“The malaria vaccine in humanist terms is the biggest need, but it gets 

virtually no funding. If you are working on male baldness or other 

things you get an order of magnitude more research funding because

 of the voice in the marketplace than something like malaria.” - Bill Gates

THE FIGHT AGAINST MALARIA IN SUB-SAHARAN AFRICA

By Boaz Yagel Ziegelboim

In Sub-Saharan Africa, one of the most challenging problems we face 

with regards to Public Health is Malaria. We are all aware that we need 

to take these measures:

-  Improving health, quality and span of life through the management and/or treatment of Malaria

-  Creating awareness in the society for Malaria prevention

- Promoting Anti-Malaria activities through organizations, foundations, NGOs and businesses

- Eradicating the disease causing agents (mosquitoes)

- Educating the public for sustainability

Controlling malaria vectors, the Anopheles mosquitoes, is an ongoing challenge in Sub-Saharan Africa. Unfortunately, the anti-malaria vaccine is still under development, nevertheless large amounts of money are invested in the research. It is still not enough! The common approach of many NGOs and WHO (World Health Organization) is to focus on the fight against malaria, mostly with LLINs (Long lasting insecticide-treated bed nets). Indeed, millions of those nets were distributed in Sub-Saharan Africa in the last ten years. They certainly have a commercial edge for the multinational companies producing those nets; and as a fact, more and more multinationals are investing huge amounts of money in order to get WHO’s approval for the nets. The idea is correct, and perhaps works perfectly in the Western society. Yet, according to my experience, it has limited effect on the African ground for a few reasons:

* Many people find it difficult to sleep under those nets as they feel suffocated. Hence, they reject the idea.

* If not tightened correctly, the net still allows the mosquitoes to enter the “protected” zone and transfer malaria.

* In most cases, there is a need for one mosquito net for one person, unless they share the same bed. With the rapid population increase in malaria-endemic countries in Africa, the supply is often insufficient.

* Mosquito nets might protect the individuals in their habitats, but will not have any effect outside, when a person is exposed to nature.

There is, however, a combined approach which helps malaria prevention much more effectively. We should use LLINs together with Larvacide, the insecticide that is specifically targeted against the larval life stage of the mosquitoes, and IRS (Indoor Residual Spraying). However, regular Larvacide has a downside. Many of the Larvacides sold in the market may also affect non-target species particularly in water reservoirs.

SUGGESTIONS AND NOVELTIES

n  Recently, we have tested an innovative, silicon-based Larvacide, which does not affect the aqua life. The success ratio in our primary results is 76-92%. The tests were conducted both in lab and field conditions. I believe, if applied correctly, adding this new product to the market will reduce the malaria vectors dramatically.

n  We also applied an innovative IRS (Indoor residual spray) successfully both for individuals and government institutes in Ghana, Africa, with a success rate of over 80%, providing a safe environment from mosquitoes, with duration of 2-3 months.

Today, I believe that the effective utilization of IRS and Lavacides should be the primary focus of the global fight against malaria. I do not rule out the LLIN, yet believe it to be an insufficient solution by itself.  This being said, without changing the way in which we are fighting against Malaria today, the universal goal of public health care cannot be achieved.