Maeve Rooney

Malaria BitesThe need to effectively combat malaria on a global scale

Background Malaria is one of the most common infectious diseases in the world and a major public

health concern worldwide. Nearly half of the world's population lives in areas where there is a

risk of getting malaria.1 It is estimated that 124 to 283 million people suffer from acute malaria

each year and approximately 660,000 people died from malaria in 2014 alone. Pregnant women

and children five years old and younger face the greatest risk of catching malaria.2 In fact,

malaria claims the lives of three- thousand children every day. 3, 4 Malaria is predominately an

issue in sub-Saharan Africa and Southeast Asia, with 90% of malaria deaths occurring solely in

Africa. 5 Despite possible eradication and effective combative measures, hundreds of thousands

die due each year due to little access to preventive measures and treatment. Malaria does not

only take toll on health, but also results in many social and economic burdens as well. Areas

with the high levels of malaria often tend to be the most poor. Malaria contributes to this by

hindering economic growth and development in many of these already struggling nations. This

poverty fuels malaria epidemics since poor individuals lack the resources to protect themselves

from infection. These socio-economic costs of malaria enable poverty to continue as a vicious

cycle. In order to effectively combat malaria in areas of poverty, international organizations or

world super powers need to intervene and implement international goals to alleviate the grasp

of malaria.

Environmental Conditions Malaria transmission occurs when a human is bitten by a female Anopheles mosquito

infected with the malaria paraiste.6 So, wherever the Anopheles mosquitos can be found,

malaria can be found as well. Certain environmental conditions are needed for the mosquito

vector to survive and thrive. There are three main climatic factors that directly affect malaria

transmission; temperature, rainfall and relative humidity. This conditions include: precipitation

accumulation greater than 80 mm, average temperature between 18°C and 32°C, and relative

humidity greater than 60%.7 Areas in sub-Saharan Africa and Southeast Asia meet these

conditions which contributes to why these areas are so heavily plagued by the disease.

In order to reproduce, the mosquito vector needs standing water for its larvae to complete

its lifecycle. Mosquito breeding sites include irrigated areas such as canals, hydraulic structures,

seepage pools, rice fields and borrow pits.8 Rural farmers often use canals or ditches to irrigate

their fields and often prime breeding areas.9 These rural areas tend to have a higher risk of

malaria since they are often without sophisticated water supply systems. The sanitation

systems that are in place often utilize streams or ponds for everyday water use. Many of these

ponds produce stagnant patches of water, which is an ideal location for the development of

mosquito larvae.10 Many people use these water systems every day which contributes to the

large malaria problem in poor, rural areas.

Social Costs Despite the obvious health costs due to malaria being a deadly disease, there are also

many social costs that can be attributed to it. A major social consequence is the increase of

both school and work absence. If a child has malaria, they will be too unhealthy to attend

school. In endemic areas, as much as 60 % of children’s schooling may be impaired as a result of

absenteeism due to repeated malaria infection.11 Children who have a serious case of malaria

often develop physical and mental impairment which effects their educational and social

development.12, 13 Reoccurring malaria infection also hinders a child’s physical and cognitive

development, and may reduce a child’s overall performance in school when they are able to

attend. 14 These children will be unable to better themselves by receiving an education and

could remain stuck in a life of poverty. Malaria induced absence holds true for the workforce as

well. 15 Being seriously ill inhabits workers from working effectively or from working at all. Not

being able to work results in lack of wages that are needed for survival or supporting a family.

Without the ability to buy food many families could become malnourished and more

susceptible to diseases. Repeated malarial infections can also have the same effect .16 This

results in an unhealthy society with a low standard of living. Many of these people will be

unable to escape a life of poverty.

