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Malaria Eradication: How Realistic Is It?

November 10, 2009 - 17:53 -- Fredros Okumu

Following the Bill and Melinda Gates declaration in 2007 that malaria eradication is their lifeterm goal, nearly every researcher and policy maker thinks this is feasible. The WHO has also made this a long term global target. I believe this agenda is too immature to be impemented in many malaria endemic countries, most of which are developing still. It will likely lead to imbalanced resource allocation for managing many other different diseases. I believe also that Malaria will cease to be a problem only when everyone knows what to do if affected and also when appropriate preventive and curative services are readily accessible to all people. The eradication goal should not be considered until we have brought the disease to a level when it's not one of the most important causes of mortality or morbidity in the endemic countries. I wish therefore to challenge all world players to instead focus their attention and resources to a more integrated disease control and human development agenda. This way we'll make a more universal impact on human kind. All diseases will be brought under control when all affected people or communities know about them, when they know what do do to prevent the diseases, and also when they know how to manage them when affected. These are the reasons that even though I live and work in a highly malarious area, I contact malaria much less frequently than I used to when I was younger and living in the same kind of environment. Its not because the parasite or the vector has been eradicated. Fredros


Jim Jackson's picture
Submitted by Jim Jackson on

Dear Fredros,

Thank you for your clear insight. I could not have said it better.

William Brieger's picture
Submitted by William Brieger on

Yes, eradication - meaning the world-wide elimination of a disease - is a ways into the future. Roll Back Malaria has therefore set out its 'Pathway to Elimination'. Malaria must be eliminated from each endemic country before it can be eradicated world-wide. The Pathway helps countries plan.

Right now most countries should ideally at least be in the scale up for impact - or SUFI - stage on the pathway. Then comes the stage for maintaining control at the scale-up level. This should help make impact on the Millennium Development Goals by 2015.

After control interventions have been sustained, we enter the pre-elimination stage on the Pathway where the epidemiology of malaria will likely have changed and interventions need to be more focused geographically. At a point elimination may be certified by WHO, but the final phase is preventing reintroduction of the disease from any remaining transmission spots around the globe.

This process may take 20-30 years. The big challenge is maintaining the interest and enthusiasm of all partners - and as was said at the MIM Conference in Nairboi - maintaining the funding and research needed to keep us moving forward.