Malaria elimination: needs assessment and priorities for the future

Abstract

When the World Health Organization announced the goal of global eradication of malaria in 2007, questions were raised about the naivety of this proposition. Since then, experts have been divided about this goal. Some scientists suggest that when defeating malaria, elimination is a worthy and challenging aim, but this has to be done with modesty and thorough analysis. Others believe that it is time to repeat the experience of smallpox eradication and to open a whole new era for public health, the eradication of many diseases. The opposing view suggests that raising expectations and failing again may set malaria control back, rather than advance its cause. This literature review focuses on malaria elimination. It summarizes the history of malaria elimination, its success factors and reasons for failure, and the controversial issues in malaria elimination. The collected articles on the challenges of elimination, and the technical and financial feasibility that countries must appreciate before proceeding, are identified. Also, this review discusses the current global strategy to eliminate malaria and highlights the main concerns for future plans aimed at elimination. These plans foresee improving currently available diagnostic methods, therapeutic and prophylactic agents and protocols, vector control procedures, vaccine development progress, and other operational tools and approaches. Finally, this review addresses a number of research priorities in the present stage of the fight against malaria.

From malaria control to elimination in South Africa: The researchers’ perspectives

“…Congruent with El-Moamly’s 6 findings, which identified vector resistance to insecticides as a potentially serious obstacle to achieving malaria elimination, this study revealed that malaria researchers were concerned about the lack of preparedness with new alternative drugs and insecticides, should resistance to current drugs and insecticides occur. Although malaria researchers participating in this study acknowledged that their role in the implementation of a malaria elimination policy was advisory and supportive in nature, through which they are expected to produce research evidence to guide the elimination programme, 6 they argued that the current state of malaria research to guide malaria elimination in SA was poor. They attributed this problem to the funding constraints to conduct malaria research in the country.…”

“…According to El-Moamly, 6 some experts viewed the proposition to eliminate malaria as naïve, whereas others were encouraged by eradication of small pox and believe that it can also be done with malaria. The anti-elimination group fears that if expectations to eliminate malaria are raised and fail again, that this may be a major setback to the malaria control community, in the light of the challenges experienced in the GMEP of 1955–1969.…”

“…The literature has already suggested that implementing a malaria elimination programme would inevitably need to address constraints relating to financial, operational, and technical considerations. 6,8,20 There is no suggestion that these constraints have adequately been addressed in SA. Brooke et al 21 argued that successful elimination of malaria in SA is dependent on more rather than less resources being invested into malaria control.…”

“…3,4 These achievements were also noted elsewhere in the world, giving rise to a new debate to target malaria elimination in countries where malaria had been substantially reduced. 5,6 South Africa, Swaziland, Namibia, and Botswana were amongst the first countries in Southern Africa to be declared by the World Health Organization (WHO) as ready to eliminate malaria. 3 …”

Perspectivas para eliminação da malária residual em área rural da Amazônia brasileira: estratégia de busca ativa reativa na identificação de reservatórios de <i>Plasmodium vivax</i>.

“…vivax em diferentes localidades requer ações integradas em diversas frentes, como a ampliação e fortalecimento dos programas de malária, desenvolvimento de novas ferramentas, especialmente de diagnóstico e tratamento, aliadas a um programa permanente e contínuo de política e financiamento (Cortter et al, 2013;Newby et al, 2016; WHO, 2016a). As intervenções na malária requerem um alto investimento econômico e promovem consideráveis retornos nos investimentos em saúde pública (Cortter et al, 2013;El-Moamly, 2013;Tusting et al, 2015). Há uma meta internacional da OMS de eliminar a malária em 35 países até 2030, posteriormente novas definições e estratégias deverão ser elaboradas e discutidas afim de planejamento para a eventual erradicação desta doença (Newby et al, 2016 (Moreira et al, 2015), portanto com capacidade de detecção do parasito em pacientes com baixa parasitemia, mas a interpretação dos resultados positivos ainda é discutida (Baum et al, 2016;Congpuong et al, 2012;Harris et al, 2010).…”