Malaria is a life-threatening disease predominantly impacting lower income families in sub-Saharan Africa(WHO). There are 15 countries that account for over 80% of all malaria cases, three of the top four contributors being in Africa: Nigeria, the Democratic Republic of the Congo and Mozambique (WHO). Together, these three countries represent 41% of the cases, but they are only a fraction of the 91 countries reporting nearly 216 million cases of malaria in 2016 alone (WHO). Solely in 2015, 88% of global cases reported were in Africa, as well as 90% of the deaths, perpetuating this health crisis and leaving a large population highly at risk of contracting the parasite (WHO). However, the ever-evolving medical field has recently brought discoveries to light that may change these statistics forever; vaccines capable of decreasing malaria transmission rates. Along with these advances have come widespread preventative measures to help in the fight against malaria.
Malaria is transmitted through the insect bites of infected female Anopheles mosquitoes, which have been described as “malaria vectors” (WHO). Malaria primarily impacts young children under the age of five, pregnant women and travelers or migrants that have not previously been exposed to these parasites (Yeung). Children under five are particularly vulnerable as they have yet to develop partial immunity, unlike adults who have been exposed to the parasite for a much longer time (CDC). This lack of immunity brings the daily death toll to 730 globally, or one child every two minutes (UNICEF).
While malaria itself can be a threat to life, it poses other burdens on its survivors. Incapable of working or attending school when ill, the disease perpetuates a cycle of poverty and financial stressors for under-served communities (UNICEF). Malaria is also rampant in rural communities, where adequate resources such as clinics are widely unavailable or understaffed (CDC). The scarcity of resources in these communities contributes to the socioeconomic entrapment individuals face, maintaining a cycle of poverty and instability, both of which result in ineffective control measures and malaria-prevention efforts (CDC). Beyond this scope, governments and the families of sick individuals are also impacted in a financial context. As of 2000, malaria has cost sub-Saharan Africa a yearly sum of $300 million for mere case management; this does not include additional resources or assistance (UNICEF). Meanwhile, families unable to report to their jobs in order to care for their loved ones will lose out on wages and may be replaced, all while having to foot prescription drug bills, travel expenses to reach adequate healthcare, the purchase of preventative measures for disease transmission and in the case of death, funeral costs (CDC).
However, since 2010, malaria child mortality rates have dropped by 34%, illustrating a decrease in transmission and better preventative measures (UNICEF). Increasing education on preventative equipment, such as insecticide-treated mosquito nets (ITNs) and, long lasting insecticide treated nets (LLINs), as well as a broader availability of antimalarial drugs and intermittent preventive treatment during pregnancy (IPTp) have contributed to a decrease in overall transmission rates (UNICEF). More recently, a pilot programme between three countries- Ghana, Kenya and Malawi- have launched a vaccine that has been developed for over 30 years (Yeung). The RTS,S vaccine has the goal of immunizing 1 million children by 2023 in the pilot programme participating countries, primarily targeting regions with high transmission rates (Yeung). In trials, the vaccine is found to be only 40% effective, however, researchers hope to continue ameliorating the formula and have decided to go ahead with the launch as the benefits of this vaccine far outweighs its shortcomings (Yeung). A multitude of global health organizations have fronted the $700 million cost associated with the development of this vaccine and its implementation into the pilot programme (Yeung). The RTS,S vaccine is complex however, as it needs to be administered four times in increments of six, seven, nine and 24 months in order to be most effective, posing a problem for rural communities (Yeung).
Hope has not been lost as research continues, with the promise of a new, more effective vaccine named PfSPZ (Yeung). While this vaccine brings its own personal set of challenges along, such as needing to be stored in liquid nitrogen and requiring high parasite doses, it could prove to be more than twice as effective as RTS,S (Yeung). New discoveries continue to arise, namely the discovery that a widely available drug that treats parasitic infections, Ivermectin, has been found to also have the potential of killing malaria-carrying parasites, rendering human blood poisonous to mosquitoes (Yeung).
Scientific innovation and discovery continues to further our understanding of human health and disease, promising a bright future for eradicating diseases like malaria, however grim their history may be.
“CDC - Malaria - Malaria Worldwide - Impact of Malaria.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 4 Jan. 2019, www.cdc.gov/malaria/malaria_worldwide/impact.html.
“Malaria.” World Health Organization, World Health Organization, www.afro.who.int/health-topics/malaria.
“Malaria in Africa.” UNICEF DATA, data.unicef.org/topic/child-health/malaria/.
Yeung, Peter. “Biting Back: New Hope in the Fight against Malaria.” Positive News, 11 Nov. 2019, www.positive.news/lifestyle/health/biting-back-new-hope-in-the-fight-against-malaria/.