The Malaria Epidemic In Africa

On January 12th, 2024, Cabo Verde became the third African country to be certified as malaria-free by the World Health Organization (WHO). Although Cabo Verde (Cape Verde) was earlier periled with epidemics in densely populated areas, its government implemented targeted disease interventions in the 1950s such as insecticides. Now, 8 of the archipelago’s 10 islands have no recorded malaria cases since the 1980s. The islands Boa Vista and Santiago similarly have been rid of it since 2017. However, the fact is out of Africa’s 54 countries only 3 (Algeria, Mauritius, and Cabo Verde) are malaria-free so far. This begs the question: Why does Africa carry a disproportionate number of global malaria cases?

Malaria is a deadly disease caused by the parasite Plasmodium and transmitted by species of female mosquitoes. Its symptoms can range from fever, chills and fatigue to seizures and breathlessness in fatal conditions. This illness is most profound in underdeveloped tropical and subtropical areas such as Africa, South Asia, and Australia, among demographics like children, pregnant women, people with HIV and travelers. According to the most recent world malaria report, in 2022 there were 249 million cases worldwide with 244 million in 2021. Alarmingly, 95% of the 680,000 deaths globally were from Africa, with Nigeria, Uganda, Mozambique, and the DRC accounting for half.

The reason for Africa’s uphill battle against malaria can be characterized by a few factors: -

1)      Poverty: Impoverished and marginalized communities lack the access to vaccines and other preventative measures. If the spread of mosquitoes is borderless, so should be the availability of healthcare.

2)      Resistance: Most vectors and parasites are highly adaptable making drug, insecticide, and vaccine resistance incredibly common. Cabo Verde eliminated malaria twice in 1967 and 1983 through systematic insecticide spraying, but subsequent lapses occurred due to resistance.

3)      Mobility: Africa is home to several vulnerable and marginalized communities who travel across the continent often transmitting malaria along with them. It is essential to make malaria diagnosis and treatment universally accessible to combat this.

Fortunately, there is a glimmer of resilience in these dark times; as remarked by the WHO Regional Director for Africa, “Cabo Verde’s achievement is a beacon of hope for the African Region and beyond. It demonstrates that with strong political will, effective policies, community engagement and multisectoral collaboration, malaria elimination is an achievable goal.” Indeed, collaboration between governments, global health organisations and community-based NGOs is essential for the advancement of public health and implementation of effective disease control strategies. This includes systematic surveillance and tracking of mosquito breeding areas in high-risk zones, installation of nets, window screens and repellents and use of vaccines. Ultimately, it takes a great commitment from governments and citizens to implement accessible and affordable prevention mechanisms and create a malaria-free world. By Keerthana Rajesh