Each year 1 million people die from malaria. Discuss whether these deaths are avoidable and what is being done to prevent and treat the infection

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Each year 1 million people die from malaria. Discuss whether these deaths are avoidable and what is being done to prevent and treat the infection.

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Each year 1 million people die from malaria. Discuss whether these deaths are avoidable and what is being done to prevent and treat the infection.

‘It occurred to me that malaria was a genocide. How was it that we had a disease that killed a million-plus people a year, and we let it happen? This was a genocide of apathy.’ (Ray Chambers, Lifeblood, page 70)

Malaria kills a million people a year, and infects up to 500 million more. It is calculated that in lost work days, expenses and wasted potential it costs Africa $30-40 billion a year (A. Perry, Lifeblood, page 11) .This expense could be spared as malaria is a preventable and curable disease. Malaria is caused by a protist parasite, of which there are 4 species that can infect humans. Of all the types of malaria, Plasmodium falciparum is the most serious, and accounts for the majority of the life-threatening cases of malaria each year. Malaria attacks the human body through entry via an Anopheles female mosquito, and goes on to destroy red blood cells and affects many vital organs include the liver, kidneys and spleen. Malaria is mainly present in Africa, Asia, the Middle East and South and Central America. Due to the nature of the parasite, it is the leading infectious killer in the world and therefore an important global health issue.  Malaria is counted as the world’s most contagious disease; its reproductive number ranges from 10-3000, compared to that of H1N1 with a reproductive number of 3 (A. Perry, Lifeblood, page 12).

One way of trying to prevent the spread of malaria is to shorten the life cycle of the mosquito, so that they cannot ingest and infect other organisms with the parasite. This is currently being done through environmental methods, as by removing the mosquito’s breeding grounds or not allowing the mosquitoes long enough to develop the parasite the spread of malaria can be slowed. This can involve drainage (the mosquitoes breeding ground is stagnant water), levelling the land, and filling depressions in the ground. It has been claimed that:

An estimated 42% of the global malaria burden (or around 500,000 deaths) could be prevented by environmental management”. (‘Preventing Disease through Healthy Environments’)

In the past, in 1950s America, oil was used to stop the growth of mosquitoes by removing their breeding ground. This suggests that if a wealthy country can eradicate malaria then there is no reason why all countries can’t eradicate it.

Another way to try and prevent the spread of malaria is use of insecticides. Indoor residual spraying (IRS) is recommended by the WHO, (WHO Malaria Report 2010, Page 17) an insecticide is sprayed on indoor walls, meaning that as the mosquito comes to rest after feeding it is killed by the uptake of insecticide through its feet. The most effective IRS spray is DDT, which can last for over 6 months. DDT is a low cost solution and an easy way to reduce mosquito numbers. However some mosquitoes have become resistant to DDT after the use of it in the previous decades.

Another way that the WHO is trying to prevent the spread of malaria is with ‘long-lasting insecticide-treated mosquito nets’, which they believe should be supplied to malaria prevalent areas either free or at a subsidised charge. These nets hang above a bed at night time, preventing the mosquito from feeding and therefore infecting people. This is especially important as the main time for mosquitoes to feed is during the night. The number of nets delivered by manufacturers increased from 5.6 million in 2005 to 88.5 million in 2009 in sub Saharan Africa, showing a dramatic increase in the use and availability of these nets. However still only 42% of households were estimated to have owned one of these nets in 2010, and only 35% of children were thought to be sleeping under one (WHO Malaria Report 2010, page 20) This shows that although the increase in nets has been dramatic, there are still not enough for each person in a malaria ridden area to sleep under one, or the people who have been provided with nets are not using them.  This indicates that although effort is being put in, it is not enough for the scale of the problem.

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For control by drugs; malaria was originally treated by Chloroquine, however due to widespread use, many strains of malaria are now resistant to the drug. The WHO recommends the use of one of 5 ACTs (artemisinin-based combination therapy) and primaquine. Unfortunately in many countries these drugs are either scarce or too expensive for the general population to be able to afford. Only 65% of patients who visited a public health facility with malaria got the treatment they needed, (WHO Malaria report 2010, page 31) and many people would not have access to a public health facility.  This problem is ...

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