Man versus mosquito: Steps to better prevent and control malaria

Something as simple as a bed net is a mighty tool against disease-baring mosquitoes.

Something as simple as a bed net is a mighty tool against disease-baring mosquitoes.

The parasite that causes malaria has shown it is adept at eluding the human immune system. Will that parasite also outrun the prevention and control efforts of global health organizations, governments, healthcare systems, pharmaceutical companies and communities? We are at a critical time to answer that question.

The parasite, which avoids detection by altering its appearance and composition, spends only minutes in the blood stream before hiding in the liver where it becomes even harder to target. This quick action by a very tiny parasite can cause a world of damage that we’ve not managed to contain with decades of work.

The parasite claims more than 600,000 lives per year, most of them children under the age of 5 living in Sub Saharan Africa. Millions of others around the world repeatedly are sickened with malaria, forcing them to miss work and school and putting increased burdens on already strained healthcare systems.

The good news is that global efforts to control and eliminate malaria have saved an estimated 3.3 million lives since 2000, reducing malaria mortality rates by 42% globally and 49% in Africa according to the World Health Organization.

New prevention methods are on the horizon, including the first vaccine against malaria that my own company hopes to file with regulators this year. We also have an investigational medicine in late-stage development aimed at treating a version of malaria found mostly in Asia and South America.

But emerging drug and insecticide resistance pose a threat at a time when climate change, such as increasing temperature and humidity, could make it even easier for malaria-carrying mosquitoes to breed and spread. This is the time to act with urgency so we do not lose ground in this fight.

What will it take to gain the upper hand on this parasite? I have a few thoughts gained from my work directing global health programs.

Keep malaria a priority on the list of global health needs.

Malaria may not be a threat where all of us live but we should act as if it were. That sense of urgency once conquered malaria in the United States. In 1946, the Communicable Disease Center opened in Atlanta to keep malaria from spreading across the nation. The agency’s 400 employees gathered trucks, sprayers and shovels to wage war on mosquitoes. And this predecessor to the Centers for Disease Control won the US malaria war.

Today The Global Fund to Fight AIDS, Tuberculosis and Malaria reports that malaria elimination is being pursued by 32 countries, while 67 countries still are working to control the disease.

Perseverance and creativity can win the upper hand in this battle.

We are supporting a project of The Carter Center in Nigeria that exemplifies the sense of urgency, perseverance, coordination and creativity that we need to replicate elsewhere. The Atlanta-based nonprofit is integrating interventions for malaria and lymphatic filariasis (LF), both of which are spread by the same mosquito.

The same bed net can fight both diseases by reducing mosquito bites. Educational programs about the proper use of bed nets also support both efforts. How to combine activities is detailed in a set of guidelines issued in February 2014 by the Nigeria Federal Ministry of Health with support from The Carter Center.

The Carter Center will focus its project in Nigeria, which has the highest malaria death rate (about 200,000) of any country and one of the world’s largest populations at risk for LF (110 million people).  In 2012, Nigeria announced that transmission of LF had been stopped completely in some areas. Now it is critical that we prevent the disease from returning.

The Center has supported the distribution of nearly eight million insecticide-treated nets in Nigeria since 2004, and more than 36 million drug treatments for LF (the medicines albendazole and ivermectin) since 2000 in central Nigeria. 

Partner with others who share the same goal of tackling malaria, especially when you approach the problem from different vantage points.

As a global business, we have the reach and expertise to deliver goods to many places. But getting access to people in the communities most affected by malaria can be a challenge. Partnering with an organization that has workers already on the ground can be the best opportunity to efficiently deliver care and education as well as medicines.

Groups like Family Health International (FHI 360) work with Community Health Workers to provide education and change behaviors. We work together to improve early recognition of malaria by caregivers and patients, and improved availability of medicines in Ghana.

I am optimistic that creative minds, stubborn determination and innovative partnerships can not only lessen the impact of malaria but ultimately control and eliminate the parasite that causes this disease.