Current Impacts, Historical Strategies And Prognosis Of Malaria

Current impact

Outbreaks of malaria affect many areas of life, such as public health, economics and the prosperity of a nation. Between 2010 and 2016, the worldwide mortality rate of malaria reduced by 25% (CDC 2019). According to the World Malaria Report for 2018, out of the 219 million reported cases in 2017, 11 countries made up for 70% of them (WHO 2018a; WHO 2018b). These 11 countries comprise India as well as 10 African nations. Due to these countries lack of healthcare and infrastructure, this is not surprising since poverty and disease are tightly intertwined (Kokwaro 2009). Unfortunately, roughly half the global population live in circumstances where there is a risk of contracting this disease (AHO 2019). As a result of malarias devastating mortality rate, Africa Health Organisation reports that on average, two children die every minute (AHO 2019). Furthermore, the severe economic impact of malaria costs Africa around $12 billion annually (Johns Hopkins 2019). Malaria exacerbates the cycle of poverty, making it increasingly harder to break as time goes on.

Historical strategies

Over the years, various techniques and strategies have been employed in the combat of malaria. Quinine from the bark of cinchona trees in South America acted as the main treatment for centuries (Achan et al. 2011), until the 1950s when the world adopted a new method using a substance called DDT. Due to its advantageous properties of fantastic durability, lasting up to 12 months, and the fact that it is relatively cheap, the success of DDT led to the launch of the Global Malaria Eradication Campaign in 1955 (WHO 2012). During the 1950s and 60s, DDT was used worldwide in an attempt to eradicate malaria. Although this chemical drastically reduced cases, DDT was banned in the United States and other places in 1972 because of its damaging effects on the environment (Hays 2011). Other strategies focus on management of the environment and water, destroying mosquito breeding grounds (WHO 2012) and improving healthcare and living arrangements (Hays 2011). These methods for tackling malaria were widely implemented in the past.

Current strategy 1

One of the current strategies implemented by the World Health Organisation and CDC in fighting malaria is vector control. There are two approaches used concurrently in this strategy. One of them is insecticide. Using insecticide is an effective, safe and inexpensive way to help control malaria (WHO 2019b). Pyrethroids are a class of insecticide that are most often used in this approach (WHO 2019b). Insecticide treated bed nets and indoor residual spraying of insecticide are frequently used throughout many regions, particularly in Africa (CDC 2018a & WHO 2019d). Personal protection with mosquito repellent, wearing long sleeves and trousers is the second approach to dealing with vector control (CDC 2018b). These approaches are a major strategy applied around the world to restrain mosquitos from causing disease.

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Current strategy 2

Another tool in overcoming malaria involves utilizing antimalarial medication and vaccines. Malaria prophylaxis is not necessarily a new strategy but rather an old and effective one, still widely used by many people today. The world health organisation and CDC recommend intermittent preventative treatment with antimalarial drugs for pregnant women and infants living in areas of regular malaria transmission (WHO 2018a; WHO 2015; CDC 2018a). It is also advised that travellers take appropriate malaria prophylaxis while visiting such places (WHO 2015). A number of options for malaria prophylaxis exist (CDC 2018b), such as chloroquine, proquanil, doxycycline and others. On the other hand, a very recent strategy has emerged that is currently being implemented by the world health organisation in several African countries (WHO 2019a). This new strategy is the malaria vaccine, RTS,S, which researchers have been developing for years (WHO 2019d). On 23 April, the pilot program for the vaccine commenced in Malawi. It will also operate in Ghana and Kenya (WHO 2019e). Prophylaxis and vaccines are some applicable strategies used to prevent malaria.

Current issues

One of the major issues associated with this is drug and insecticide resistance of mosquitos (White 2016; WHO 2015; WHO 2018a; WHO 2019a; WHO 2019c). This results from the mosquitos change in ability to overcome the effects of insecticide over time (WHO 2019b). Recent reports have been released about insecticide resistance causing problems in disease control (Menka 2019) and issues of drug resistance have also been reported in Myanmar (Simmons 2019). In addition is the issue of a lack of finances (WHO 2015). Though the funding in 2017 amounted to around US$3.1 billion (WHO 2018b), as of 2016, an extra US$673 million was required for research and development each year (WHO 2015). Furthermore, the fact that malaria is related to poverty creates supplementary ongoing challenges to inhibiting malaria dissemination. These challenges comprise a lack of access to healthcare, doctors, medical equipment and resources, especially in rural areas and weak surveillance, monitoring and evaluation systems (WHO 2015).

Prognosis for disease control

Continuing with current strategies is anticipated to lead to further elimination of malaria, however with the growing issue of mosquito resistance to insecticide, further research into the development of a new insecticide should provide assistance to overcome this problem. Moreover, the discovery of new scientific innovations and resources has the potential to bring new hope to the world by generating substantial increases in the efficiency of combating malaria. In addition, regular malaria prophylaxis surveillance is recommended in order to monitor and detect any adverse effects caused by the medication (WHO 2015). Based on all this, advised actions include continuing to employ known strategies, identify and deal with current problems, and research more effective methods to eradicate malaria.