Monday, November 7, 2016

Resurgence of Malaria

The world’s see-saw battle against malaria began in 1955 with the launch of the Global Malaria Eradication Programme (GMEP). GMEP, which was halted in 1969, did have a measure of success. Europe, North America, the Caribbean and parts of Asia and South-Central America became malaria free. But with periodic episodes of malaria resurgence, the war against the vector disease remains a deadly one.

The term malaria resurgence is applied when the disease reappears in areas where it had been eliminated or was previously well in control. A study conducted by the Clinton Health Access Initiative, in conjunction with the UCSF Global Health Group and the Johns Hopkins Malaria Research Institute analyzed the causes of 75 documented episodes of malaria resurgence throughout the world over the past 80 years. The study was published in the April 24, 2012 issue of Malaria Journal. It concluded that 68 out of the 75 episodes of resurgence (91%) were due to reduced focus on malaria control programmes. In 39 of these 68 cases, the programmes failed to take off due to a lack of funds.

The cessation of the GMEP brought to an end the global fight for eradication of malaria and shifted the focus to regional elimination via the use of tools like vector control and insecticide treated nets. However, the newly independent countries of Africa in the 1990s did not have the funds to fight malaria on a war footing, causing a resurgence of the disease. The Roll Back Malaria initiative was launched by the World Health Organization in 1998 in view of this resurgence. Increased resources were allocated to fight malaria through the Global Fund to Fight AIDS, Tuberculosis and Malaria, the World Bank’s Booster Program, the US President’s Malaria Initiative. With more funds available for anti-malaria intervention, malaria eradication in specific geographic areas has gained momentum since the year 2000.

But there is a caveat to the success of the malaria control programme. The success is fragile. It can be maintained and sustained only if accompanied by financial and political support. Otherwise, malaria resurgence is likely to rapidly erase any gains made towards elimination or eradication.