There have been remarkable strides in the prevention and control of malaria in the last decade. Consequently, malaria-related mortality, as well as, morbidity have declined worldwide. The reduction has largely been as a result of increased investments in strengthening health systems. However, the epidemic persists and poses a huge human and economic burden worldwide, as a result of challenges in its control and possible eradication, as follows.
Shifts in the malaria epidemiology particularly in countries that are on the verge of malaria elimination have complicated intervention measures (Guyant, Corbel, Guérin, Lautissier, Nosten, Boyer and White, 2015). The changes have resulted in the disease being more prevalent among male adult population rather than the traditionally vulnerable expectant women and children. New cases are also clustered geographically such as among migrants and marginalized groups. Increasing cases of resistance to insecticides and artemisinin-based therapy, which have been vital in achievements made this far has further complicated matters. Consequently, new strategies need to be utilized in control of malaria (Hemingway et al., 2016).
Public health strategies should focus more on prevention of new cases through the use of insecticide-treated bed nets and indoor residual spraying. This would consequently reduce morbidity and mortality since there would be no new cases. Further, prevention is much cheaper as compared to remedial measures which require a lot of investments. However, the preventive measures would differ depending on the geographical region as there are places where there is increased resistance to insecticides such as in Africa (Hemingway, Shretta, Wells, Bell, Djimdé, Achee and Qi, 2016). Further, some populations have myths that discourage use of bed nets and would require extensive education to transform their beliefs.
If given 20million dollars to allocate to a high-endemic country in lowering the malaria burden, I would allocate the money as follows; 10 million would be utilized in vector control mechanisms that ensure reduction of any new infection. This is because the majority of populations in this countries lack basic preventive facilities such as nets and can barely afford insecticides (Guyant et al., 2015). 10 million would then be utilized in the development of adequate health care systems that ensure active surveillance and treatment in the marginal areas. This is because malaria prevails in marginalized and poor communities and further increases poverty
In conclusion, for the effective prevention and control of malaria massive investments need to be injected .The intervention approach should integrate preventive measures such as vector control mechanism, as well as, curative measures that reduce illnesses. Further, surveillance and reporting of developments would be useful in ensuring the epidemic does not spread to the eliminated areas.
Guyant, P., Corbel, V., Guérin, P. J., Lautissier, A., Nosten, F., Boyer, S.,& White, N. (2015). Past and New Challenges for Malaria Control and Elimination: The Role of Operational Research for Innovation in Designing Interventions. Malaria Journal, 14(1), 279.
Hemingway, J., Shretta, R., Wells, T. N., Bell, D., Djimdé, A. A., Achee, N., & Qi, G. (2016). Tools and Strategies for Malaria Control and Elimination: What do we Need to Achieve a Grand Convergence in Malaria?. Plos Biol, 14(3), E1002380.