As we recognize World Malaria Day on April 25, we reflect on the relentless battle against malaria, a life-threatening disease transmitted by female malaria-carrying mosquitoes. According to the World Health Organization (WHO), in 2022, there were 5.1 million people affected by malaria in Ethiopia, and about 75 million people were at risk of contracting the disease. In addition to its public health impact, malaria imposes a large financial burden on households. Malaria is estimated to cost Ethiopia about USD 200 million annually and hence, reducing the malaria disease burden has the potential to improve socioeconomic development.
The United States President's Malaria Initiative (PMI), the U.S. government's largest program leading the fight against malaria, has been a cornerstone in the global fight against this disease since its inception in 2006. With a strategic focus on 30 countries, including Ethiopia since 2008, PMI's efforts have yielded remarkable outcomes, dramatically slashing malaria cases and enhancing national and regional health infrastructure. Further, the US government is the largest donor to the Global Fund to Fight AIDS, TB and Malaria, comprising one-third of all resources.
US efforts in Ethiopia: A decade of progress and innovation
PMI's partnership with Ethiopia has been instrumental in the national effort to control and eventually eliminate malaria. Since 2008, by distributing over 53 million mosquito nets, over 15 million malaria treatments, and over nine million diagnostic kits, the initiative has substantially decreased the prevalence of the disease. PMI has also procured 27 million antimalarial medicines and more than two million injectable antimalarial medicines for treatment of severe malaria.
Furthermore, PMI has supported the Federal Ministry of Health to spray over 700,000 houses with mosquito killing insecticides to protect over two million people from malaria every year. PMI also invests in Ethiopia's efforts to strengthen its health system, including by training and supporting health workers to respond to malaria outbreaks.
One innovative approach in Ethiopia has been the fight against the invasive Anopheles stephensi mosquito, which poses a new challenge due to its unique breeding habits and resistance to conventional control measures. PMI's introduction of larval source management appears to be an effective way to control An. stephensi killing mosquitoes before they reach adulthood. This control measure has been piloted in eight towns.
The pilot project - which began in July 2022 in Dire Dawa and seven other locations in Afar, Oromia, and Somali Regions - reduced An. stephensi larval numbers by over 95 percent on average. However, additional research and data are required to verify the impact of larval source management on malaria cases within the population.
Challenges and the road ahead
Despite the successes, the fight against malaria in Ethiopia faces significant challenges, including the emergence of insecticide resistance, changing weather patterns and severe weather events, and ongoing conflicts that disrupt malaria prevention and treatment campaigns. The recent global increase in malaria cases reported by the WHO underscores the need for continued innovation and collaboration among international partners, local governments, and communities.
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Alongside the Federal Ministry of Health of Ethiopia and other stakeholders, PMI and the US government remain dedicated to the goal of eliminating malaria by 2030. However, getting back on track towards malaria elimination will require additional resources both domestically and globally and ensuring that all partners work together to implement quality, comprehensive, accessible and timely interventions.
As we mark World Malaria Day, all stakeholders must reinforce our commitment and adapt to the evolving challenges of malaria control to achieve a malaria-free Ethiopia. This goal, and the journey to achieve it, is not just about combating a disease but also about increasing economic stability and improving the quality of life for millions.
(Ervin Massinga is the US Ambassador to Ethiopia.)
Contributed by Ervin Massinga (Amb.)
