Lancet series examines malaria eradication goal

Oct 30 2010

"Eliminating malaria can be achieved only with repeated investment over the long term and will require a major shift in policy and funding," according to some experts, Reuters reports (Kelland, 10/29). The Associated Press reports that the feasibility of "eliminating malaria was examined in a series Friday in the Lancet. Experts analyzed issues like the practicalities of wiping out malaria and its financial costs" (10/29).

According to the BBC, the series ultimately "urges a pragmatic approach in which efforts and resources are concentrated on shrinking the global area where malaria still prevails. It suggests some countries, particularly in sub-Saharan Africa, may be better pursuing a policy of controlling the disease rather than one of eradication," the news service reports (Bowdler, 10/29).

One paper in the Lancet series cautioned that malaria eradication cannot be attained quickly, Reuters reports. "Like immunisation, it would require long-term investment over and over to make sure the disease does not come back, even after the intense activity of wiping it out is over," the news service writes. "Successful elimination will need a fundamental shift in the perception of malaria investment from a so-called quick win to a routine expenditure," explained Oliver Sabot of the Clinton Health Access Initiative, who was the lead author of the study (Kelland, 10/29).

Another paper in the series "suggests wiping out the parasitic disease may be feasible in Latin America and Asia," but that it would be the least feasible "in Africa, where most of the world's estimated 247 million yearly cases occur," the AP continues (10/29).

In a paper examining a map of malaria cases, researchers "point out that malaria and mosquitoes do not respect national borders and that both parasite and insect may develop resistance to existing drugs," the BBC writes (10/29). Reuters reports that "scientists said that the most practical way forward in fighting the disease was to continue shrinking the 'malaria map' of countries where it is endemic" (10/29).

A fourth paper looks at current eradication strategies, concluding that "[m]alaria elimination cannot be business as usual, but needs a systemic and new programmatic approach supported by political and financial commitment, ideally throughout an entire region of nations" (Moonen et al., 10/29).

In 2007, the Bill & Melinda Gates Foundation called for the world to completely eradicate malaria, "an aim which was then endorsed by the WHO's Director-General Margaret Chan," the BBC reports.

According to the news service, WHO's Global Malaria Program Director Robert Newman responded to the Lancet series in a statement, where he noted, "WHO has always supported - and will always continue to support - endemic countries in their efforts to control and eliminate malaria. ... It is entirely feasible to eliminate malaria from countries and regions where the intensity of transmission is low to moderate, and where health systems are strong" (10/29).

"In a commentary on the findings of the papers, Lancet editors Richard Horton and Pamela Das said they showed that countries should not set their sights on malaria elimination without careful analysis of the costs and implications," Reuters reports. "Focusing on trying to eradicate the disease when that goal is too far off could lead to dangerous swings in funding and political commitment, they said, and may jeopardise the success of efforts to control malaria," according to the news service (10/29).

In the piece, the editors write:" Malaria elimination efforts will also require strengthened health systems and sustained country commitment. Ultimately, the maintenance phase of elimination will be the responsibility of the once endemic countries themselves, not international donors." They also point out that "[i]f existing control efforts were indeed scaled up, by 2015, 1.14 million children's lives could be saved in sub-Saharan Africa alone." Three other commentaries about malaria elimination are available on the series website (10/29).