Almost 20% of all infectious diseases are vector-borne. These diseases typically rely on mosquitoes, ticks and fleas to be transmitted to humans and they include lesser known conditions such as Rocky Mountain spotted fever, cat scratch disease and sleeping sickness (or trypanosomiasis).
They also include some of the world’s most destructive diseases – like malaria and dengue fever.
The most deadly, however, is malaria, which kills over 600,000 people annually. Sadly, most of these deaths are African children under the age of five. There are over 200 million cases of malaria every year and 80% of these occur in Sub-Saharan Africa, where a child dies every minute from the disease. “The fact that so many people are infected and dying from mosquito bites is one of the greatest tragedies of the 21st century,” said Dr. Margaret Chan, director-general of the WHO.
For decades, governments around the world have struggled to control vector-borne diseases. The unpredictable habits of mosquitoes, ticks and fleas and the microbes that they carry are significant obstacles.
Climate change hasn’t helped either. We are likely to see an increase in these diseases as the planet gets hotter. Global warming has an escalating influence on biting rates, breeding sites and reproduction rates. And as globalization spreads, the reach of these non-passport holding carriers-of-disease increases.
Limited resources in the poorest countries where the disease is most prevalent also make controlling the malaria-causing plasmodium, carried in the gut of female anopheles mosquitoes, extremely difficult.
Facts about Malaria
According to the latest estimates by the WHO, released in December 2013;
– There were about 207 million cases of malaria in 2012 (with an uncertainty range of 135 million to 287 million)
– An estimated 627 000 deaths (with an uncertainty range of 473 000 to 789 000).
– Malaria mortality rates have fallen by 42% globally since 2000, and by 49% in the WHO African Region.
Malaria is transmitted exclusively through the bites of Anopheles mosquitoes. The intensity of transmission depends on factors related to the parasite, the vector, the human host, and the environment. Transmission is seasonal, with the peak during and just after the rainy season. Malaria epidemics can occur when climate and other conditions suddenly favour transmission in areas where people have little or no immunity to
Malaria is an acute febrile illness. In a non-immune individual, symptoms appear seven days or more (usually 10–15 days) after the infective mosquito bite. The first symptoms – fever, headache, chills and vomiting – may be mild and difficult to recognize as malaria. If not treated within 24 hours, P. falciparum malaria can progress to severe illness often leading to death. Children with severe malaria frequently develop one or more of the following symptoms: severe anaemia, respiratory distress in relation to metabolic acidosis, or cerebral malaria. In adults, multi-organ involvement is also frequent. In malaria endemic areas, persons may develop partial immunity, allowing asymptomatic infections to occur.
The WHO recommends ‘Integrated Vector Management’, and this focuses on the ties between health and the environment. Environment management (eliminating breeding sites, like stagnant water), biological controls (the use of larvicides where there are few, easily locatable, breeding sites) and chemical methods (indoor spraying) can together prevent the spread of vector-borne disease.
Of course, this should be combined with the use of early diagnosis and treatment of malaria and prevention using insecticide-treated bed nets.
Traditional methods of advocacy, such as flyers and billboards, should be replaced with more innovative techniques using celebrities and mobile technology. Friends Africa, a pan-African non-profit that fights AIDS, TB and Malaria, uses Nollywood stars and soccer players to educate the public about malaria, and we have found them to be a powerful and effective voice. They can certainly make the use of bed-nets sound much ‘cooler’ to a teenager than any government.
It will take significant innovative financing, leadership and technology to win the battle against malaria. African governments need to play a stronger role in securing finance for malaria programmes, monitoring transmission trends and designing national strategies to control the disease. Governments also need to increase domestic funding for operational research to ensure locally-tailored approaches are being used. They should also provide effective public outreach to educate people about treatment and control of these diseases. The question is, do already overwhelmed governments in Africa have the capacity to do this?
African governments are engaged on the issue. I have witnessed first-hand how excited our presidents are about progress on malaria. But there is a long road ahead, and we must not give up.
Friends Africa (Friends of the Global Fund Africa) is a pan-African’s leading health advocacy organization which works to mobilize strategic political and financial support for the fight against HIV/AIDS, Tuberculosis and Malaria. Their core operational areas are: advocacy, documentation, capacity building and technical assistance. The organization which has received numerous international awards implements its work by working closely with civil society, the private sector and government – to combat these three diseases in Africa. www.friends-africa.org