Malaria Eliminated From Sri-Lanka. Hope For Nigeria?

Hopes of eliminating malaria from more than 30 countries with a total population of 2 billion have risen following the successful removal of the disease from Sri Lanka

Public health officials said 13 countries, including Argentina and Turkey, had reported no cases for at least a year and may well follow the success of Sri Lanka, which this week declared itself malaria free after meeting the criterion of going three years without an infection.

By the end of the decade, another 21 countries, including China, Malaysia and Iran, could be free of the disease, which kills 400,000 people, mostly babies and pregnant women, every year.

Public health officials believe that in years to come the elimination from Sri Lanka, highly symbolic because the island came within a hair’s breadth of defeating malaria more than 50 years ago, may be regarded as the beginning of the end for the disease.

The director of the World Health Organisation’s global malaria programme said Sri Lanka had shown that, with commitment, any government could eliminate malaria, even with the tools available.

“The country took ownership of the problem themselves,” Dr Pedro Alonso said. “They wanted to eliminate malaria even in the face of the civil unrest they had in the last decade. They paid for it themselves.

“In a world where a lot of declarations are made, the translation of that commitment into real action is best exemplified by putting real resources in themselves,” he said. Other funders, such as the Global Fund to Fight Aids, TB and Malaria then came in with support.

Secondly, Sri Lanka had an enlightened public health system and academia. It did not just buy in millions of mosquito nets and drugs; it conceived a plan to solve its own particular problem.
Sri Lanka’s director general of health services said success came through teamwork and strong political commitment over many years.

“Elimination of malaria from every nation is possible. That’s the best lesson I guess: you have to work hard,” Dr Palitha Maheepala said.

More than 80% of Sri Lanka’s 22 million people live in rural areas which provide ideal ecosystems for Anopheles culicifacies mosquitoes, which are one of the main vectors for malaria in the region.
It was not possible to eliminate the mosquitoes from jungle areas, so the government focused instead on the parasite which causes the disease in humans, and is transmitted from person to person by the mosquito.

The quick diagnosis of malaria in children meant they could be treated earlier, reducing the chances of mosquitoes sucking up the parasites in their blood and transmitting the disease to other people.
Sri Lanka also sent mobile clinics into the worst-affected areas and spent time, money and effort on educating the public.

Other countries have also been doing well. The millennium development goals, set by the United Nations in 2000, focused minds and attracted money. The number of new malaria cases worldwide fell by 37% between 2000 and 2015 while death rates dropped by 60% overall and by 65% among children under the age of five.

The countries on the list of 21 that could eliminate malaria within the next four years, published by the WHO in April, are: China, Malaysia, South Korea, Iran, Saudi Arabia, Belize, Costa Rica, Ecuador, El Salvador, Mexico, Paraguay, Suriname, Bhutan, Nepal, Timor-Leste, Algeria, Botswana, Cape Verde, Comoros, South Africa and Swaziland. All have brought down malaria cases dramatically and share a political commitment to the endgame.

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