The COVID-19 pandemic is having a massive impact on health and nutrition.
There have now been several reports of delays to routine child vaccination programs as a result of travel and contact restrictions due to the pandemic. The effect of these delays may not be immediately obvious as children are having less contact with others, but will come sooner or later. The risk of malnutrition in children has increased due to high death rates of parents and carers, loss of family income and declines in food production due to the loss of labour inputs.
“The unprecedented global social and economic crisis triggered by the COVID-19 pandemic poses grave risks to the nutritional status and survival of young children in low-income and middle-income countries (LMICs). Of particular concern is an expected increase in child malnutrition, including wasting, due to steep declines in household incomes, changes in the availability and affordability of nutritious foods, and interruptions to health, nutrition, and social protection services.” [1]
The International Food Policy Research Institute estimates that in Lower-Income Countries there will be an 8% decline in GNI and a 14·3% increase in the prevalence of moderate or severe wasting among children under 5 years. This is 7 million more children with wasting and about 130000 more child deaths in 2020. About half will be in Africa and another quarter in southern and eastern Asia [2].
This shows the catastrophic impact that COVID-19 has made on public health/
Malaria
COVID is having an impact on malaria. The mainstay of prevention, particularly in Africa, is the distribution of long-lasting insecticide-impregnated nets. This has been almost halted due to the disruption caused by the COVID epidemic. Malaria remains a very serious public health problem with 230million cases and 405000 deaths last year, with 95% in Africa. If the distribution of mosquito nets decreases by 50% for 6 months there could be 800000 extra deaths [3]
Decades of research have failed to develop a malaria vaccine, an example that optimistic politicians who think there will soon be a COVID vaccine could do well to take note of. But another problem is looming, Artemisinin resistance is developing. Cambodia seems to be a hub for malaria resistance to develop and resistance was detected there in laboratory specimens more than 5 years ago[4]. Now for the first-time artemisinin resistance has been detected in the field in Africa [5].
Artemisinin was developed from a Chinese traditional medicine in response to resistance developing to the traditional medications such as chloroquine.
This makes the use of insecticide nets even more important.
- Akseer, N.; Kandru, G.; Keats, E.C.; Bhutta, Z.A. COVID-19 pandemic and mitigation strategies: implications for maternal and child health and nutrition. Am J Clin Nutr 2020, 112, 251-256, https://doi:10.1093/ajcn/nqaa171.
- Headey, D.; Heidkamp, R.; Osendarp, S.; Ruel, M.; Scott, N.; Black, R.; Shekar, M.; Bouis, H.; Flory, A.; Haddad, L., et al. Impacts of COVID-19 on childhood malnutrition and nutrition-related mortality. Lancet 2020, 10.1016/S0140-6736(20)31647-0, https://doi:10.1016/S0140-6736(20)31647-0.
- Sherrard-Smith, E.; Hogan, A.; al., e. The potential public health consequences of COVID-19 on malaria in Africa. Nature Medicine 2020, https://doi.org/10.1038/s41591-020-1025-y
- Miotto, O.; Almagro-Garcia, J.; Manske, M.; Macinnis, B.; Campino, S.; Rockett, K.A.; Amaratunga, C.; Lim, P.; Suon, S.; Sreng, S., et al. Multiple populations of artemisinin-resistant Plasmodium falciparum in Cambodia. Nat Genet 2013, 45, 648-655, https://doi:10.1038/ng.2624.
- Uwimana, A.; et al. Emergence and clonal expansion of in vitro artemisininresistant Plasmodium falciparum kelch13 R561H mutant parasites in Rwanda. Nature Medicine 2020.
Colin Binns, MBBS, PhD
Editor-in-Chief, Asia-Pacific Journal of Public Health
School of Public Health, Curtin University, Perth, Australia
Wah Yun Low, PhD
Managing Editor, Asia-Pacific Journal of Public Health
President, Asia-Pacific Academic Consortium for Public Health
Deputy Executive Director, Asia Europe Institute
University of Malaya, Kuala Lumpur, Malaysia
Victor Hoe Chee Wai, MBBS, PhD
Webmaster, Asia-Pacific Academic Consortium for Public Health
Department of Social and Preventive Medicine, Faculty of Medicine
University of Malaya, Kuala Lumpur, Malaysia
