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The State of Malaria in South-East AsiaAlthough Malaria remains at the forefront of global health issues, malaria in Southeast Asia represents a success story in terms of mobilizing aid in the fight against the disease. In 2018, the World Health Organization (WHO) reported 8 million malaria cases, a decline of 69% since 2010, marking the largest decline of all WHO regions.

Direct Aid Strategies

Southeast Asia has been the target of hefty aid strategies from a variety of organizations. The aid primarily comes from the WHO and the Global Fund to Fight AIDS, Tuberculosis and Malaria. As the Global Fund puts it, “The fight against malaria is one of the biggest public health successes of the 21st century.” The multi-pronged strategies used by these organizations begin with a tactic known as surveillance.

Surveillance involves testing, record-keeping and reporting malaria cases. Surveillance systems have become more efficient. As a result, health care systems maintain a much more refined picture of malaria cases in any given region. This eventually gains “near real-time individual case data in small areas.”

Vector control is limiting contact between people and the mosquitos that transmit the disease. It has also helped eliminate malaria in Southeast Asia. One of the most effective means to achieve this is the wide-scale distribution of insecticidal mosquito nets. So far, the Global Fund has donated 142 million nets, providing a simple means for those in rural and urban areas alike to protect themselves.

Strengthening Local Health Care Systems

Besides direct aid, many organizations also turn to bolster already-existing local health care systems in the fight against malaria in Southeast Asia.

Malaria Consortium is a nonprofit organization specializing in addressing the disease. It began working in Myanmar in 2016 to train locals in rural areas to administer essential health services. Malaria Consortium also taught local health workers to treat malaria, working to close the gap in rural health care.

In one village, 13 health care workers received training in the treatment of malaria and other diseases common to the area. These workers went on to teach local mothers and adolescents, expanding the web of health care knowledge even further. By the end of the program, 90% of trainees could diagnose malaria cases correctly. Trainees were also able to run malaria diagnostic tests and administer Artemisinin. Artemisinin is the most widely used drug to treat the disease.

Concerns with Treating Malaria

Aid has been successful in treating malaria in Southeast Asia. However, a new drug-resistant strain on the rise reignites concerns around the disease. Artemisinin-resistant malaria has the potential to undermine malaria prevention and was first recorded in the Mekong River region of Vietnam, Thailand and Cambodia. In 2014 and 2015, studies conducted by Vietnam’s National Malaria Control Program found treatment failure rates ranging from 26% to 46%.

From the perspectives of nonprofits and medical experts, the rise of this new Artemisinin-resistant malaria in Southeast Asia means surveillance efforts must be bolstered to prevent global spread. Likewise, instead of merely treating already-present cases, the goal must be to prevent transmission in the first place. Chris Plowe, the director of the Duke Global Health Institute, is using all the tools available to the institute to eliminate aggressive malaria in the Greater Mekong subregion.

Overall, direct aid, community mobilization and the bolstering of health care systems have transformed a region once fraught with malaria. As these efforts continue, malaria in Southeast Asia moves closer toward its extinction.

Jane Dangel
Photo: Flickr