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Malaria is one of the leading causes of death worldwide. In 2015, there were an estimated 438,000 deaths globally due to malaria, 340,000 of which were children under the age of 5 [1].
World Malaria Day (25th April 2016) [2] aims to raise awareness of the 214 million cases of malaria in 2015 and the international effort to treat and prevent malaria. The theme for World Malaria Day this year is “End Malaria for Good”, which echoes the World Health Organization’s goal to eradicate malaria completely.
What is malaria?
Malaria is caused by a number of different parasites and is often transferred to humans via the female mosquito bite. It initially infects liver cells, but, as it moves into the blood stream it can cause anaemia, fevers, possible hemorrhaging and multiple-organ failure.
Effects on society
3.2 billion people are at risk of malaria, which is almost half of the world’s population [4], and in India, around 82% of the population lives in malaria-endemic regions. Malaria presents a significant economic burden; it has been estimated that the total economic cost of malaria in India is around US$ 1940 million, mainly due to lost earnings [5]. Accessing treatment can also be challenging as the majority of malaria cases occur in rural and remote areas where health services are sporadic and of poor quality.
Eradicating malaria
The United Nations set the reversal of malaria incidence as one of its Millennium Development Goals in 2000 [6]. Efforts to control mosquito populations and protect people from mosquito bites have reduced transmission, and greater supplies of antimalarial drugs have reduced mortality. Since 2000, there have been 1.2 billion fewer cases of malaria and 6.2 million fewer deaths caused by malaria [1].
However, there are still many challenges in the fight to eradicate malaria. The emergence of resistance in the malaria parasite to antimalarial drugs is a huge threat to malaria treatment across the world. Resistance can emerge when the parasite is able to survive treatment, due to people not completing their drug courses. The accidental treatment of non-malaria cases with antimalarial drugs can also lead to resistance. This resistance can then spread through the parasite population, leading to cases that cannot be treated by the usual anti-malarial drugs. There is constant pressure to develop new antimalarial drugs to overcome resistance, however this cycle is not sustainable and new drugs are becoming increasingly expensive.
In 2015 the UN announced its Sustainable Development Goals, including the eventual goal of complete malaria eradication [7]. By 2030, it aims to:
Reduce malaria incidence and mortality by 90% compared to 2015
Eliminate malaria from at least another 35 countries
Prevent re-establishment of malaria in all countries that are malaria free.
Lepra’s Work
Lepra’s project in Adilabad district in India works towards this goal [8]. Lepra provides mobile health services to provide care to those in more remote and rural areas as well as running health education sessions so that families can learn how to prevent malaria and recognise the symptoms earlier. Lepra also helps implement preventative measures by promoting the use of long-lasting insecticide bed nets and cleaning mosquito breeding sites.
Lepra also trains ashas on how to test for malaria. They have small malaria testing kits, which Lepra is able to show them, as well as local village doctors, how to use to test for the malaria parasite. This ensures that only patients who definitely have malaria receive anti-malarial treatment. This is important in working to prevent the emergence of drug resistant malaria.
In a new project in Odisha, Lepra aims to halve the number of deaths caused by malaria by 2017 in 1,174 villages across three endemic Districts. Through this project, Lepra will be helping the most vulnerable populations like pregnant women, young children and the elderly.
The area of the map afflicted by malaria has shrunk rapidly however, the eradication of malaria still poses significant challenges. By donating, you can help in the international effort to end malaria for good.
James Maye is a second year medical student at Oxford University. His current focus is on the philosophy of medicine and what medical practice is actually for. He is interested in understanding the processes driving aspects of society, such as how global health policy is drafted, agreed upon and then implemented. His major interests outside of medicine include computer programming and writing.
References:
World Health Organization, World Malaria Report 2015 (Geneva, 2015)
http://www.worldmalariaday.org/
Levinson A, Review of Medical Microbiology and Immunology (thirteenth edition) (USA, 2014), pp. 420-425
World Health Organisation, Global technical strategy for Malaria 2016-2030, (Geneva, 2015)Gupta, I., & Chowdhury, S. (2014). Economic burden of malaria in India: the need for effective spending. WHO South-East Asia J Public Health, 3(1), 95-102.
United Nations, World Development Goals (New York, 2000) Target 6.C
nited Nations, Transforming our World: The 2030 Agenda for Sustainable Development (New York, 2015) pp. 20
https://www.lepra.org.uk/other-diseases