The eternal war against malaria

Today is being observed by the global community as World Malaria Day (WMD). The theme for this year’s commemoration is: “Zero Malaria Starts with Me”. The WMD was established in May 2007 by the 60th session of the World Health Assembly, the decision-making body of the World Health Organisation (WHO), with the cardinal objective of providing “education and understanding of malaria” and spreading information on “year-long intensified implementation of national malaria-control strategies, including community-based activities for malaria prevention and treatment in endemic areas.” The body then designated April 25 every year as a day to reflect on the danger posed by the disease to humanity.

Malaria is a mosquito-borne disease of humans. And it is prevalent in tropical and subtropical regions, including much of Sub-Saharan Africa, Asia and the Americas. There are over 100 species of malaria parasite, the most deadly being the Plasmodium Falciparum, found in Africa.

The disease results from the multiplication of malaria parasites within red blood cells, causing symptoms that typically include fever and headache, and in severe cases progressing to coma and death. Malaria is not just a disease commonly associated with poverty but also a cause of poverty and a major hindrance to economic development. The disease has been associated with major negative economic effects on regions where it is widespread.

According to the statistics released by WHO, over three billion people in 106 countries are sickened by the disease with more than a million of the populace dying of it annually. In the buildup to the 2014 World Malaria Day, the European Vaccine Initiative announced 16 new projects for the acceleration of malaria vaccine development. The projects were to be undertaken by an international consortium involving partners from the public and private sectors from Europe, USA and Africa. But three years down the road, the immunization regime is yet to see the light of the day. Many believe that the initiative is frustrated by a cartel of drug manufacturers in Europe that are profiting from the scourge.

Recent reports have revealed that in many parts of the world, mosquitoes carrying the disease have developed resistance to most of the drugs and insecticides available in the markets, making it extremely difficult to combat the disease and the spread of infection. As part of the renewed effort to put the scourge on the back foot, emphasis is being placed on the insecticide-treated mosquito nets (ITNs). The introduction of new medications like the oral Artemisinin-based Control Therapy (ACT) as a replacement for the mono therapies was geared towards rolling back the scourge which targets and kills most kids before they attain the age of five as well as two out of every 10 pregnant women in endemic areas.

What is making the battle against malaria seemingly protracted is that the killer insects have the ability to breed in millions within days. As if mankind had run out of ideas, a renowned malariologist, Prof. Akintunde Sowumi of the University of Ibadan, during the 2009 World Malaria Day, advocated, perhaps out of frustration, that to eliminate the disease, every Nigerian must endeavour to kill at least one mosquito a day. He described the bug as mankind’s number one enemy that kills more quickly than HIV/AIDS.

However, prevention scale-up is yielding results.  According to the latest estimates from WHO, many countries with ongoing malaria transmission have reduced their disease burden significantly. On a global scale, new malaria cases fell by 21% between 2010 and 2015. Malaria death rates also fell by 29% in the same 5-year period.

Beyond the global efforts at eradicating the malady, the most effective preventive measure is to address the basic factors that fuel the disease. These include grinding poverty, inaccessibility to good medicare, fake drugs, poor sanitary conditions and bushy environments that breed the insects in the neighbourhoods.

In the pre-colonial era, emphasis was placed more on prevention. There were sanitary inspectors whose duty was to comb the surroundings and ensure that the basic conditions that helped the killer insects to populate did not exist. Gutters were kept clean and disinfectants were regularly sprayed by health workers.

This year’s commemoration is subdued by the Covid-19 pandemic that has engaged the global attention since the beginning of the year with no cure in sight, unlike the malaria ailment. The theme of this year’s celebration retreats into insignificance in the face of the killer plague.

However, in the midst of this latest menace brought upon humanity, the race to develop a vaccine against malaria parasite should not slow down. While the plague would not last for too long like others before it, malaria has remained with mankind from primordial times, claiming millions of lives annually.

The annual observation of Malaria Day does not eliminate the disease. What is needed is a pragmatic approach to combating the plague as well as the cooperation of the citizens. It is the only way to win the war against our common enemies.

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