The mosquito, one of the smallest and yet deadliest animals, acts as the vector for infectious diseases such as malaria, dengue, chikungunya, yellow fever, and Zika. These diseases infect 340 million people every year, with an estimated 228 million cases of malaria alone in 2018. Beyond human suffering and death, they cause economic disruption, by causing work absenteeism or preventing people from engaging in economic activity, and additional burden to strained healthcare systems in the most vulnerable countries and communities, especially rural communities that already face heavy burdens.
The global community and endemic countries have committed resources and investments to make great strides towards the goal of ending malaria in our lifetime. More countries are closer to elimination than ever before but many places in Sub-Saharan Africa and India still face high rates of malaria. To achieve what would be one of the greatest public health successes in history, it is crucial to continue prioritizing malaria control and elimination efforts.
The path to malaria eradication also requires understanding another global issue: a changing climate. Malaria is climate-sensitive — changing weather patterns are introducing new challenges in our efforts to effectively control, prevent, and eliminate it. Climate change and its effects, including malaria and other mosquito-borne diseases, are being felt by millions of people already burdened by poverty. One of the greatest risks is extreme weather events such as cyclones or heavy rains, which are increasing in frequency and severity, and cause flooding that leaves stagnant water that becomes a breeding ground for mosquitoes and prevents the delivery of life-saving health interventions and treatments.
The combination of malaria and climate change has the potential to wreak havoc on rural communities that already have increased difficulty in accessing malaria prevention and treatment and often basic health services. But around the world, organizations and governments are continuing to rise to the challenge, as they’ve done over the last two decades in a sustained focus on malaria elimination, to protect their rural communities from the impacts of malaria.
In Odisha State, India, the Government of Odisha used learnings from comprehensive case management of general health services project to implement an innovative program to combat malaria in hard to reach communities. The program, called DAMaN, set out to detect all people with malaria infections, even those without symptoms, in all remote, inaccessible, under-served, and un-served villages within the state. DAMaN uses camps to screen people for malaria and treat all cases found, provide health awareness and community mobilization, and address related health issues. In addition to providing services to rural communities, the State program timed these camps around monsoon season to wipe out the parasite reservoir prior to the heavy rains that provide a breeding ground for mosquitoes. This program has led to a 90% decline in malaria incidence during 2016-2019 in Odisha State.
As extreme weather events become more commonplace and put vulnerable populations at greater risk by disrupting the delivery of life-saving health interventions and treatments, there is increased urgency to anticipate and accelerate progress against mosquito-borne diseases. As global weather patterns change, weather-informed strategies can provide an opportunity for meeting the challenges brought about by climate change.
Malaria No More has convened a new initiative, Forecasting Healthy Futures, with partners such as the Abu Dhabi Crown Prince Court’s Reaching the Last Mile, PATH, Institute for Health Metrics and Evaluation (IHME), and Tableau, to explore how weather data such as temperature, precipitation, and humidity can be combined with epidemiological, supply chain, and program data to better inform and enhance efforts in Odisha State to target malaria interventions. By harnessing weather data, we can turn weather obstacles into opportunities by more precisely targeting and timing health interventions to reduce the risk that extreme weather and changing weather patterns pose in urban and rural areas.
If we know that one village generally has increased malaria transmission one week after the onset of the monsoon season while another village sees increases three weeks later, we can ensure that essential commodities are in place at the right time. If we can track weather data over time showing that heavy rains are expected in an area that’s especially difficult to reach, we can ensure that community health workers make their rounds early, or that commodity stocks are adequate. If we can recognize and more accurately predict trends in when the rains are starting, we can ensure that interventions such as indoor residual spraying campaigns, insecticide-treated bed net distributions, or mass screen campaigns are conducted early enough to protect vulnerable populations before the transmission starts increasing.
Developing predictive models based on weather data can help countries understand how to better time and target interventions to control – and eliminate — malaria in endemic geographies, especially hard to reach, rural areas. Looking beyond combating malaria in the hardest to reach areas of India, insights from this work can be applied to other disease areas and geographies, having a ripple effect on the health and livelihoods of millions of people around the world, from the smallest village to the largest city.
This Article is part of our 60th-anniversary series. It is written by Dr. Sanjeev Gaikwad. Dr. Gaikwad is the Country Director, Malaria No More- India. He is a physician with a doctoral degree in preventive and social medicine and a master’s degree in Community Health with 30 years of experience in the field of Sexual and Reproductive Health, Family Planning, Maternal and child health, sexually transmitted infections, and HIV/AIDS, TB, and Malaria. His expertise includes strategic participatory planning; program management; devising technical solutions, approaches, and behavior change communication. He has developed several innovations that have been included as best practices in the National guidelines for targeted interventions and are now being replicated in several countries.
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