Imagine this: every single day, the world loses the equivalent of two Airbus A380s full of passengers to malaria – a staggering 1 600 lives snuffed out by a relentless disease. That’s 600 000 lives each year, a tragedy of colossal proportions. But last month was a time to rejoice – Egypt was declared malaria free by the World Health Organisation (WHO), providing hope in the ongoing fight against this adversary.

To attain this status, a country must not have recorded any indigenous malaria cases for three consecutive years. In Africa, Egypt follows in the footsteps of Carbo Verde, which was certified as having rid itself of the disease in January. Before that, Mauritius, Morocco and Algeria had been officially malaria free since 1973, 2010 and 2019 respectively.

The only other African countries where one is unlikely to get malaria are Lesotho, Libya, Seychelles and Tunisia, which are listed in a section of the WHO’s register of malaria- free countries indicating that the disease never existed or disappeared without specific measures.

This continent bears the brunt of the world’s malaria burden, with the WHO’s most recent statistics – for 2022 – showing that Africans comprised 94% of the 249-million people who contracted the disease that year and 95% of those who succumbed to it. The hardest hit countries are Nigeria, the Democratic Republic of Congo, Uganda and Mozambique, which collectively account for nearly half of all malaria deaths worldwide.

But malaria is more than just a public health issue; it also has economic implications, as it significantly affects the working- age population, leading to employee absenteeism and reduced income. Moreover, children suffering from malaria often miss school, hindering their education and future economic contribution, while placing additional burdens on healthcare systems and families.

Research published in the American Journal of Tropical Medicine and Hygiene empirically demonstrates a close correlation between economic development and the malaria burden at the country level, even after adjusting for potential confounding factors. According to the study, the loss of economic growth in countries with endemic malaria is estimated to be as high as 1.3% a year.

Another report, published by nongovernmental organisation Malaria No More, based on analytics from Oxford Economics Africa, shows that achieving the WHO’s target of reducing malaria by 90% by 2030 would not only avert more than 600 000 deaths a year but also increase Africa’s GDP by $16-billion a year from 2023 to 2030. This is not an amount to be sniffed at and would definitely make a difference on our continent.

Malaria in the North African country dates back to the time of ancient Egyptian civilisation, having plagued some of its pharaohs as far back as 4 000 BCE. Historically, cases concentrated in Nile river communities, owing to ideal breeding conditions.

In the 1920s, Egypt launched efforts to reduce human-mosquito contact, including banning rice cultivation near homes. By 1930, malaria was designated a notifiable disease, and a 1936 survey revealed prevalence rates ranging from less than 1% in Giza to 40% in some districts. However, malaria cases surged to three-million during World War II, driven by population displacement, disruption of medical supplies and services, and the invasion of a highly efficient mosquito vector, among other factors.

But Egypt regained lost ground from the 1950s to the 1970s through measures such as environmental management, larval control, mosquito surveillance and DDT campaigns.

After controlling the disease in 2001, Egypt’s Ministry of Health launched a vigorous campaign to eliminate remaining cases. A brief outbreak in the city of Aswan, along the Nile river, was quickly contained through early detection, treatment and vector control. By June of that year, the last case was cured, and no malaria case was diagnosed in two years, indicating success in containing the outbreak.

In the past decade, Egypt has expanded healthcare access, with 95% of the population now living within 5 km of a primary healthcare centre. Malaria diagnosis and treatment are free, even for undocumented migrants.

As we celebrate Egypt’s milestone, let’s aim for a future where malaria in Africa is relegated to history books, much like the pharaohs – remembered but firmly in the past.