MOZAMBIQUE FACES NEW CHALLENGES IN THE FIGHT AGAINST MALARIA AS MOSQUITOES ADAPT

Source: Interview with Pedro Aide on Radio France Internationale (RFI)

In an interview with Radio France Internationale (RFI), Pedro Aide, researcher and coordinator of the Malaria Area at the Manhiça Health Research Centre (CISM), highlighted some of the main challenges that continue to hinder malaria control in Mozambique. Despite the progress achieved, the disease remains one of the leading causes of illness, hospitalisation and death in the country.

Mosquitoes increasingly adapting

One of the main challenges highlighted by the researcher is the growing ability of mosquitoes to develop resistance to insecticides used in indoor residual spraying and insecticide-treated mosquito nets.

At the same time, changes in vector behaviour have been observed, with mosquitoes increasingly tending to bite and rest outdoors. This shift may reduce the effectiveness of interventions traditionally designed to act inside homes and reinforces the need to develop and test new control strategies.

In this context, Pedro Aide mentioned some approaches being studied in different parts of the world, including the use of genetically modified mosquitoes, while stressing that these approaches still require further research to determine their effectiveness.

Climate change adds another concern. Changes in temperature, rainfall and water availability can affect mosquito breeding, distribution and behaviour. High temperatures, cyclones and floods can create favourable conditions for vector breeding and contribute to changes in the geographical distribution of malaria, including the re-emergence of transmission in areas where it had previously been reduced or eliminated.

Malaria control requires a multisectoral response

For Pedro Aide, combating malaria cannot be the sole responsibility of the health sector. The way houses are built, urban growth, water management and community planning also directly influence exposure to mosquitoes. In many rural areas, for example, openings in roofs, walls, doors and windows can facilitate the entry of vectors. On the other hand, settlement in swampy areas or near rivers and other water bodies can create favourable conditions for mosquito breeding.

The researcher therefore advocates for an integrated approach involving, in addition to health, sectors such as agriculture, urban planning, public works and transport, including aspects related to community planning and the construction and maintenance of roads, drainage channels and drainage systems.

Vaccination should complement other prevention measures

The malaria vaccine represents another important tool, but it does not replace other interventions. According to Pedro Aide, the vaccines currently available have an efficacy of around 40% to 50% and should be used in combination with other preventive measures. The R21 vaccine, which has already been introduced in almost the entire country, is part of this set of tools.

However, the researcher also emphasises the importance of community adherence to the correct use of insecticide-treated mosquito nets and indoor residual spraying. “It is through the combination of different interventions that it will be possible to increase the effectiveness of control measures and reduce the burden of malaria in Mozambique,” emphasises Pedro Aide.

CISM research in the fight against malaria

Malaria is one of CISM’s main areas of research. Since its establishment, the Centre has contributed to the development and evaluation of innovative strategies for the prevention, control and elimination of the disease in different transmission settings in Mozambique.

The research conducted covers, among other areas, the study of the pathophysiological and immunological mechanisms of malaria and antimalarial drug resistance; clinical trials of drugs and vaccines; the development of entomological intelligence and new vector control tools; and implementation research aligned with the priorities of the National Malaria Control Programme.

This work also includes areas such as communication for behaviour change, malaria prevention during pregnancy, vector control and case management, contributing to the generation of evidence to support the national response to the disease.