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On 20 August 1897, British surgeon Ronald Ross made the momentous discovery that mosquitoes transmitted malaria parasites to humans. More than 100 years later, much progress has been made, but nearly half the world’s population are still at risk from malaria. Each year, 250 million people become severely ill and 863,000 die from the disease. Although effective ways to prevent and treat malaria exist, one child dies needlessly from the disease every 45 seconds in Africa.
Malaria has a disproportionate impact on the poor, children, pregnant women, people living in conflict affected and fragile states and those living with HIV and AIDS. It place an immense burden on national health systems. It impoverishes families and holds back economic growth. And while we currently have effective tools to prevent and treat malaria, emerging drug and insecticide resistance threaten the gains we have made so far.
Countries such as Rwanda and Zambia, which have both acted to dramatically reduce their levels of malaria, show that progress is possible. We need to support countries to repeat and sustain such gains. The challenge is enormous, but the rewards are far greater. Ultimately, lowering the burden of malaria will help to reduce poverty and contribute to development.
The Coalition Government is committed to help meet this challenge by increasing its focus and ambition on malaria. We will publish a malaria evidence paper and a business plan by the end of 2010. These will give a rationale for our approach and set out what we will do, how we will work with others and how we will measure results in achieving our objectives. The business plan will be backed up by spending of up to £500 million per year where we can deliver results and value for money.
On the month of the anniversary of Ross’s discovery we are launching a public consultation on what more the UK could do, how best to focus our efforts and how to deliver results. We would like your views on how, together, we can break the cycle of malaria.
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Our thanks for all the comments submitted. All of the ideas and suggestions put forward will feed into our new policy, helping to shape the direction of our work.
Once the final policy document is released you will be able to find it at www.dfid.gov.uk
Countries like Rwanda and Zambia have indeed accomplished great reductions in malaria morbidity and mortality. But make no mistake: many places have seen such successes before (Sri Lanka, India), only to experience a resurgence afterwards when resources dried up or resistance kicked in. We cannot celebrate success unless permanent removal of the disease has been achieved.
‘There is no such thing as partial success. It is either glorious success, or dismal failure’ – the words of legendary Fred L. Soper. So true, also in 2010. Current methods of vector control focus on adult mosquitoes (ITNs, IRS) and these tools will not be sufficient to eliminate disease. More is needed, and area-wide approaches will have to play a key role in elimination efforts. These worked in the past, these can work now (if we do it well).
The only truly successful campaign against malaria has to focus on eradication. Control methods will only promte more drug resistant organisms that will become more deadly in time. The Moheli project is a great example of a current eradication campaign that has been successful.
I agree entirely with Tom C’s view. The Moheli project (mass drug administration with ACTs) has woken up the world that elimination campaigns a) can be successful, and b) that such campaigns can only be successful when run in a rigorous manner. Anything less is a recipe for dismal failure…
Surely the question of diagnosis is important as if this is undertaken early and often enough, treatment can be implemented much sooner, with I presume (although not my area of knowledge) could reduce the number of people suffering from malaria.
WHO have recently published studies of the use of rapid test kits (RDT’s), but from personal knowledge of the Clinics in Nigeria, virtually 100% of tests are performed in the laboratory using microscopy techniques.
Our organisation supplies both of the above tests, and would like to explore discussion of how costs to NGO’s or Government funded donations can be more commercially (that is financially) effective?
malaria can be checked from 3 angles. 1 is the option of eliminating the mosquitoes. 2 is the option of eliminating their breeding grounds. and 3 is the option of treating the victim of the parasite.
the most effective option in my opinion is the choice of eliminating their breeding grounds. say no to stagnancy. let all the waters flow. remove all blockages. we can irrigate all stagnant waters into arid farm lands. thank you
Equitable Access to quality healthcare services and a government-driven coordination mechanism for the application of a constructive integrated approach to malaria control is the way to achieving any sustainable success in Nigeria. It is not enough to eradicate breeding sites; it will be an uphill task and will not result to much because it rains all year round here. So, the mosquitoes always have a fresh source for reproduction and the tiniest water pocket is equal to a breeding site.
@Ogheneovo – the aim is not to eliminate breeding sites, which indeed is an impossible task. The aim is to eliminate larvae therein, which is doable. Not because I claim this, but because it has worked in the past. The vector elimination programmes staged in Brazil and Egypt attest to this. I would encourage you to read the book ‘Anopheles gambiae in Brazil: 1930-1940′ by F. L. Soper and D.B. Wilson (published in 1942) or the elimination story of Egypt by Shousha (Bull WHO, 1 (2), 309-352), which may change your views on vector elimination.
