As the global malaria community observes World Malaria Day on April 25, 2020, there are plenty to celebrate. Yet this year, the coronavirus disease 2019 (COVID-19) outbreak is greatly dampening the spirits. While the Asia-Pacific region has made substantial progress against malaria, with a 42% reduction in confirmed cases between 2010 and 2018, the emergence of COVID-19 could undermine elimination efforts. Like malaria, one of the most common symptoms of COVID-19 is fever. Diagnosis of fever in the Asia-Pacific region has always been a challenge due to the large number of febrile diseases prevalent in the region, including malaria, dengue fever, scrub typhus, typhoid fever, and leptospirosis, among others. The initial diagnosis of febrile disease in the Asia-Pacific region is commonly done by frontline community health-care workers. Physical distancing measures implemented to manage COVID-19 are making it difficult for volunteers to access patients with fever, potentially compromising progress towards malaria elimination. This is compounded by a lack of knowledge of infection control and prevention methods and of access to effective PPE by many community level and primary health-care workers, making safe interactions with suspected COVID-19 cases difficult.
Therefore, to ensure continued access to diagnosis and care for patients with malaria during a pandemic, frontline workers need the appropriate training, equipment, and health-care packages to distinguish between different febrile diseases. Strengthening febrile disease diagnosis and management long term will support malaria elimination efforts and improve preparedness for future outbreaks.