Abstract

At the beginning of the Roll Back Malaria (RBM) initiative around 2000, sub-Saharan Africa was going through a major malaria epidemic, compounded by the failure of chloroquine and emerging resistance to sulphadoxine-pyremithamine, as the first-line treatments for uncomplicated malaria. The initial call for increased funding through the 2000 Abuja Declaration only began to materialise in 2002 when the Global Fund to Fight AIDS, Tuberculosis and Malaria was established. The scale-up of malaria interventions, especially for vector control, began in earnest in 2004 in sub-Saharan Africa but by 2007 only less than 20% of children in Africa had slept under an insecticide-treated net. In addition, it is only from 2006 that the widespread use of artemesinin combination therapy (ACT) started to occur on a wide scale. By 2015, however, substantial coverage with both vector and treatment interventions had been achieved. Consequently, the malaria burden has decreased across sub-Saharan Africa. Here I review the current malaria situation in sub-Saharan Africa and discuss opportunities and challenges. I discuss some of the analytical work, including mapping that contributed to our understanding of the epidemiology of malaria and progress during the RBM era. I present examples of how this research has led to changes in policy and practice globally and in sub-Saharan Africa. I discuss the current major research needs and policy gaps in the malaria elimination agenda and how these may be applicable to other diseases in the EDCTP remit. I conclude with suggestions on the potential role of EDCTP in supporting clinical trials and capacity strengthening towards malaria elimination.