Malaria: Control, Elimination, and Eradication

Abstract

Control, elimination, and eradication of malaria is one of the world's greatest public health challenges, especially in Sub-Saharan Africa. While there has been an impressive gain in malaria control with decreased mortality rate over the years, eradication and elimination seem to be elusive in Sub-Saharan Africa. Control and elimination of malarial parasites was previously achieved in Europe and America using insecticides and manipulation of environmental and ecological characteristics. The emergence of drug-resistant parasites coupled with environments that support the breeding of mosquito vector and the need for caution with insecticides, such as dichlorodiphenyltrichloroethane, has slowed down control efforts, making elimination and eradication an uphill task in Sub-Saharan Africa. The expectation of producing an effective vaccine has been on for .40 years, but the recent breakthrough announcement of a malaria vaccine showing some level of protection among infants and children 3-4 years post vaccination seems like an excellent starting point. The globally accepted strategy for the control of malaria rely on chemotherapy, but unfortunately the overreliance on chemotherapy without proper control of drug usage and diagnosis has encouraged the selection of drug-resistant parasites, significantly contributing to the problem. Therefore, the prospects of malaria eradication rest heavily on integrated approaches that would include chemotherapy, vector control, manipulation of environmental and ecological characteristics, and vaccination. This article reviews the current state of malaria control and elimination and the need for an multistrategic integrated approach in order to achieve malaria eradication if the challenges faced by elimination are addressed.