The Brazilian experience was unique, involving an exotic species descended from relatively small numbers of insects brought across the Atlantic in ballast tanks of small ships. Under Soper’s leadership (after Shannon had detected An. gambiae and urged action) the eradication campaign was a success but was directed against a mosquito population with low genetic diversity, no insecticide resistance and in a country ruled by a dictatorship. The situation in any sub-Saharan African country is a lot more complex. We shouldn’t talk about eradicating the vector species completely, rather on reducing contact with susceptible humans. And unlike the Brazilian campaign of the 30′s, success will depend on educating local people and giving them the tools to help themselves.
@Bruce Alexander. Perhaps the Brazilian experience was unique, but the Egypt experience wasn’t. Moreover, if we’re talking about vector elimination based on larviciding, there is no place in Africa where larval stages are resistant to Bti. As for dictatorship, there is ample proof that elimination of a pest is feasible under democratic systems – take the elimination of New World Screwworm in the USA and Central America as an example. Education of local people is an essential component in controlling infectious diseases, but give me one example where ‘giving the tools to help themselves’ has led to elimination of the problem. What I am advocating is not based on tools (which we have and work against larval stages) but on strategy – rolling out campaigns based on the principles developed in the Brazil and Egypt campaigns. Soper once wrote in his diary ‘Difficulties of eradication become apparent only when eradication is attempted’. Your suggested approach of reducing contact with susceptible humans is far from what is needed to eliminate malaria. If the world is becoming serious about eliminating malaria, then area-wide approaches are the only way to go – meaning larviciding. How better to start then to build on the successes of the past?
Naturally our bodies have built in mechanism to fight disease. It be bacteria or virus created/related. A well nourished body will detect foreign entrants, identify them, fight them and through them out of the body, A well nourished body with strong living cells builds a strong immunity system able to fight disease. Malaria, HIV/AIDS can be eradicated. People with resources, should try to help Nutritionists towards fighting disease. We thank DFID for the effort they are exerting on the fight of disease. Thank you very much DFID. There is need to sensitize society on the way of life if one is to live a health enjoyable sickness free life. Cleanness at all levels is absolute. There is no way we are going to fight disease with related implications when people are so dirty both in and outside their bodies, the environment in which the majority live in is extremely dirty. People must be taught about all these facts. What people eat is very important in building our bodies and enhancing our immunity system. We are what we eat. Diet affects the workings of our brain and thus our thinking and our attitude. Ignorance is no excuse, when people continue to live in ignorance no matter what the world does people will continue to suffer the repercussions of the things they are ignorant about. Put in a touch of understanding and Love and you will see the difference. I thank those who are sincerely looking for ways and means of touching people’s lives for the best.
All the comments made so far point to one FACT – There is an absolute and URGENT need to bring in very resourceful, all-inclusive new team of healthcare professionals with the best brains, minds and hands who know what REALLY WORKS and is PRACTICALLY EFFECTIVE in the Prevention, Treatment, Cure and Eradication of malaria; especially so in Sub-Saharan Africa and Asia. Competence MUST also be matched with the LOVE and COMPASSION in their hearts to SAVE HUMAN LIVES. It does not matter if they are western orthodox (allopathic), natural & holistic (naturopathic), homeopathic or alternative healthcare professionals. If we all agree that there is a common Goal and Objective – TO ERADICATE MALARIA – , all can work together cooperatively to achieve it much more easily. My 25 years experiences working in the “trenches” of the “malaria jungle” attest to this FACT – MALARIA CAN BE ERADICATED EASILY IF THE RIGHT THINGS ARE DONE AND IN THE RIGHT WAY. This synergistic approach is essential and very important for any meaningful progress to be made or for the sustainability of a dynamic effective disease eradication Programme. Putting focus and emphasis on an ineffective one-system approach and then modifying it with “modern technology” to have an “enticing appeal” to the people or their governments, will not in any way help the global malaria eradication programmes; rather it complicates it and makes the task much more difficult to accomplish. At the very best, that, “modified ineffective one-system approach” will only continue to provide temporary relief for malaria sufferers and potential victims. What the World desires and need URGENTLY is the PERMANENT SOLUTION; and that is available to anyone who sincerely desires to have it. Humanity can then be saved the trauma and agony of the fast spreading worrisome new variant of the malaria phenomenon a.k.a. MWB (“Malaria Without Borders”); whose onset does not depend on the “bite” of the female anopheles mosquito alone but other factors that conventional medicine has consistently refused to accept or deliberately ignore.