According to the World Health Organization, last year there were 219 million cases of malaria – an preventable but potentially fatal disease that is transmitted mainly by biting the female Anopheles mosquito between the night and the early morning hours. Every year over 90% of malaria-related deaths occur in Africa, but warming and climate change may soon change this story.
In fact, the story is already rewritten. Vector-borne diseases such as Zea, dengue and West Nile virus appear in areas where they were previously unknown. And it's not just the weather: as people in rural areas are rapidly migrating to urban areas to avoid the effects of climate change, they bring new diseases to densely populated and crowded communities that do not have immunity.
Half of the world is now at risk of contracting malaria, and with higher temperatures and precipitation variations, Florida University researchers expect that malaria-vulnerable areas will change and the common transmission area will expand. As malaria arrives in new areas, this poses a significant risk to populations that are never exposed to the malarial parasite; these people lack protective immunity and epidemics are possible in changing weather conditions.
Babies, children under five and pregnant women are particularly vulnerable to severe malaria disease. There are also immunocompromised people who have no protective immunity, such as non-immune migrants and the mobile population, including travelers and refugees returning to endemic zones. In fact, the United Nations Children's Fund (UNICEF) believes that malaria – which I want to repeat – is preventable – kills one child almost every minute. This is approximately 1200 children every day.
Malaria during pregnancy may result in miscarriage, stillbirth, low birth weight and prematurity, as well as other congenital infections and abnormalities and early death in neonates. Moreover, malaria strengthens poverty. Malaria can be debilitating to the point that infected people are unable to work, and repeated episodes are expensive in terms of access to treatment and loss of income due to missed work. Such a disease turns families into a cycle of suffering, poverty and illness.
Over the last 20 years, the Concern has been at the forefront of the fight against malaria by working with other international partners and national ministries of health. In many sub-Saharan African countries, malaria is the leading cause of illness and death in young children. Families do not have sufficient access to healthcare facilities and face high alternative costs and spending on pocket care. Not surprisingly, there is often a delay in seeking timely and appropriate medical care.
Nearly two decades ago, Rwanda responded. Only six years after the genocide, bold and ambitious steps have been taken to bring malaria treatment to the door of the home. Village volunteers were identified and trained to test malaria, identify signs of danger, and treat positive cases of malaria. Instead of having to spend hours walking in a health facility when they or their children get sick, people are treated right in the homes.
Over the next decade, the Ministry of Health in Rwanda has worked with international partners and more than 7,000 volunteers. Overall, these efforts accounted for 20% of the Rwandan population and over 600,000 cases of fever in children were managed. This model, now known as integrated case management in the community, was so successful that it was expanded to include other diseases such as diarrhea, pneumonia and malnutrition, and was extended throughout Rwanda. As such, this experience has shown a significant reduction in child mortality, one of the first studies of this type.
But progress was not limited to Rwanda. In Sub-Saharan Africa, I witnessed the symbiotic efforts between the international community and national governments to fight malaria by investing in communities and health systems and testing innovative solutions to overcome this millennium problem.
In Niger, studies show that under the appropriate training low literacy and illiterate mothers can identify, test and cure children with malaria in their communities. In fact, these mothers successfully managed to cure over 5,000 children over a period of 13 months, resulting in a 20-fold increase in proper malaria treatment and almost double the number of children regularly sleeping under a treated mosquito net. Such approaches – where communities, with some support and investment, save their children's lives – were replicated in Burundi, South Sudan and Sierra Leone, among other countries around the world.
In Tanzania, we learned that a locally available plant, Lantana camara, which grows in most of Sub-Saharan Africa, is naturally repulsive mosquitoes. Our experience in working with community members to introduce the plant has brought remarkable results: Lantana camara homes have had over 55% less malaria transmitting malaria, helping to prevent malaria. By planting them around the homes, people's lives are now saved.
Since 2000, UNICEF has estimated malaria mortality by 40%. Concern Worldwide is proud to contribute to steady progress towards reducing the burden of malaria and congratulates partners who support cutting-edge approaches and technologies such as the development of a vaccine to eliminate malaria.
However, this progress is not without cost: malaria management costs Sub-Saharan Africa $ 300 million a year and 1.3% of total GDP in Africa. Despite these investments, climate change is increasing and weather-related events are becoming more frequent and more severe, endangering progress towards eliminating malaria and creating a global risk to public health.
Vector vectors are already emerging in new areas and now is the time to invest in overcoming preventable diseases such as malaria before they spread. Considered by UNICEF to be the best buyer in global health, return on investment is high: the world is ready to win about $ 270 billion and save countless lives by eliminating malaria in sub-Saharan Africa.