The future of malaria in Africa

Although the map of malaria in Africa has seen little reduction since 1970, the likelihood of getting infected has never been so low. For further progress, we need better tools – insecticides, drugs and vaccines – as well as economic development and investments in health systems. Cartography of the disease helps design interventions, and a better understanding of how immunity develops will also shape the future of malaria in Africa.

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Malaria control in Africa

Quality data is vital to design better malaria control programmes. This project helps various African countries gather epidemiological evidence to better control malaria. Professor Bob Snow shows how sub-regional, evidence-based platforms can effectively change malaria treatment policies.

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115 years of malaria in Africa

Bob Snow tells us about 21 years of research that led to the publication of the Nature Research Letter The prevalence of Plasmodium falciparum in sub-Saharan Africa since 1900

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Bob’s career began in The Gambia where he undertook the first clinical trials of insecticide treated nets (ITN) [1984-1988]. Following a move to Kenya, he established the framework to undertake linked community-based mortality and hospital admission trials at Kilifi and directed one of four large-scale, community-randomized mortality trials of ITN in Africa [1989-1993]. Subsequently he investigated the possible long-term effects of reduced parasite exposure on the clinical epidemiology of malaria to understand the consequences of sustained ITN use and/or its interrupted use on disease burdens [1994-2003]. This was used as a basis to establish new epidemiological methods to define the mortality, morbidity and consequential burdens posed by malaria in Africa [1995-1999] and clinical disease globally [2005]. As part of new ways to articulate disease burdens he started the Mapping Malaria Risk in Africa (MARA) project with colleagues in South Africa [1996], which served as the model for a global initiative founded by Bob in Nairobi, known as the Malaria Atlas Project (MAP) [2005].

Since 2010, he has led a science-to-policy initiative, funded by DFID, UK, to ensure the best possible use of epidemiological data to design malaria control programmes in 22 African countries. In 2015, this work extended to support countries in the Arabian Peninsula as a collaboration with WHO’s EMR office in Cairo; focusing on countries in conflict, entering phases of malaria elimination, or aiming to prevent malaria re-introduction.

Bob is the longest serving Oxford scientist at the Kenyan Programme. His current interests include the epidemiology of malaria parasite exposure (transmission intensity) and disease outcomes (age/immunity) across Africa; the use of hospitals as sentinels for disease surveillance in resource poor settings; and the promotion of the science of malaria risk mapping to guide appropriate selection of interventions, working directly with national governments in the WHO Africa and Eastern Mediterranean regions.