Health ... Malaria
Zambia

The end of malaria is within reach

Burgess COMMENTARY

Peter Burgess

The end of malaria is within reach

PATH and the Zambia National Malaria Control Centre are leading an effort to rapidly eliminate the malaria parasite from large regions of the country. The approach is to treat everyone, including people who are carrying the disease but don’t know it. Photo: PATH/Gabe Bienczycki.

PATH and the Zambia National Malaria Control Centre are leading an effort to rapidly eliminate the malaria parasite from large regions of the country. The approach is to treat everyone, including people who are carrying the disease but don’t know it. Photo: PATH/Gabe Bienczycki.

By Dr. Kent Campbell, Director of the Malaria Center of Excellence at PATH

For thousands of years, people around the world have suffered from malaria. Although the illness has been largely eliminated from North America and Europe, it is still found in nearly 100 countries.

Author Dr. Kent Campbell directs PATH’s Malaria Center of Excellence at PATH. Photo: PATH/Patrick McKern.

Author Dr. Kent Campbell directs PATH’s Malaria Center of Excellence at PATH. Photo: PATH/Patrick McKern.

Each year, malaria affects more than 200 million people and kills about 600,000. Most deaths are among children under five, and children who survive may have lifelong mental disabilities.

Malaria also imposes economic and health hardships on families, communities, and countries. It leads to loss of work and school time, and it forces many families to use limited cash for treatment at the expense of food or school fees.

The societal and pure health impact of malaria is now recognized as largely preventable, and advances in science, technology, and public health have made an end to malaria within reach. This will be a major global challenge, however, requiring sizeable increases in global funding and a continuing array of new and more effective control tools.

Threats to progress

Since 2000, globally the number of new cases of malaria has declined by 25 percent, and deaths have fallen by 47 percent, saving an estimated 4.3 million lives over 15 years. In the past century, this represents a historic low in the number of people suffering or dying from malaria.

We’ve made remarkable progress in 15 years. Click to see our full infographic. We’ve made remarkable progress in 15 years. Click to see our full infographic.

However, progress against malaria is fragile. Attempts to sustain malaria transmission at low but detectable levels, known as malaria control, has been demonstrated to be unsustainable, and resurgence of malaria transmission and health impact is a constant threat.

The malaria parasite and the mosquitoes that transmit it have begun to develop resistance to currently available drugs and insecticides, and these resistant strains will spread. In addition, the cost of maintaining interventions to control malaria has reached several billion dollars per year, an amount that is difficult for donors and countries to cover indefinitely. Despite the remarkable success of previous malaria control efforts, the push for total elimination is the only sustainable goal or end point for malaria.

Accelerating progress, advancing excellence

To develop the next generation of tools and approaches to eliminate malaria, PATH has created a Malaria Center of Excellence that aims to address critical needs in malaria elimination, spur continued innovation to improve our ability to diagnose and treat the disease, and strengthen the enabling environment for malaria programming so that progress is leveraged and impact is magnified.

PATH’s Malaria Center of Excellence aims to combine the most effective tools and approaches to eradicate malaria. Click to see larger version. PATH’s Malaria Center of Excellence aims to combine the most effective tools and approaches to eradicate malaria. Click to see larger version.

Our approach is multipronged. First, we are supporting countries to optimize proven malaria-prevention techniques, like distribution of insecticide-impregnated bednets and spraying of insecticide. We are also locating malaria “hot spots” where the disease is flourishing, which requires intensive planning, training, and systems development to transmit time-sensitive health information across swollen rivers and miles of dirt paths.

In parallel, we must also develop new, transformative strategies to further accelerate the goal of eradication. In Zambia, we are testing a novel technique of treating entire populations for malaria, whether they show signs of the disease or not. The goal is to track down and treat every infection before it spreads. Careful, continual surveillance will ensure that potential new outbreaks are stopped in their tracks and enable PATH and our partners to assess what’s working and what’s not. We will apply effective strategies derived from these proof-of-principle settings to other countries, continents, and ultimately the world.

Teams working with PATH’s MACEPA program in Zambia use Android smart phones equipped with Open Data Kit software to collect demographic information as they go house-to-house testing and treating for malaria. Photo: PATH/Gabe Bienczycki.

Teams working with PATH’s MACEPA program in Zambia use Android smart phones equipped with Open Data Kit software to collect demographic information as they go house-to-house testing and treating for malaria. Photo: PATH/Gabe Bienczycki.

Within reach of a malaria-free world

Reducing the burden of malaria is key to improving health and economic development in many countries. It is also one of the best public health investments available today. Worldwide, an estimated US$208 billion could be gained by 2035 through further progress in reducing and eliminating the disease.

A hospital mural in southern Zambia reminds mothers to protect their families from malaria by using insecticide-treated nets. Malaria rates have dropping significantly in this region, but there is much work left to be done. Photo: PATH/Gabe Bienczycki. A hospital mural in southern Zambia reminds mothers to protect their families from malaria by using insecticide-treated nets. Malaria rates have dropping significantly in this region, but there is much work left to be done. Photo: PATH/Gabe Bienczycki.

The return on investment is remarkable. Every $1 invested in malaria prevention and treatment delivers an estimated return of $20 in economic benefits. Overall, the eradication of malaria would contribute to a projected global economic boost of more than $2 trillion by 2040.

With extensive collaboration and support by groups and individuals around the globe—and especially by national governments striving to build sustainable, high-quality health systems and economic prosperity for their countries—we can defeat malaria within our lifetime. Achieving this goal will require additional, substantial investments in research and development and in the use of transformative new tools and strategies.

In partnership with national governments, PATH is mobilizing partners around the world and taking innovation to scale to deliver measurable results that disrupt the cycle of poor health and poverty.