Economic Costs Malaria, seen as a consequence of poverty, is also a major cause of poverty and its

prevention is an important part of poverty alleviation. Malaria-endemic countries are among

the worlds most impoverished. Malaria has been estimated to cost Africa more than US$ 12

billion every year in lost GDP, even though it could be controlled for a fraction of that sum. 17, 18

Malaria continues to slow growth by more than 1% a year. 19

Paying for treatment is a substantial economic burden for many families in malaria

endemic areas. In these poverty stricken areas, families spend an average of over one quarter

of their income on malaria treatment. 20 There is also the added cost of buying preventative

measures like mosquito nets. Malaria-afflicted families also suffer a loss of income from the

inability to harvest as many crops as healthy families. On average, these malaria affected

families can only harvest 40 % of the crops that healthy families can.21 Malaria also influences

crop preference by farmers. Individual farmers are more inclined to plant subsistence crops

rather than more labor-intensive cash crops because of malaria's impact on labor during

harvest season.22 Therefor smaller amounts of less profitable crops are being harvested so

economic productivity and profit is not being maximized.

Malaria also has a global impact on the economies of endemic nations. The presence of

malaria inhibits foreign investment due to traders' unwillingness to travel to and invest in

endemic areas due to obvious heath concerns. 23The threat of the disease also decreases

tourism and leads to an undeveloped tourist industry since potential travelers are reluctant to

visit these malaria-endemic areas.24 As a result, the economies of malaria affected nations tend

to be isolated, with their economies frozen at a subsistence level.25

Poverty/ Socio-economic cost United Nations International Children's Emergency Fund (UNICEF) refers to Malaria as a

“disease of poverty” due to the direct correlation between poverty and instances of malaria.26

Most countries with malaria are among the poorer nations and are trapped in a vicious cycle of

disease and poverty. 27The only parts of Africa free of malaria are the northern and southern

extremes and are home to the richest countries on the continent. There is also no coincidence

that Haiti has the worst malaria in the Western Hemisphere and it is the poorest country in the

hemisphere. 28

Attaining proper protection from malaria is attributed to socio-economic factors since

treatment is not free. Those living in poverty are unable to afford proper treatment or means of

prevention. Preventing mosquitoes from entering the house and biting people is key way to

prevent infection. Those who are wealthy will a have more access to preventative measures

such as fully screened houses or even air-conditioning, which prevents mosquitoes from

inhabiting the house.29These individuals are also more likely to have access to a long-lasting

insecticide treated bed net that prevents them from being bitten by infected mosquitos.

Sufficient income enables these people to gain access to proper medical treatment if they get

infected.30 Those living in less affluent circumstances do not have this luxury. People living in

poverty do not have access to these health benefits and have little protection from malaria-

carrying mosquitos. Because of this, poorer people have a much greater likelihood of

contacting the disease. Therefor poverty can be considered both result of malaria and a cause

of it.

Prevention Today, there are many effective ways to combat malaria. In order to prevent the

disease, the World Health Organization recommends the use of mosquito nets. Nets prevent

people from getting bitten by infected mosquitos. It is estimated that the use of insecticide-

treated bed-nets can reduce episodes of malaria by 50 % in areas of high transmission31 but

despite this fewer than 2 % of African children sleep under a net.32

Indoor Residual Spraying (IRS) of insecticides is also an effective prevention technique.

This process requires coating the walls and other surfaces of a house with a residual insecticide

that will kill mosquitoes when they come in contact with them.33 By reducing the mosquito

population at the source, the spread of malaria is also reduced.

There are variety of antimalarial drugs on the market such as Malarone, Chloroquine, or

Doxycycline that are used as treatment against malaria.34 But there is no “magic” antimalarial

drug that is 100% protective. The use of antimalarial drugs needs to be combined with the use

of other prevention methods.35 Although these prevention methods seem relatively accessible,

these treatments put an additional burden in the already fragile economies of malaria endemic

countries.

