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Malaria: A Devastating Public Heath Concern


Malaria: The Controversy

Failure of malaria eradication efforts abroad
Economics of battling malaria
More devastating effects
Are Insecticide Treated Bed Nets enough?
Solutions to come: The Assault

"The emergence of drug resistance, widespread resistance to available insecticides, wars and massive population movements, difficulties in obtaining sustained funding from donor countries, and lack of community participation made the long-term maintenance of the effort untenable. Completion of the eradication campaign was eventually abandoned to one of control." [4]

 

Failure of malaria eradication efforts abroad:

While the US eradicated malaria in 1951, malaria eradication worldwide has not been as fruitful.  In 1955 the World Health Organization believed that a quick and effective blow to malaria could eradicate malaria worldwide. The eradication efforts began with house spraying with residual insecticides, much like the US malaria eradication, but the plans also included anti-malarial drug treatment and surveillance.  Climate was an important factor in successful eradication.  In regions with temperate climates where transmission was only seasonal, eradication was successful.  In other areas such as India and Sri Lanka there were huge reductions in the number of cases, but cessation of control efforts led to a resurgence of the disease.  Some nations showed little or no progress, such as Indonesia, Afghanistan, Haiti, and Nicaragua, while other regions such as most of sub-Saharan Africa were never even included in the program.  The CDC lists the following as the main reasons why the campaign failed: “The emergence of drug resistance, widespread resistance to available insecticides, wars and massive population movements, difficulties in obtaining sustained funding from donor countries, and lack of community participation made the long-term maintenance of the effort untenable. Completion of the eradication campaign was eventually abandoned to one of control.”[1]  Malaria was not always called a disease of poverty, but the poverty stricken regions are among those that were not able to eradicate malaria in the first great effort. 

Map [3] 

The plethora of environmental and social factors that influence the prevalence of malarial cases designate certain regions as more susceptible.  80% of malarial deaths and over 60% of malarial cases occur in Sub-Saharan Africa.[2]  Other affected regions include parts of northern South America, Central America, southwest Asia, and Oceania.  There are currently 107 countries that have malaria risk.  Entrance into many of these countries requires vaccination against a number of vector borne diseases and prophylactic drug treatment against malaria.  This is however a luxury that local citizens do not have, for prophylactic drug treatment is too expensive, can be toxic in the long run, and would likely lead to the quicker occurrence of drug resistant strains of the malaria parasite.  Malaria has been called ‘a disease of poverty and caused by poverty.’  This is a new conceptualization, for, in the ‘40s and ‘50s malaria was a simply a disease.  Perhaps poverty is what separated those that now no longer know what it is from those that live with it on a daily basis.                        

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