IRIN examines debate over malaria control versus eradication

Nov 2 2010

After the recent publication of the Lancet series on malaria eradication, IRIN examines the debate over control versus eradication, stating the findings of some of the studies.

"Bruno Moonen, of the Clinton Health Access Initiative, says the decision to move from control to elimination is not as easy or as obvious as one might imagine," IRIN writes. According to Moonen, "When infection gets below 1 percent of the population, you have to make a choice. And you may choose to say, 'We have almost no deaths and very few cases, and we can handle that.'" Moonen discusses what makes eliminating a disease so challenging, noting that it would require all cases - even mild ones - to be fully treated.

Oliver Sabot, one of the contributing authors to the Lancet series who found that eradication would probably be more expensive than control, said, "The moment you take your eye off the ball, malaria is going to come roaring back."

"So is there a risk of governments embarking on elimination as a prestige project, without thinking through the implications?" IRIN asks. Richard Feachem, director of the Global Health Group, part of the University of California, San Francisco, "thinks there is, telling IRIN: 'There are a number of malaria-endemic countries that have begun to speak about elimination in a way which is almost certainly premature … In our view they should do a feasibility study and be influenced by the mass of evidence, and for some of these 'premature eliminators,' if they did such a study, they might retreat and say, 'Not yet,' not just because of their own situation but also because of their neighbours.'"

But Feachem does believe malaria can ultimately be eliminated. "My guess ... would be 2050 or 2060. That would be a reasonable guess for complete eradication" (11/1).