Potential Strategies:International Initiatives

Since malaria influences many nations throughout the world, international organizations

such as the United Nations should lead the way in combating it. Currently, the fight against

malaria is one of the UN’s eight Millennium Development Goals. Goal 6 specifically focuses on

the disease since the goal is to combat HIV/ AIDS, Malaria and other diseases.36

(Above: The text of the UN’s Millennium Development Goal 6 and its emphasis on malaria)

The World Health Organization (WHO) is a specialized agency of the UN that is concerned with

international public health and therefor plays a major role in combating malaria. 37 According to

WHO, four countries have been certified free of malaria in the last decade. 38 Now the World

Health Organization hopes to eliminate the disease in 35 more countries and reduce malaria

cases and deaths by 90% by 2030. 39

Although advances have been made, The World Health Organization believes the

current rates of progress will not be enough to meet global targets for malaria control. In order

to effectively combat the disease today, there is a dire need for renewed investment in

diagnostic testing, treatment, and surveillance for malaria. 40 Malaria is notorious for becoming

resist to anti-malarial drugs41 so new drug developments are desperately needed to successfully

fight the disease. More funding for these initiatives is urgently needed to make them available

to the people who need them and to combat emerging drug and insecticide resistance.42 In

order for international organization to have the a greater affect, funding must be allotted to

meet these new initiatives. The UN must encourage international support for this initiatives to

raise the funds needed for success. The research initiatives for new antimalarial drugs should be

carried out and international research initiatives should be started. If many powerful nations

worked together to combat malaria there is no doubt great progress could be made.

U.S. Initiatives

Another strategy in

combating malaria would be for the United States to take the lead in eradicating malaria. A

malaria- free superpower like the United States would make an excellent example of what

could be possible when malaria is taken out of the picture. Malaria is no stranger to the United

States and was a health concern in the US until the 1940s. In 1949, the country was declared

free of malaria as a significant public health problem and by 1952, all antimalarial operations

ceased altogether. Total elimination was slowly achieved by DDT insecticide spraying, improved

drainage and removal of mosquito breeding habitats.43 Due to elimination success in the US,

these successful methods could be modeled for foreign nations. Encouraging and aiding these

efforts to malaria endemic countries could help alleviate the problem in other nations just as it

did at home.

(Above: 1940s-50s U.S. Public Health Service malaria prevention posters)

Since U.S. eradication, the United States has had an active role in combating malaria

through foreign aid agencies like USAID. They seek to work with national governments to

increase capacity to prevent and treat the disease. USAID also invests in the discovery and

development of new antimalarial drugs and malaria vaccines. 44 The President’s Malaria

Initiative was to reduce malaria related death by 50% across 15 countries in sub-Saharan Africa

by providing prevention and treatment measures.45The United States should also begin the

development of new antimalarial treatment the WHO is calling for. A super power like the

United States taking a stand against malaria would help shine a light on the severity of the

disease worldwide. Helping struggling foreign nations combat malaria would help improve US

foreign relations which later could be beneficial to US interests. These efforts would also bolster

positive opinion towards the United States due to the extensive humanitarian effort taking

place to combat the disease. Not to mention the global health benefits that would follow

eradication of the disease.

ConclusionMalaria is a devastating disease that effects the lives of millions every day. Thankfully, a

variety of prevention methods exist that effectively deter infection rates. But more funding

must be put toward preventive methods in order to successfully reduce global infection.

Combating malaria is a global issue that needs support from international organizations or

global super powers. The nations malaria severely affects cannot be expected to battle malaria

alone. This is a global problem that needs global attention. Nations must work together to

successfully reduce and eradicate malaria. Malaria must be viewed as something that harms

humanity as a whole. We are all human and we all deserve to be healthy.

End Notes1. "Malaria, A Global Crisis." UNICEF. UNICEF, Apr. 2014. Web. 29 March. 2015.2. "Malaria Status & Challenges of the Epidemic." Green Facts. N.p., n.d. Web. 29 Mar. 2015 3. "Malaria Prevention Basics." Malaria Prevention Basics. SOCIETY FOR YOUTH AWARENESS

AND HEALTH DEVELOPMENT (SYAHD), 2003. Web. 29 Mar. 2015.4. "Malaria, A Global Crisis." UNICEF. UNICEF, Apr. 2014. Web. 29 Mar. 20155. Ibid6. "Malaria Frequently Asked Questions (FAQs)." Centers for Disease Control and Prevention.

