Malaria is an illness that sickened 228 million people worldwide in 2018—405,000 of whom died. By far the greatest number affected live in Africa’s poorest countries. Africa was home to 92 percent of the malaria cases and it was where 93 percent of the malaria-related deaths took place, according to the World Health Organization (WHO). Furthermore, although these figures look worrisome, they represent an improvement from the year 2000, when 839,000 people lost their lives. Malaria is also present in South Asia and Latin America, and there have been some reported cases in the US and Europe.
Malaria is transmitted by Anopheles mosquitos which live in tropical areas. The disease is caused by the Plasmodium parasite. Malaria is often not lethal if diagnosed and treated promptly, according to the Centers for Disease Control and Prevention (CDC). One of the main concerns is the ease with which both the Anopheles mosquito and the Plasmodium parasite have evolved to adapt to the most recent attempts to kill them. Mosquitos have adapted to powerful insecticides, and some varieties of the parasite are already showing resistance to medication. Consequently, it is imperative to eliminate malaria before our best drugs become ineffective.
In 2016, a study was commissioned by the WHO aiming to outline the path to malaria elimination, and the results were published in September 2019 in The Lancet. One of the main findings was that it is possible to eradicate malaria by the year 2050, but the challenges are enormous. It would cost an additional annual spend of at least $2 billion from now until 2050, considering that in 2018 the funding for malaria was roughly $4 billion per year. Increasing spending by half that amount will probably be an issue.
According to the Malaria Consortium, the more accepted way to fight malaria in a country is by working in all areas at the same time. This is because if workers attempt to clear one area, mosquitos then move to the other. Then, once workers move to the area where mosquitos escaped to, the previously cleaned area can be re-infected.
Specifically, to eliminate malaria will take the following resources:
- Vaccination: There is an immunization called “RTS,S” from the company GSK which cost about a billion dollars to develop. The problem is that it is only effective 40 percent of the time.
- Bed-nets: These are insecticide-impregnated nets that cover beds. They keep mosquitos away from people. They are effective and they are relatively low-cost; sometimes they are given for free.
- Chemoprevention: This involves providing preventive medication to potentially vulnerable people in areas of highly seasonal transmission.
- Gene Editing: The idea is to modify a mosquito’s genome to block their reproduction by using a technique called CRISPR. Once this editing is accomplished in mosquitoes, they will spread the modification to offspring using what is called Gene-Drive.
- Repellent Soap: In addition to the recommendations provided by The Lancet we suggest Faso Soap, which repels mosquitoes for up to six hours after one takes a shower.
Malaria is a disease of poor countries. The implementation of strategies to defeat this disease depend, to a large extent, on resources they don’t have. Furthermore, enacting these strategies may be more complicated in countries where governments are fragile or corrupt. Additionally, climate change could complicate things further. This is because the Anopheles mosquito lives in tropical regions and, as the earth warms, tropical weather may be spread to more regions.
Other concerns are that mosquito longevity and transmission rates could increase. Furthermore, malaria is prevalent in countries where the disease is apt to end the lives of those with other dreadful diseases such as tuberculosis, cholera and HIV/AIDS. Malaria definitely complicates the treatment of other diseases.
Eradicating malaria is an achievable goal, but it will take the coordinated action of national and local government agencies and many NGOs.
John Hoffmire is Chairman of the Center on Business and Poverty. He also holds the Carmen Porco Chair of Sustainable Business at the Center. Mario Alejandro Mercado Mendoza, Hoffmire’s colleague at the Center, did the research for this article.