Malaria is the leading cause of death for children under five in Africa. So when Ugandan malaria researcher Krystal Burungi’s son turned five, she celebrated big:
– All day I walked around with a big smile on my face, I was so happy! At the same time, I thought about the children who don’t get to experience their fifth birthday – and that we can’t be satisfied with what we’ve achieved so far.
According to the World Malaria Report, there were 249 million confirmed cases of malaria in 2022 compared to 244 million in 2021. In 2022, 608,000 people died as a result of malaria, 95 percent of which occurred in Africa. And the worst hit are children: 78 percent of all malaria deaths in the region were under the age of five.
– So when my son turned four, we celebrated, we celebrated life! All day I went around with a big smile – like an idiot – telling anyone who would listen! But I also thought a lot about the children who don’t get to experience their fifth birthday.
Malaria researcher Krystal Birungi laughs at the memory. Amidst the laughter there is great seriousness. Because the fight against malaria is now on. New vaccines and better mosquito nets with double impregnation create better conditions to fight malaria. At the same time, climate change is causing people in areas that were not previously exposed to be affected.
– That is why we must not give up now that we have made it this far, states malaria researcher Krystal Birungi in Uganda.
Krystal Birungi grew up in a small community outside Uganda’s capital Kampala in a family that was anything but rich. As a child, she and her siblings often suffered from malaria.
– When it started to rain, the mosquitoes always came, we knew that. We also knew that there was nothing we could do about it, because you can’t kill every single mosquito. My parents were not ignorant, they knew there was treatment. But they also knew that we couldn’t afford the medicine that was required. So every time the malaria season started and you got sick it was like roulette: will I make it this time?
A strong memory from Krystal’s childhood was when her youngest brother was five years old and had suffered severe convulsions during a bout of malaria.
– I remember how I saw my mother washing him all night, She tried to keep him cool and stop the cramps. Imagine such a situation for yourself: you do not know if your brother will be alive the next morning – and your mother does not know if she will lose a child. No mother should ever have to end up in that situation.
Sweden is an important donor
In the early 2000s, things started to happen in the fight against malaria. The Global Fund against AIDS, Tuberculosis and Malaria was established in 2001 with Sweden as one of the major contributors. As a teenager, Krystal and her family gained access to mosquito nets and free medicine for the first time thanks to this. This allowed the family to spend money on things other than treatment and healthcare, such as sending Krystal and her siblings to school.
– Now it was possible to avoid malaria. And if you got hit, you didn’t have to die because there was medicine available. It was a total change, Krystal remembers today.
Perhaps it was also when Krystal Birungi decided that she herself would become part of the fight against malaria. Krystal had always been interested in science, particularly biology, and after studying entomology (the study of insects) at university, she decided to add a course in genetics. So it happened that in 2015 she started working on Target Malaria, a regional research project that works to reduce the spread of malaria through, among other things, genetically engineered mosquitoes.
– Yes, it was fantastic to start there and feel that I can make a difference. Maybe it was meant to be, after all, much of my life has been shaped by my own experiences with malaria, which I often got when I was little.
Today, Krystal Birungi is the coordinator of the entomological field work for Target Malaria in Uganda and strongly involved in the global network collaboration with different malaria researchers:
– We have partners in other affected countries such as Ghana and Burkina Faso, but we also collaborate with researchers from the “north”. It is an incredibly important collaboration where we complement each other. African researchers are needed. If you want to reach people who live in remote areas without electricity or roads, a completely different mindset is required than when it comes to healthcare in Sweden. That is why it is so important that the development of technology and methods also takes place in Africa. So through the collaboration we can combine the best of both worlds, continues Krystal Birungi.
Malaria is also strongly linked to poverty, it forces older children to stay at home to care for younger ones who are sick, and it prevents children – especially girls – from going to school. In addition, it often means large costs for the families.
Thanks to mosquito nets and medicine, there was a sharp decline in the number of deaths and infections from malaria, but in the last ten years the decline has not been as rapid. And during covid the number of cases even increased in many countries because people could not seek care.
Climate change affects
One of the major challenges in the work against malaria is climate change, which leads to malaria also spreading to people in cooler areas that were previously spared. The combination of drought and floods also means that health care is cut off, that people are forced to move into the slums of the cities where they build simple homes in low-lying places.
– We see how habitats throughout the world are changing and this leads to increased spread. Something that is very serious is that the Asian malaria mosquito is now rapidly spreading in Africa, which leads to widespread outbreaks, also in places that were previously unaffected.
– This means that people who have not been affected before and who lack immunity suddenly start to get malaria. It can lead to devastating effects and mean an even higher mortality rate among children. Therefore, we need to find new methods of malaria control adapted to these places. And of course we must try to stop climate change because it is at the root of the problem.
So what will happen in the future? In the flow of news from Gaza and Ukraine, it is easy to lose sight of malaria, which is “just” a silent, slow death. At the same time, the work against covid can serve as a model for the fact that it is actually possible to mobilize resources. Only if the countries of the world unite can they achieve fantastic things, says Krystal Birungi:
– Incredible work is already being done today by local health workers around Africa. We know that the new and more efficient mosquito nets make a big difference. Vaccines are also important. So if we combine all the methods we have, we have a real chance. Therefore, we must continue, because the longer it takes, the more lives will be lost. We literally waste life when we waste time.
Before we finished talking we will return to her son, of course it cannot be avoided. Today he is fine, but what will his future be like?
– People who are born in poverty do not have to remain in poverty. My family and I are proof of that. Thanks to the help we received when I was a child, I was able to become who I am today – an entomologist fighting malaria. So it was amazing! But it also means that my son’s life started better than my own. I can afford to treat him, I can take him to hospital.
– My dream now is that when my son has a child, the generation that then grows up will not even understand what we mean when we talk about the threat from malaria that once frightened all families here in Uganda.
David Isaksson
Facts: New and more efficient mosquito nets
The New Nets Project, an initiative funded by Unitaid and the Global Fund and led by the Innovative Vector Control Consortium (IVCC), was the first to use dual insecticides in countries with malaria between 2019 and 2022 to address the growing threat of insecticide resistance. Compared to regular mosquito nets, the distribution of 56 million state-of-the-art mosquito nets in 17 countries in sub-Saharan Africa has prevented an estimated 13 million malaria cases and 24,600 deaths.
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