According to a new study published in BioMed Central’s open access journal Malaria Journal, there have been 75 documented episodes of malaria resurgence worldwide since the 1930s, the majority of which were associated with weakening of malaria control programs. The study, which is in line with the theme of this year’s World Malaria Day ‘Sustain Gains, Save Lives: Invest in Malaria,’ on the 25th April, established that the most frequent reason for the weakening of malaria control programs was due to disruptions in funding.
Even though Malaria is both preventable and curable, the World Health Organization estimates that there are more than 200 million cases of malaria each year, 85% affect children under the age of 5 years. In 2010, 655,000 people died unnecessarily worldwide from malaria, most of them African children, despite the fact that low-cost treatment is available and simple preventive solutions, such as insecticide treated mosquito nets and malaria prevention during pregnancy, have proven to reduce the number of malaria-related deaths.
By 2015, Roll Back Malaria, an initiative set up in 1998, aims to reduce malaria-related child mortality by two thirds by implementing these simple solutions on a large scale.
A collaboration of researchers from various institutions, including the Clinton Health Access Initiative, the Johns Hopkins Malaria Research Institute, the Center for Disease Dynamics, Economics and Policy, and the Global Health Group at the University of California in San Francisco (UCSF) decided to systematically review the literature to identify all documented malaria resurgence events, where the disease reappeared, although the area was previously thought to be under control.
The team assigned the causes of malaria resurgence into 3 categories, consisting of weakened malaria control programs, increased intensity of malaria transmission due to movement of people or mosquitoes, weather, or changes in land use, or technical obstacles including resistance of the malaria parasite to drugs.
They discovered that 91% of the 75 resurgence events were at least partially linked to the weakening of malaria control programs.
Justin Cohen, PhD, MPH of the Clinton Health Access Initiative and lead author of the study, explains:
“Malaria control programs have been shown to be extremely successful in reducing the number of cases of malaria to very low levels, but history demonstrates that gains can be lost rapidly if financial and political support is not sustained. Finding ways to ensure continued funding for malaria control today will be crucial to building on the gains of the past decade.”
Investments in malaria control have resulted in a unprecedented momentum, and yielded remarkable returns in the past years. However, the future of anti-malaria programs is uncertain as current funding is projected to decline over the next few years.
Sir Richard Feachem, KBE, FREng, DSc (Med), PhD, who was the founding Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, and current Director of the UCSF Global Health Group, calls on the malaria community and donors to heed these results in order to continue the fight against malaria.
“This work demonstrates the historical evidence on what happens when malaria control efforts and funding streams prematurely turn their attention away from malaria. This paradox of success needs greater attention to maximize our investments in malaria control and elimination.”
In order to carry on saving thousands of lives in the future every year, it is essential to find new ways that continue to support the successful investments into malaria control and elimination programs to ensure that this dramatic momentum that has already been achieved in the battle against malaria can be maintained and expanded even further.
In an Abstract in the same journal, the authors concluded:
“Given that most malaria resurgences have been linked to weakening of control programmes, there is an urgent need to develop practical solutions to the financial and operational threats to effectively sustaining today’s successful malaria control programmes.”
Written by Petra Rattue