World Malaria Day

Thursday was World Malaria Day and Susan Rice, the U.S. Ambassador to the United Nations issued a statement for the event calling for the eradication of Malaria. I quote (extensively):

For about half the world’s population, malaria remains one of the greatest threats to public health—a disease that plunges families into poverty, rattles shaky public health systems, and steals Africa’s children away from her.

Let us assume that today is an ordinary day in tropical Africa; that means it is also a day when nearly 3,000 people die of malaria. And to make that toll even harder to bear, nearly 90 percent of malaria’s victims are children under the age of 5. This is a human cost that we will never be able to fully tally. We will never be able to know whether an infant who died of malaria might have grown up to be the next Nelson Mandela, Wole Soyinka, Youssou N’Dour, or Ellen Johnson-Sirleaf.

The economic losses caused by malaria are staggering—an estimated annual toll of $12 billion. This puts a terrible burden on the most fragile economies and public health services. In Rwanda, for example, malaria is responsible for up to half of all outpatient visits to health facilities—and more than half of those visits are for children under 5.

This is a serious fight. But we have seen significant progress. And we have the tools to do even more.

We now have effective and increasingly affordable drugs to treat malaria and related illnesses. We now have reliable ways to prevent malaria—especially bed nets treated with insecticides, indoor spraying, and safe, inexpensive drugs that can be provided to ante-natal pregnant women.

Governments are working together with nonprofit groups, businesses, community leaders, priests, and imams. Community groups are teaching pregnant women to take anti-malarial drugs and helping mothers to get sick children the care they need.

Comment: I am very pleased that there has been a renovation in public health concern for malaria and that progress is being made against the disease.

I would caution, however, that we not become overconfident about the eradication of the disease to the point that we stop developing new techniques for its treatment, prevention and control.

Recall that based on the successful experience in developed nations, the World Health Organization embarked on a global campaign to eradicate malaria a half century ago, based on DDT and the then available case finding techniques and drugs. It turned out that many countries were unable to run malaria campaigns good enough and long enough to eradicate the disease, that mosquitoes developed resistance to pesticides and the malaria plasmodium developed resistance to the Chloroquine drugs. Combined those things resulted in a massive resurgence of a disease that was harder to control than the original one.

There is encouraging research that should lead to malaria vaccines and to better ways to control mosquitoes or to reduce their ability to transmit the disease. There is a lot that can be done to develop techniques to improve the management of malaria programs. I really hope that we continue to explore these and other alternatives that may be needed in the future. JAD