A tipping point for eradicating malaria in Africa
The U.S. eliminated malaria in the 1950s -- how close is Sub-Saharan Africa to doing the same?
Friday, December 24, 2010 - 19:39
GIVE A LITTLE: A $10 donation to Nothing But Nets buys a mosquito net that provides years of protection. (Photo: barakacommunity/Flickr)
Malaria — that far-away, developing-country disease that will inevitably plague Sub-Saharan Africa and kill 800,000 people yearly — once ravaged American territory. Until 1951, the U.S. battled malaria without vaccines, global aid or 21st century technologies. So for anyone under the impression that it will take a miracle to rid Africa of history's worst epidemic, think again.
We have had the tools to eradicate malaria for well over a century, and more keep emerging. The recent development of Mosquirix, the first malaria vaccine, has excited activists fighting to end this disease in concert with the rest of 2015's Millennium Development Goals. Its main focus is Sub-Saharan Africa, where most cases occur. But the efficacy rate of the new vaccine is only at 50 percent. To be successful at large, scientists and doctors would need at least an 80 percent success rate before widespread dissemination for fear users would develop a false sense of security and neglect full-proof methods.
So what is a full-proof method? Mainly, Africa needs more nets. Since 2008, 23 more countries in Africa have adopted the World Health Organization goal to provide mosquito nets to everyone at risk of malaria. By the end of 2010, 289 million nets will have been delivered to Sub-Saharan Africa since 2008 — enough to protect 76 percent of the people in affected areas. This rapid improvement signifies just how serious this generation is about eradicating malaria from Africa — and how close it is to succeeding.
And luckily, history shows we don't need to wait for a perfected vaccine to do so. If other countries eradicated malaria 100 years ago, the technologies and heightened global awareness of today are enough to squash the bug in Africa for good.
How Uncle Sam squashed the bug
This disease was once on our shores. America's fear of malaria outbreaks spiked in the early 1900s, when malaria was a major cause of death for workers building the Panama Canal during U.S. military occupation in Cuba. 21,000 out of the canal's 26,000 workers were hospitalized in 1906. The U.S. implemented a vigorous insect control program, and by 1912, only 5,600 out of 50,000 workers were infected.
By 1933, the U.S. Tennessee Valley Authority (TVA) established a large malaria control program in a region where 30 percent of the population was affected by malaria. After extensive research, aggressive attacks on mosquito breeding sites, and careful control of water levels, the disease was eliminated in the area by 1947. Also in 1947, a cooperation between the CDC and southeastern state health agencies established the National Malaria Eradication Program. After 15,000 malaria cases were reported that year, the number of cases began decreasing exponentially. By 1951, malaria was altogether eliminated from the country.
Without the use of vaccines, 21st century technologies or a global coalition of volunteers, the U.S. eliminated malaria. The country's aggressive insect control operations were achieved through cooperation between government and health organizations, as well as a brief influx in federal funds. With dozens of U.N. member nations, NGOs, nonprofits and governments focused on the elimination of malaria, no piece of history or science indicates this disease cannot be eradicated in Africa as well.
The economic parasite
Africa's current malaria battle is not just about reclaiming integrity and quality of life; it is powerfully reversing a downward spiral of poverty. Consider what happens when hoards of people in a Sub-Saharan African village — husbands, mothers, children, caretakers, breadwinners, guardians — are suddenly incapacitated if not wiped out forever. Work stops. People stop. Entire towns become grief stricken or whittled down. In countries of high malaria transmission, GDP can decline by 1.3 percent yearly. These aggregated annual losses create tremendous rifts between the wealth of nations over time.
In heavily infected countries, malaria can also account for 40 percent of public health expenditures, 50 percent of inpatient hospital admissions and 60 percent of outpatient health clinic visits. Poorer families are disproportionately affected by their lack of funds for treatment. This puts incredible strain on governments, healthcare facilities and villages forced into economic regression.
A sudden decline in malaria cases would surely require some societal reorganization, but there is no question that eradication would dramatically improve quality of life and potential for economic stability. A study of Sri Lanka's malaria eradication in the mid-20th century, for example, showed that while the subsequent population rise after eradication can pose negative economic effects, these are only temporary. Sri Lanka's campaign brought malaria from 97 percent in 1935 to 17 cases in 1963. The initial effect of eradication was increased fertility in the population, but this suddenly larger cohort then displayed fewer births and higher human capital after a temporary congestion period.
This generation can stop it
Activists are often frustrated by mandates to eliminate poverty, achieve universal education and instill gender equality on a global scale. When? How? At what cost? Sweeping panaceas for these problems are hard to come by.
But ending malaria does not require a miracle. It does not necessitate new governments or major cultural shifts. It does not have to take a lifetime. There are scientific, finite and viable ways to stop the spread of this disease, most of which involve aggressive dissemination of mosquito nets. Andrea Gay, the U.N. Foundation's director of Children's Health, explains, "Theoretically, if every person in Africa slept at night under a tent, nobody need ever die of malaria again."
Buying $10 mosquito nets through the UN's Nothing But Nets initiative is one of the most effective ways for us to stunt the growth of this disease. Common drugstore bug spray brands like OFF! and Cutter cost about 5 to 7 dollars a bottle. If you're willing to pay that amount to ward off mosquitoes from a summer picnic, consider making a comparable donation to shield your peers in need.
The average person may unconsciously perceive malaria as a distant problem indigenous to economically depressed countries. They may believe no one person can have an immediate effect on such a massive health crisis. Yet just one person's ten dollar bill can shield a family for years. If enough people do so, malaria could potentially disappear from Africa within half a lifetime.
Make a Christmas donation to Nothing But Nets. We are so close. Be part of the generation ending history's most catastrophic epidemic.
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