Africa fooled on Mosquito/Malaria Control? (2)
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Last year I attended an international training course on tropi-
cal diseases control. The course was conducted in China. It is
sad to learn that while several other countries have succeeded
to eliminate (or almost eliminate) malaria and maintain that
status for years, we in Africa are virtually accepting the dis-
ease as ineradicably in our environment. We have accepted the
targets set for us by WHO reducing malaria to certain preva-
lence, reducing child/infant mortalities to so and so... preva-
lence by year so and so. They have declared eradication or
rather elimination to be impractical and we have bought the
idea. We remain to be inexhaustible market for therapeutic anti-
malarials made elsewhere!
I totally agree with the senior scientists that revisiting our
previous efforts (in 1970s) will shed light to the way forward.
Elimination of malaria needs integrated approach. Vector control
mainly through environmental modification coupled with the use
of safe insecticides should be central to parasite clearance
through prophylactic and therapeutic treatments. The major chal-
lenge thrown to us, especially with the issue of environmental
modification has been the huge costs involved. Moreover, despite
elimination programmes being such capital intensive, maintaining
the controlled area free from re-invasion is another big chal-
lenge. India once (in early 1960s) eliminated malaria but then
took no further efforts to sustain the situation. Just in three
year there came re-invasion, which exploded with prevalences and
mortalities far higher that those experienced before the elimi-
nation was launched.
Community sensitization, I believe is the key to successful sus-
tainability of elimination programmes. To help overcome the
challenge of intensiveness of the required capital, it would be
of use if we think of integrating the components of environ-
mental modification (aiming at communicable disease control), to
all construction projects. Currently we have many such projects
in our country which include road constructions, residential
area constructions (e.g. mradi wa viwanja elfu ishirini in Dar),
schools renovations, rehabilitation of tape water systems in ur-
ban area etc. We would benefit a lot if all these would seri-
ously include elements of environmental modification to discour-
age mosquito breeding and propagation of other disease causing
microbes.
Sincerely,
Victor Wiketye
mailto:wikeetye@yahoo.co.uk