World Malaria Day takes place on the 25th of April to open up global participation in the reduction and eventual eradication of malaria. As we look towards the future, engineers will continue to be at the forefront when it comes to finding unique ways of malaria prevention.
The international occasion is a major platform for the World Health Organization (WHO), the specialized agency of the United Nations that is responsible for international public health. From their efforts, cases of malaria dropped by 50% between 2000 and 2015. However, there are still millions who will die from the disease if more drastic interventions don’t happen soon.
In its 2020 report on the state of malaria, WHO remains firm that young and poor people remain the most vulnerable to the disease. Of the 219 million cases of malaria reported annually, 400,000 resulted in death, with children under five making up 67% of recorded deaths. Furthermore, 93% of deaths occurred in sub-Saharan Africa, which allows a clear pinpoint for action.
Engineering for Change
In the late 80s, Dr. Pierre Carnevale from the French Institute for the Research and Development made one of the first significant contributions in malaria prevention with Long-Lasting Insecticidal Nets. These treated nets made a significant impact in reducing the number of positive malaria cases in Africa.
Now, the World Health Organization is encouraging action in specific areas where engineers can help to ensure a malaria-free world.
1. Climate Change Innovation
New ways to combat climate change will be needed to curb the spread of malaria. According to WHO, climate influences population, and any climatic shock can impact the functioning of health systems. Governments then need to pull funds to address those concerns at the expense of malaria control.
On a macro level, engineers can be responsible for creating sustainable cities and environments through civil engineering and keen innovation that lessen the effects of climate change on nations that are also navigating malaria control.
2. Improving Urbanization
According to WHO, improved infrastructure and housing will have a major role to play as urbanization occurs in malaria-affected countries. Keen planning can greatly impact economic development as well as malaria roll-out plans from individual governments.
There are however still plenty of threats.
While deforestation in areas like the Congo Basin will reduce transmission, intense agriculture and new irrigation could have a detrimental effect. Any large-scale changes to land need ongoing surveillance to see how it will diminish or change the spread of malaria.
In terms of how malaria is spread, WHO estimates that climate changes up to 2050 will be more modest than major land changes.
3. Well-run Information Systems
When there’s a specific roll-out of effective malaria intervention, the readiness of health systems is detrimental to positive results. Connected systems can yield greater results when effective databases are in place for malaria management.
IT, data engineering, and various analytics can ease this process and ensure systems are well run, accurate, and can offer surveillance in terms of malaria control. Tracking surveillance systems currently detect only one-tenth of the estimated global number of cases. In many countries, it’s not possible to make a reliable assessment of malaria trends due to incompleteness or inconsistency of reporting over time.
Strong malaria surveillance systems are needed to enable a timely and effective malaria response in endemic regions, to prevent outbreaks and resurgences, and to ensure that interventions are delivered to areas where they are most needed.
The Road to Eradication
This year El Salvador became the first Central American country to achieve the status to be Malaria free.
Certification of malaria elimination is granted only by WHO in countries that have halted the spread of malaria for three consecutive years, and several policies and action plans are in place. El Salvador reported no indigenous cases of the disease since 2017.
How did the country do it? By surveillance.
The country reoriented its malaria program based on the geographic distribution of cases. This network allowed new cases to be treated more rapidly. The surveillance module has also ensured mainland China is seeing a rapid decline in new malaria cases.
In China, the surveillance strategy is known as “1-3-7” which has strict timelines. For it to be effective any malaria case must be reported within one day, by day three the country’s Centre of Disease Control and Prevention will have confirmed a case and determined its risk. By day 7 this module allows health workers to be in the community where the case was reported and be active in testing the community to ensure it doesn’t spread.
All this requires information systems that can enhance the work of detection and testing in local areas.
Last year Myanmar managed to strengthen its malaria surveillance system by changing to a web-based structure. The public sector as well as government, ministries, and the military as well as private and public sector health providers have been included in the country’s surveillance system. The development of an app with the support of WHO allows for real-time reporting of surveillance, case management, investigation, and malaria classification.
The latest statistics on malaria will be released by the World Health Organization on the 25th of April. It is simple designs and engineering like nets and apps that will ensure the eradication of this preventable disease.
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References
Global Malaria Programme, 2020. World Malaria Report 2020. World Malaria Report. [online] World Health Organization. Available at: <https://www.who.int/publications/i/item/9789240015791> [Accessed 13 April 2021].
Centers for Disease Control and Prevention, 2019. CDC - Malaria - Malaria Worldwide - How Can Malaria Cases and Deaths Be Reduced? - Insecticide-Treated Bed Nets. [online] Cdc.gov. Available at: <https://www.cdc.gov/malaria/malaria_worldwide/reduction/itn.html> [Accessed 13 April 2021].
