay caused by the pandemic, but longer hold-ups would require more resources and thus cause a “greater burden of morbidity”.

It singles out the parasitic worm disease schistosomiasis, also known as bilharzia, and the bacterial eye disease trachoma as of particular concern.

Examining goals for seven neglected tropical diseases, the modelling indicates that at least three could miss the 2030 goal of their elimination as a public health problem.

Polio vaccination programmes resumed in Pakistan and Afghanistan in July after a four-month pause. They are the only countries in the world where what is known as wild polio still occurs naturally in humans, and eliminating the disease has proved challenging.

The latest figures, released on September 23, show 37 cases of wild polio were recorded in Afghanistan and 65 in Pakistan this year. This compares with 29 cases for Afghanistan in the whole of 2019 and 147 in Pakistan, which had registered 67 cases at this point last year.

Abu Dhabi’s new institute will focus on eliminating five diseases – polio, malaria, river blindness, lymphatic filariasis and measles – regionally or globally.

Mr Bland, who previously ran the UNAIDs programme to fight HIV, has long sounded warnings of the potential for disease to rebound if not controlled.

There is some good news, though, from the pandemic. The infrastructure for eradication campaigns in Pakistan has been adapted to fight Covid-19, while Nigeria, which was at last declared polio-free this year, has learnt from its experience of Ebola.

“Repurposing the polio infrastructure and emergency operation centres to handle [Covid-19] was a really strong lesson,” Mr Bland says.

The impact of coronavirus on Africa has also not been as devastating as was feared.

“There’s some hope fully understanding what’s going on in Africa, with Covid,” Mr Bland says.

“The potential good news is that Africa is, by and large, a continent that understands infectious disease, of which it has a high burden relative to the rest of the world.

“It’s dealt with issues like malaria, tuberculosis, HIV, outbreaks of Ebola. It’s had in place community health, testing and tracing – it’s done a lot of things that that we actually haven’t done in the West.”

For the world, fighting Covid-19 is a question of whether countries will take a protectionist approach, particularly in sharing drugs and potential vaccines, or accept that “we’re in this together – let’s really learn from one another and work effectively together”.

“That this it is a huge challenge right now,” Mr Bland said. “And I don’t quite know where that ends.”