Nepal | July 13, 2020

End malaria for good

Number one threat

Chandra Mani Kafle
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Global trends have given us a clue that if control and prevention measures are carried out vigorously throughout the globe, malaria can be made a thing of the past


Illustration: Ratna Sagar Shrestha/ THT

We assume life can be shut down to abyss any time in the unseen future. Natural calamities also agonize us as we just experienced the Gorkha earthquake last year. We stress over being bitten to death by snakes or stung by scorpions while hiking around the outskirts of the city on the very sunny day of an weekend. Numerous stories of mishaps on roads and air give chills to the bones while taking off for anywhere. We take the above mentioned gruesome statements as great threats to humanity. However, we always fail to count the greatest threat of humanity of all time in this list. Mosquito, the deadliest animal with minuscule shape and size comfortably flying around you, yes you guessed it right: it is the number one killer. Let’s not forget Dengue Hemorrhagic Fever, West Nile fever, Chickungunya, Yellow Fever and Zika: including malaria, all are transmittable by the bite of different species of mosquito responsible for the high number of death toll each year.

The World Health Organization (WHO) estimated the total number of illnesses and 400, 000 deaths due to malaria in 2105 AD. Sub-Saharan Africa alone experienced more than 90% of the total fatality associated with malaria and among them, 350,000 were children who were yet to celebrate their fifth birthday.

In the recent report, WHO estimates that nearly half of the total population of the world live in the area where malaria transmission is high. WHO has listed 95 countries as malaria transmission territories which include countries of Sub-Saharan Africa, Latin America, Asia and to a lesser extent some countries of the Middle East are also included in this list.

The high risk areas of Nepal are represented by foothills and river belts, forest fringe areas, forests of Terai area, inner valleys and some Terai districts. Low risk area basically lie in plain cultivated outer Terai, mountain and mountain river valleys.

In order to curtail the disease burden, early case diagnosis and prompt treatment accompanied by effective means of controlling malaria transmission become necessary. For a nation, it not only requires a lot of investment for the prompt management of the burden of malaria but also it needs a vigorous strategy and improved malaria surveillance system to get rid of the otherwise unceasing burden of malaria.

The Millennium Development Goals (MDGs) aimed to halt and reverse transmission and incidence of malaria by 2015. Although MDG related to malaria was not achieved in all countries but it resulted in 60% reduction of malarial mortality rate globally. Thanks to the increased control and prevention measures more than 6 million lives have been saved globally since 2001. Malaria trend seen in Nepal is steeply declining though some major outbreaks are reported. In the decade of 2002 to 2012 AD, Nepal made significant progress in controlling malaria as the total confirmed malaria cases declined to 84%. The decreased trend of malaria cases with zero death since 2012 AD has been observed. Government has scaled up the access of on the spot diagnostic apparatuses (RDTs), anti-malarial drugs, massive coverage of Long Lasting Insecticide Bednets (LLINs) distribution in endemic districts and increased socio-economic status of vulnerable communities and people in order to control malaria in the country. Because of the socio-political upheaval Nepal is experiencing, attainment of the targets of all indicators of MDGs could not be made. In September 2015, United Nations Sustainable Development Summit adopted Sustainable Development Goals (SDGs) with seventeen broad agendas and are expected to be more effective than the MDGs.

Nepal has taken a long term malaria control strategy and sets a long term vision of a malaria-free nation by 2026 AD which accords with SDG-3 that aspires to ensure the good health and well-being to all by ending epidemics of malaria, tuberculosis, HIV/AIDS and other communicable diseases by 2030 AD. WHO has also launched Global Technical Strategy for Malaria (2016-2030 AD) with the ambitious yet achievable aim of reducing malaria cases and deaths associated with it by at least 90%, eliminating malaria from at least 35 countries and preventing further resurgence of it on malaria free countries.

In order to celebrate the incredible progress made on controlling malaria, 25 April is marked as World Malaria Day. The theme for this year is “End Malaria for Good” to recognize success of MDGs and reflects on the agendas of SDGs. For the low income and middle income countries, the efforts of elimination of malaria should be made along with with the alleviation of poverty. Prompt treatment, vector control, easily accessible healthcare facility and highly effective surveillance system are necessary for the elimination of malaria which is possible only when the country has been brought out of the vicious cycle of poverty.

Retrospective trends of global malaria situation have given us a clue that if control and prevention measures are carried out vigorously throughout the globe, malaria can be pushed back to the history. This, as aimed by SDGs 3, could be possible if we could make the halt the epidemics of malaria, tuberculosis, HIV/AIDS and other communicable disease. By doing so we could save the lives of hundreds of thousands of children and let them experience a better Earth of tomorrow.

Kafle is a microbiology graduate

A version of this article appears in print on April 25, 2016 of The Himalayan Times.

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