Rolling back malaria

On the 25 ^th April 2011, the world commenurated the World Malaria Day which a laudable global effort to control malaria which kills 1.5-2.7m people annualy and 500m people are infected with the parasite globally while one-quarter of the population are at risk. Sub-Saharan Africa bears the largest burden of human malaria infection especially children under the age of 5 and pregnant women. The global effort to combat this public health problem is gaining momentum especially with the formation of the Roll Back Malaria Initiative whose long term goal is the complete eradication of malaria infection. The question been asked is can we completely eradicate malaria? This is not easy to answer but from the field, many factors support the believe complete eradication of Human Malaria infection will not be possible. First, the world is faced with the huge challenge of drug resistance. Almost all the antimalaria drugs available are now clinical irrelevant due to resistance. Even with the current regimen (ACT), there has been report of resistance in Thailand. The malaria parasite seems to be advancing just as we the Scientists advances. What an interesting scenario. But the most important factor is human behavoiur. In a letter to the Lancet in September 1998, Kevin Marsh stated one important fact: “Malaria disaster in Africa is a disaster which is not just on its way but is already happening”. What is pushing this disaster? One as I stated earlier is human behavoiur which includes individuals selling fake drugs, patients not keeping to their regimen schedule, etc but the worse is creating the enviroment for the malaria parasite to thrive. Different control and preventive methodologies have been tried since malaria was first described as man’s enemy in 1897. The statistics looks bad: More people are dying of malaria each year than 30 years ago. In a nutshell, one can say malaria is making a re-launch! A visit to Ghana and Nigeria will provide a useful clue to why malaria is making such headway against humanity:Choked gutters and rubbish are found almost everywhere. When I last visited Kano in Nigeria, I was shocked. The rubbish “dams” are so much that you ask where are the public health officers? In Accra, the capital of Ghana, it is the same. You find people eating, sleeping and talking by “mountains” of rubbish which creates the right enviroment for mosquito to breed [Figure 1] and [Figure 2].That is why malaria cases is now on the increase in these parts of the world.

If we want to lessen the malaria burden not even to think of eradication, then individuals needs to take responsibilities and address the social aspect of malaria then the government should show the political will to face the malaria problem devoid of political inferences. Only then can the Scientists find the right methods to help control and prevent malaria before we can start thinking of eradication which is a very distance aim. There are lots of work to be done in malaria: Dealing with resistance, developing new and potent antimalaria drugs and Malaria vaccine. But can we take into consideration this analysis by Russell F Doolittle in his paper titled: The Grand Assault in which he concluded: “… indeed since that insecticide (DDT) was sharply curtailed in the 1970s, 30 million people may have died fom Plasmodium-infected mosquito bites, and ten times that number have suffered from this debilitating disease”. Indeed we can but in the 1970s, the challenges were not huge as present. The Africa Health Research Organization has just initiated “Project Malaria” to help fight Malaria in Africa. Let’s join forces!

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1755-6783.80512

[Figure 1], [Figure 2]