The Guardian (USA)

'Malaria will not be eradicated in near future', warns WHO

- Sarah Boseley Health editor

Malaria will not be eradicated in the foreseeabl­e future even though it is achievable and would save millions of lives, according to World Health Organizati­on (WHO) experts following a three-year review.

The WHO remains committed to the “disappeara­nce of every single malaria parasite from the face of the planet”, as it has been since the UN organisati­on was launched in 1948, said Dr Pedro Alonso, the director of its global malaria programme.

But the experts warned in their review that there must not be a repeat of past disasters. The WHO’s first global malaria eradicatio­n programme that lasted from 1955 until 1969 rid several countries of the disease, but was not implemente­d in sub-Saharan Africa, the region most badly affected.

“Falling short of eradicatio­n led to a sense of defeat, the neglect of malaria control efforts and abandonmen­t of research into new tools and approaches,” the review stated. “Malaria came back with a vengeance; millions of deaths followed. It took decades for the world to be ready to fight back against malaria.”

In 2007, support by the Bill and Melinda Gates Foundation led to the distributi­on of millions of insecticid­eimpregnat­ed bednets, new drugs and a vaccine. Alonso said that, though these tools substantia­lly reduced the numbers of malaria cases and deaths, they are not enough to rid the world of the disease that disproport­ionately kills small children and pregnant women.

The review was commission­ed in 2016 to investigat­e how eradicatio­n could be achieved. It found that there are no biological or environmen­tal barriers to eradicatio­n and that global developmen­t will probably mean less malaria in the future.

“However, even with our most optimistic scenarios and projection­s, we face an unavoidabl­e fact. Using current tools, we will still have 11 million cases of malaria in Africa in 2050,” said the review. “In these circumstan­ces, it is impossible to either set a target date for malaria eradicatio­n, formulate a reliable operationa­l plan for malaria eradicatio­n or to give it a price tag.”

Drug resistance in the malaria parasite has made it harder, but even without that, the bednets and the new vaccine are only 40% effective, said Alonso. “Smallpox had a very safe, highly effective vaccine,” he said. “So does polio, which is close to eradicatio­n.

“We will always fall short of eradicatio­n because our tools are imperfect,. They have allowed us to make huge progress over the last 15 years, but they are far from being a silver bullet in any shape or form.

“Our priority now should be to establish the foundation for a successful future eradicatio­n effort while guarding against the risk of failure that would lead to the waste of huge sums of money, frustrate all those involved, national government­s and malaria experts alike, and cause a lack of confidence in the global health community’s ability to ever rid the world of this disease,” said the report.

Progress has stalled in the last two years in efforts to meet the target of 90% reduction in cases by 2030, it says. It calls for a major investment of $34bn (£28bn) to scale up current interventi­ons over the next 11 years and strong political leadership to ensure affordable healthcare in affected countries. Better data on malaria transmissi­on is also needed and better tools to control mosquitoes and protect and treat people in malarial regions.

 ??  ?? The review calls for a global investment of $34bn (£28bn) over the next 11 years to provide healthcare in malarial regions. Photograph: Jennifer Huxta/The Guardian
The review calls for a global investment of $34bn (£28bn) over the next 11 years to provide healthcare in malarial regions. Photograph: Jennifer Huxta/The Guardian

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