Deaths from malaria could double across sub-Saharan Africa this year if work to prevent the disease is disrupted by Covid-19, the World Health Organization has warned. The UN’s global health agency said that if countries failed to maintain delivery of insecticide-treated nets and access to antimalarial medicines, up to 769,000 people could die of malaria this year. That figure, which would be more than double the number of deaths in 2018, would mark a return to mortality levels last seen 20 years ago. “While Covid-19 is a major health threat, it’s critical to maintain malaria prevention and treatment programmes,” said the WHO’s Africa director, Dr Matshidiso Moeti. “The new modeling shows deaths could exceed 700,000 this year alone. We haven’t seen mortality levels like that in 20 years. We must not turn back the clock.” In 2018, 94% of global deaths from malaria occured in sub-Saharan Africa. The WHO said it was crucial for programmes to continue focusing on preventative treatment for pregnant women and children. The organisation has previously warned that Covid-19 could have secondary impacts if restrictions imposed to stop its spread led to other diseases killing more people. It has called on countries to accelerate anti-malaria campaigns while coronavirus cases across Africa remain relatively low. “We have a precious window in which to act before the arrival of peak malaria season in many parts of Africa and the further spread of Covid-19 across the continent,” said Dr Abdourahmane Diallo, who heads the RBM Partnership to End Malaria. Earlier in April, the WHO advised governments to adapt their malaria campaigns to safeguard against coronavirus infections by preventing large gatherings of people at collection points, and protecting workers distributing treatments and nets. The agency also warned of potential confusion caused by shared symptoms, such as fevers. It cautioned that medical workers in malaria zones should be careful to ensure any patient diagnosed with Covid-19 was also tested for malaria to ensure that illnesses did not go untreated. The WHO praised the leaders of Benin, the Democratic Republic of the Congo, Sierra Leone and Chad for initiating campaigns to distribute nets during the pandemic. “Right now the focus must be on making sure that these vital malaria measures go ahead as planned, and frontline health workers have all the help they need to manage the multiple threats to the people they care for,” said James Whiting, chief executive of Malaria No More UK. “As countries rightly look to take measures to prevent the spread of Covid-19 we have to do all that we can to make sure that planned malaria prevention – such as bed net distribution – doesn’t get disrupted, otherwise the knock on consequences will be grave in terms of young lives lost to malaria.”