Centers for Disease Control and Prevention, 04 Mar. 2015. Web. 29 Mar. 2015.7. "Malaria Historical Analysis." Malaria Historical Analysis. International Research Institute for

Climate and Society, 2005. Web. 10 Apr. 2015. 8. "Malaria & Water Management." International Water Management Institute (IWMI). CGIAR,

n.d. Web. 10 Apr. 2015. 9. "Socio-Economic and Environmental Conditions Contributing to Malaria." MALARIA.

Malaria.com Uniting Against Malaria, n.d. Web. 29 Mar. 2015. 10. Ibid11. "Malaria, A Global Crisis." UNICEF. UNICEF, Apr. 2014. Web. 29 Mar. 2015

12. Ibid13. "Economic Analyses Indicate That the Burden of Malaria Is Great." Malaria Foundation

International. Malaria Foundation International, n.d. Web. 30 Mar. 2015. 14. Ibid15. Ibid16. Ibid17. "Malaria, A Global Crisis." UNICEF. UNICEF, Apr. 2014. Web. 29 March. 2015.18. "Economic Analyses Indicate That the Burden of Malaria Is Great." Malaria Foundation

International. Malaria Foundation International, n.d. Web. 30 Mar. 2015. 19. "Malaria, A Global Crisis." UNICEF. UNICEF, Apr. 2014. Web. 29 Mar. 2015.20. Ibid 21. "UNICEF Ghana Fact Sheet- Malaria." Malaria. UNICEF, 2007. Web. 30 Mar. 2015.22. "Malaria and Extreme Poverty." The Earth Institute. The Earth Institute - Columbia

University, n.d. Web. 30. Mar. 2015. 23. Ibid24. Ibid25. Gallup, John Luke. "The Economic Burden of Malaria." The Economic Burden of Malaria. U.S.

National Library of Medicine, 2001. Web. 9 Apr. 2015. 26. "Malaria, A Global Crisis." UNICEF. UNICEF, Apr. 2014. Web. 29 March. 2015.27. "Malaria Frequently Asked Questions (FAQs)." Centers for Disease Control and Prevention.

Centers for Disease Control and Prevention, 04 Mar. 2015. Web. 29 Mar. 201528. Gallup, John Luke. "The Economic Burden of Malaria." The Economic Burden of Malaria. U.S.

National Library of Medicine, 2001. Web. 9 Apr. 2015. 29. Socio-Economic and Environmental Conditions Contributing to Malaria." MALARIA.

Malaria.com Uniting Against Malaria, n.d. Web. 29 Mar. 2015. 30. Ibid31. Malaria." WHO. World Health Organization, n.d. Web. 10 Apr. 2015. 32. Gallup, John Luke. "The Economic Burden of Malaria." The Economic Burden of Malaria. U.S.

National Library of Medicine, 2001. Web. 9 Apr. 2015.33. "Indoor Residual Spraying." Centers for Disease Control and Prevention. Centers for Disease

Control and Prevention, 2012. Web. 10 Apr. 2015 34. Choosing a Drug to Prevent Malaria." Centers for Disease Control and Prevention. Centers

for Disease Control and Prevention, 2012. Web. 10 Apr. 2015 35. Ibid 36. United Nations Millennium Development Goals." UN News Center. UN, n.d. Web. 10 Apr.

2015.37. "About WHO." WHO. World Health Organization, 2014. Web. 9 Apr. 2015.38. "World Malaria Day 2015: Invest in the Future. Defeat Malaria." WHO. World Health

Organization, 2015. Web. 29 Mar. 2015.39. Ibid 40. Ibid

41. Ibid42. "Antimalarial Drug Resistance." WHO. World Health Organization, 2014. Web. 10 Apr. 2015.43. "Elimination of Malaria in the United States (1947 — 1951)." Centers for Disease Control

and Prevention. Centers for Disease Control and Prevention, n.d. Web. 10 Apr. 2015.44. "Fighting Malaria." Fighting Malaria. USAID, n.d. Web. 10 Apr. 201545. "PMI, President's Malaria Initiative, Fighting Malaria and Saving Lives." About PMI. N.p., n.d.

Web. 10 Apr. 2015