Why It Is Difficult to Eradicate Malaria in Sub-Sahara Africa

Abstract

Malaria is a major public health problem in Sub-Sahara Africa (SSA). First-time pregnant mothers and children below the age of five are the most vulnerable. Governments of the region have relied on both local and international donor agencies to fight against malaria where emphasis has been on financial interventions, provision and distribution of insecticide-treated bed nets (ITNs), provision of rapid-test apparatus, and drugs for first line treatment. However, the impacts of local and global efforts have been minimally felt as the burden of malaria continues unabated. The rate of malaria infections is still apocalyptically alarming. This article argues that the reason why cases and deaths attributable to malaria continue to rise is because wrong approaches are used in the so-called broad fight against malaria. Based on the assumptions of the epidemiological triangle model, the web of causation and social determinants of health, the article argues that for countries in SSA to effectively fight malaria, the nexus between the agent, host, and environment must be acknowledged. It is constructively argued that efforts to tame the scourge of malaria in SSA would be in futility where the environmental factors that produce the breeding ground for malaria are not adequately addressed. European and American experiences are compared to sufficiently substantiate this line of argument.

Pooled prevalence and risk factors of malaria among children aged 6–59 months in 13 sub-Saharan African countries: A multilevel analysis using recent malaria indicator surveys

“…The risk of being infected by malaria among children from the richest household was 84% less compared to the poorest. Malaria is often referred to as the epidemic of poverty [ 26 ]. In this study, almost a quarter of children are from the poorest household.…”

Why the World Health Organization should reconsider long lasting insecticide nets (LLIN) and indoor residual spraying (IRS) in primary mosquito/malaria control in favour of house screening

“…Rapid deterioration (Bhatt et al, 2015) 31 Hole development (Msellemu et al 2017;Minta et al 2017;Vanden Eng et al, 2017) 32 Impose thermal related distress (Galvin et al, 2011;Ahorlu et al, 2019;Eleazar et al, 2022) 33 Provoke nightmares, claustrophobia ((Galvin et al, 2011) 34 Huge international efforts dependent (Tesfazghi et al, 2015;Okumu, 2020) 35 Accumulate dust Some social groups and governments look beyond their shores for help in whatever form to cope with supply of mosquito/malaria control materials. It is therefore not surprising that SSA largely depend on technical and financial help from WHO, GFATM, UNICEF, USAID, International Federation of Red Cross, US President's Malaria Initiative (Tesfazghi et al, 2016;Abdullahi et al, 2019;Okumu, 2020). This dependence makes it impossible for SSA nations to make decision that funders object to.…”

“…Unfortunately, mosquito/malaria control is like a recurring decimal in SSA where debility and casualty tolls resulting therefrom keep the region underdeveloped and in poverty (Ugwu, 2021). Every year, affected governments recycle donor dependent mosquito/malaria interventions that they had previously (Abdullahi et al, 2019). The WHO adopts two main tools to deal with malaria vectors.…”

“…However, the question remains why WHO could not consider other outdoor tools for complementary general use (Aïzoun et al 2021) and looks the other way when permanent and sustainable measures like house screening is offered as alternatives to deal with these intractable problems caused by mosquito/malaria? Containing malaria in SSA will fail if the environmental factors that create opportunities for mosquito breeding are not adequately addressed (Abdullahi et al, 2019). There is overwhelming need to review the current approach to mosquito/malaria control if SSA must attain or push beyond malaria elimination.…”

Correlation of Climate Change Indicators with Health and Environmental Data in the Philippines

“…The mortality of malaria was highly associated with environmental factors -temperature, rainfall, humidity, and sanitation. 76 While most of the ecological factors affecting the prevalence of malaria are natural factors, sanitation is humaninduced. Some of which are overgrown bushes, littered wastes, potholes, empty water sachets, and receptacles that could provide breeding grounds for mosquitoes.…”