Since
the 1930s, there have been 75 documented episodes of malaria resurgence
worldwide, most of which were linked to weakening of malaria control programs,
finds a new study published in BioMed Central's open access journal Malaria
Journal.
The study, which is allied to the theme of this
year's World Malaria Day (25th April 2012) "Sustain Gains, Save Lives:
Invest in Malaria", found that the most common reason for weakening of
malaria control programs was funding disruptions.
There are over 200 million cases of malaria each
year with 85% of all cases being children under five years old and, according to
the World
Health Organization, in 2010 malaria was responsible for 655 000 deaths
worldwide, mostly among African children. Deaths which are unnecessary, because
malaria is both preventable and curable.
Low cost treatment is available and simple solutions
to prevent the diseases, like insecticide treated mosquito nets and malaria prevention during
pregnancy, have all been shown to reduce the number of deaths due to malaria.
Initiatives like Roll
Back Malaria, set up in 1998, aim to reduce child mortality due
to malaria by two thirds, by 2015, using large scale implementation of these
simple solutions.
Researchers from 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, San Francisco (UCSF) conducted a systematic review of
the literature to identify all documented malaria resurgence events where
malaria had returned to an area previously under control.
The causes of malaria resurgence were categorized as
being due to weakened malaria control programs,
increased intensity of malaria transmission (such
movement of people or mosquitoes, weather, or changes in land use) , or
technical obstacles including resistance of the malaria parasite to
drugs. 91% of the 75 resurgence events found were blamed at least in part on
the weakening of malaria control programs.
Lead author Justin Cohen, PhD, MPH of the Clinton
Health Access Initiative 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 created
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."
Finding innovative ways to continue investing in
successful malaria control and elimination programs is necessary to ensure that
the dramatic progress in the fight against malaria is maintained and extended.
Maintaining support for these programs will allow them to continue to save
thousands of lives year after year.
More
information: Malaria resurgence: a systematic review and
assessment of its causes, Justin M Cohen, David L Smith, Chris Cotter, Abigail
Ward, Gavin Yamey, Oliver J Sabot and Bruno Moonen, Malaria Journal (in
press)
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