We are creating a hugely inflated burden of malaria through poor information, with knowledge gaps that are hurting us very badly indeed, as our malaria cases rise inexorably.
In 2010, we had fewer than one million confirmed malaria cases. In 2021, we had nearly four million. Yet we have poured funds into insecticide-treated bed nets, we have run malaria programmes and opted early into new vaccinations.
Certainly, we face environmental factors that are pushing our cases up. The mosquitoes are developing resistance to the insecticides used on bed nets, weakening a tool that had reduced their population.
At the same time, climate change is pushing up our temperatures, which are now some 2 degrees Celsius higher than in pre-industrial times, accelerating the breeding of mosquitoes.
As cold-blooded insects, their growth and life cycle are driven by heat. As a result, climate change analysts are now reporting we are in for huge increases in malaria, with more mosquitoes overall, and malaria-spreading mosquitoes also moving into areas that were previously too cold, such as Nairobi.
Yet, in all our focus, we have paid little attention to the breeding centres for the malaria parasite – which is humans.
Malaria parasites cannot breed in mosquitoes. The insects merely carry them from one human to another.
It is when a parasite-carrying mosquito bites a human that it puts the parasite into the human’s blood, and then the parasites breed, inside us.
Future mosquitoes biting the same human pick up the newly bred parasites and move them on to everyone else that it bites.
In short, no parasites in humans equals no parasites being moved by mosquitoes. Yet, the non-adherence I wrote about last week is creating a walking population of malaria-parasite-breeding factories.
When our most effective drugs are taken they kill most of the parasites in the first two-day life cycle.
That third day of medicine clears the rest as the next two-day life cycle opens. Yet, by Day Three, most of us feel better, as it is the explosion in parasite numbers in our blood that gives us fever and chills: so often the third day’s drugs aren’t taken.
Studies show that then leads to an ongoing malaria infection, the parasites stay, but in three-quarters of cases they are asymptomatic.
We don’t get symptoms and do nothing about it: except feed them to every passing mosquito to give to everyone else, and thus create nearly four million cases a year.
And now we are adding a vaccination miracle that only kills the parasites in around half of cases.
Which, altogether, shows that, sometimes, the biggest tool is information and knowledge and that without it we can quadruple our problem every decade.
The writer is a development communication specialist.
