The Lancet provides a brief history of the attempt to eradicate malaria.
In 1955, WHO set out to rid the world of malaria. The campaign, called the Global Malaria Eradication Programme, focused on vector control. The plan was to interrupt malaria transmission primarily by attacking the malaria’s mosquito vector with the potent, new insecticide dicholoro-diphenyl-trichloroethane (DDT). It was thought that if the parasite’s cycle of transmission from human to mosquito and back again could be blocked for 3 years, the parasite, and with it the disease, would disappear.
Scores of nations joined the programme. Poor nations shifted substantial portions of their health budgets to malaria eradication, and donor nations poured the equivalent in today’s money of billions of dollars into the effort. Eradication teams spread out around the world; wetlands were drained; forests and fields were dusted; and millions of homes were sprayed.
There were remarkable successes. Malaria was eradicated from southern Europe as well as parts of north Africa and the Middle East. From 1955 to 1963, Sri Lanka saw the number of clinical cases drop from 1 million a year to 18. But soon the effort began to falter. Insecticide-resistant mosquitoes and drug-resistant parasites began to emerge. Eventually, funding slowed and by the end of the 1960s malaria eradication was abandoned for the less ambitious goal of eliminating the disease where possible and controlling it where it could not be eliminated.
But now there is a new movement afoot to eradicate malaria:
Last week, Bill and Melinda Gates, whose foundation has donated US$1 billion to a variety of malaria programmes, called for the world to launch a new campaign to eradicate the disease. At a conference in Seattle convened by their foundation, they argued that new scientific advances and growing financial and political support for malaria initiatives have made the goal of eradication realistic. They pointed to new drugs being developed by the Medicines for Malaria Venture, including four fixed-dose artemisinin combination therapies that are likely to obtain international registration by the end of next year and 20 other new drugs in the Venture’s development pipeline. They pointed to the Malaria Vaccine Initiative’s eight vaccine candidates, three of which are in clinical trials, including the promising RTS,S vaccine, which is expected to enter phase III trials in eight African countries next year. They highlighted progress being made in a number of sub-Saharan countries where insecticide-treated bednets, intermittent prophylactic treatment, household spraying, and other measures are already reducing the incidence of the disease. And they point to unprecedented financial support now flowing from the Global Fund to Fight AIDS, Tuberculosis and Malaria, the US President’s Malaria Initiative, and the World Bank’s Booster Program for Malaria Control in Africa.
Eradication would not be cheap. A back-of-the-envelope estimate suggests it would cost about $9 billion a year for two or three decades to make and distribute the necessary vaccines, drugs and equipment. But that compares with $3 billion a year indefinitely, merely to contain the problem–not to mention the economic damage done by the disease.
It’s uncertain whether it’s even possible to eradicate malaria but if we succeed the payoff is enormous. Steve Levitt has links to papers that estimate some of the benefits:
Hoyt Bleakley, a professor at the University of Chicago Graduate School of Business, documents the long-term benefits of malaria eradication in the American South in the 1920s, and then later (when DDT became available) in Mexico, Brazil, and Colombia. By comparing areas that did and did not have malaria problems before the eradication campaigns, Bleakley cleanly measures some of the benefits of abolishing malaria. Using individual-level census data, he finds that getting rid of malaria led to higher wages and literacy rates for children who grew up post-eradication. Wages rose 10 to 40 percent after eradication in the places that were worst affected by malaria.