In the midst of the second concerted effort to eliminate malaria from the world, scientists and health workers are increasingly hopeful that significant progress can be made in the battle against one of the globe’s biggest killers.
Malaria infects between 300 and 500 million people each year and claims more than one million lives, most of them children. Although the mosquito-borne disease exists in 109 countries around the world, most deaths occur in Africa and half of the total deaths occur in just five countries: Nigeria, Uganda, Ethiopia, Tanzania and the Democratic Republic of Congo, according to the global partnership Roll Back Malaria.
World leaders last September committed to providing nearly three billion dollars to reduce malaria deaths to near zero by 2015 under the Global Malaria Action Plan. This boost in funding, as well as the use of relatively new drugs, bed nets and insecticides, and a groundswell of support in the battle have made the community fighting malaria believe elimination is achievable.
“Providing we don’t get donor fatigue, which is a big worry, I think it can be done, possibly in our lifetime,” said John Lucas, a field development manager for the global vector control division for Sumitomo Chemical UK Plc. “We’ve got better tools and better global commitment and we’re more of a global community now than we ever have been.”
Brian Greenwood, a malaria expert at the London School of Hygiene and Tropical Medicine, agrees that the world is more united in the fight against malaria. Previously, the anti-malaria campaign had largely been waged from Europe and the United States. Now Western scientists and health workers are working more closely with their newly trained African and Asian counterparts in malaria-endemic countries, he said.
Greenwood is more conservative about how much can be achieved in the next 10 years, but he believes the international community has learned from past mistakes.
“The last global eradication program was too ambitious and set too high a standard and too high a goal and when that failed everybody just sort of threw up their hands,” he said. “I think this time people are being more realistic in terms of what we might be able to achieve and saying we might be able to eradicate malaria in the next 50 years. But in the next 10 years we can stop transmission in 15 countries.”
However, most in the malaria-fighting community agree that it is a race against time. Resistance to the leading drug to fight the disease, artemisinin, has already appeared in Southeast Asia. Additionally, scientists have discovered resistance to pyrethroids, the group of insecticides approved by the World Health Organization for use in bed nets.
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“We’ve got to use our interventions wisely and given that we’ve got a suite of them at the moment and a limited number of chemistries available, a short, sharp shock is definitely the way to go. A short, sharp shock can get rid of it where short is 50 years, rather than hundreds of years,” Lucas said.
And if eradication is not achieved, scientists and health workers still see reason for hope.
“The most seriously affected areas by far are in tropical Africa. And engaging on malaria for even good control much less eradication means you have to do something very serious about the very week primary healthcare systems there,” said Donald Hopkins, vice president of health programs at the Carter Center.
“So in the process of developing that capacity you are inevitably are going to strengthen public health systems and primary healthcare systems in Africa and I think that would be another very positive benefit.”
