Malaria is a devastating disease that occurs mostly in tropical and subtropical environments in areas around the world. Malaria is the number one killer of children in underdeveloped countries and is often responsible for the child mortality rates of children under the age of five. Failure to eradicate this disease in these countries is a result of poverty, scarce resources and socio-economic instability. In regions like Africa, mainly south of the Sahara region, those are of the major causes of the continued spread of this devastating disease, creating a noticeable link between malaria and poverty in underdeveloped countries
Malaria in Underdeveloped Countries
Malaria is the number one killer of children in underdeveloped countries. Children who contract severe malaria frequently develop one or more of the following symptoms: severe anemia, respiratory malfunction and cerebral malaria. In areas where transmission is higher, children under the age of five are more susceptible to infection and death, with more than 70% of all malaria deaths falling into this group. Even though the number of malaria deaths within this age group had decreased by 155,00 in 2016, malaria remains the major cause of death for children under five years of age, ending a life every two minutes.
Malaria occurs when climate and other conditions suddenly favor transmission to areas where people have no immunity to malaria. They can also occur when people with low or no immunity move into areas of intense malaria transmission, for example, refugees and those looking for work. Human immunity plays a very important factor, especially in areas of moderate and intense transmission conditions. Partial immunity can be developed through the years, and while it never provides complete protection, can reduce the risk of infection. However, children under the age of five have not had the chance to build any kind of immunity because they have not been exposed to the disease.
The High Cost of Malaria
Malaria is directly related to poverty and economic inequality in underdeveloped countries due to the exponential costs that these countries must face by both individuals and governments. Costs include the purchase of necessary medication, treatment, maintenance, supply and staffing of trained personnel in health facilities, lost days of work with resulting loss of income, burial expenses and the overall loss of economic opportunities ventures through tourism during an outbreak.
Direct costs for illness, treatment and premature death are estimated to be at least $12 billion per year. Total funding for malaria control and elimination was only $2.7 billion in 2016, but this amount is not enough to eradicate the program to its completion. In order to hit the 2030 target from the WHO, an investment of $6,5 billion will be required annually by 2020. Which may be a problem because, on average since 2014, investments in malaria treatment and control have actually been declining in many highly affected countries.
Investing in the Eradication of Malaria
The level of progress in a specific country depends on the strength of that country’s national health system, the level of investment of the disease control and a number of factors including biological determinants, like the environment and the social, demographic, political and economic factors in a particular country.
Some of the challenges in trying to eradicate malaria include the lack of sustainable and predictable international and domestic funding, risks posed by countries in endemic areas, anomalous climate patterns, the emergence of parasite resistance to anti-malaria medicines and mosquito resistance to insecticides and other substances used for eradication and control purposes. In the 41 high-burden countries, malaria funding often remains below $2 per person.
All of these factors contribute to the reversal in recent progress of the eradication and continued treatment of the disease. Many high burden but low-income countries have reported reducing the funding per capita for the population at risk of malaria. For example, the complex situation of Nigeria, South Sudan, Venezuela and Yemen have all resulted in the interruption of services and increasing instances of malaria.
The Sucess of the Global Fund
The Global Fund response to malaria has been very successful, but it presents many future challenges in the battle of eradicating this disease. Between 2002 and 2017, the Global Fund has provided more than half of all international financing for malaria, investing $10.5 billion in programs aimed at controlling the disease in more than 100 countries. The approach targets several areas, such as education about symptoms, prevention and treatment; prevention methods like mosquito nets, insecticides and preventive treatment for children and pregnant women and diagnosis.
The Global Fund works with at-risk communities by providing training and treatment to stop the disease. They provide information about what malaria is, how it is transmitted, what treatments are available and, most importantly, what action to take if malaria is detected. In Ghana, for example, village elders educate their community “not to let the sun set twice” on a child with a fever.
Malaria is a devastating disease that affects everyone but presents a higher risk in children under the age of five especially in areas like the sub-Saharan region in Africa. There is a noticeable link between Malaria and poverty in underdeveloped countries. The efforts to eradicate this disease have been enormous, but the lack of funding, the disease’s immunity to drugs and insecticides, the socio and economic instability of the governments of some of these countries and the lack of training and information about the disease present major challenges to the successful eradication of the disease. Investing must continue. Hopefully, the work of organizations such as the Global Fund will ensure a future without Malaria.