108 countries now malaria-free. What’s happening in the rest of them?

May 13, 2009

     By Duncan Green     

The Financial Times recently published an excellent special report on Combating Malaria (can you name any other newspaper that would do that?). It pulls together a really good overview of the disease, including the science, politics, examples of successful eradication in Mozambique and elsewhere, the role of community health workers, the debate over bed nets, impact of climate change, and the changing attitudes and practices of aid donors.

Here are some highlights from the overview piece by FT pharmaceuticals correspondent Andrew Jack: There has been a radical change since 2004. Malaria is now on the international agenda, and there is a lot more money available. Ambitious targets have been drawn up to bring worldwide malaria deaths “near to zero” by 2015.

Every year, about 1m people die and hundreds of millions are infected. The economic toll is heavy, with an estimated $12bn loss in productivity and costs of treatment in Africa alone. The scandal is that such a toll ought to be largely avoidable. Unlike many other diseases, simple prevention methods – notably insecticide sprays and bed nets – have long existed; reliable diagnostics are available; and there are effective drugs for plasmodium falciparum, its most lethal variant.

A little over half a century ago, few countries were malaria free. Now, 108 can claim that status, the most recent being the United Arab Emirates in 2007. Countries with strong political commitment such as Rwanda, Ethiopia and Zambia have put in place effective control programmes that have sharply reduced deaths and illness from malaria.

Andrew Jack also rings some alarm bells: ‘There is a risk that malaria becomes the “new” HIV: not in its science or epidemiology, but in the sociology of how a once neglected orphan of a disease has swiftly accumulated so many resources that many may be misspent while bringing unintended consequences. One danger is that the resurgent malaria movement gets ahead of itself, claiming successes and diverting its energies to more ambitious targets such as elimination while more pressing but long-term basic challenges of control remain to be tackled.’

(Meanwhile, over on Aid Watch, Bill Easterly has been getting very upset about what he sees as dodgy data on the malaria debate. For UK-based campaigning on malaria, check out the Malaria No More website, where David Beckham and Andy Murray are promoting bednets!)



May 13, 2009
Duncan Green