Spring rains will bring swarms of hungry mosquitoes carrying a disease as devastating as Aids – malaria.
An old killer is expected to return with a vengeance in the next few months and could claim even more lives in Southern Africa than the Aids epidemic.
According to medical experts, the heavy rains the drought-ridden region is praying for would awaken hordes of dormant mosquitoes that are expected to carry the malaria parasite far and wide.
This spectre was raised by the region’s health ministers and private health industry representatives at the recently concluded Southern Africa Malaria Control Conference in Swaziland.
The World Health Organisation (WHO) sponsored the yearly meeting. Swaziland, South Africa and Botswana have gone far to contain malaria, and the sub-continent experienced a significant decline in cases last year. But the health experts fear that is about to change.
The drought that dried up mosquitoes’ breeding grounds this year should be broken by spring rains. Their severity through summer will be predictable by September.
”Our past experiences from the 1992 drought and other droughts is that after the drought breaks and the first rains fall there is a natural biological response from the mosquitoes. They move in large numbers,” said Zimbabwean conference chairperson Shiva Marugasampillay. ”We must prepare to keep malaria down when the rains come.”
Worldwide attention is focused on Aids in Africa, but malaria is still the continent’s worst killer. Unlike Aids, malaria is treatable. But outbreaks of the disease, together with its prevalence, might devastate tourism, which many malaria-belt areas rely on for much of their income.
”Malaria caught from the buzzing but invisible mosquito conjures fears of 19th century safari dangers, with explorers in pith helmets desperately quaffing quinine,” said Graham Root, the East Africa region field officer for the Malaria Consortium, a resource centre that provides technical support to health ministries.
Root, who works out of Uganda where 63% to 80% of children are infected by the mosquito-borne parasite that causes malaria, feels that malaria control efforts have at best a two-year window of opportunity before medical attention and resources are shifted to the Aids crisis.
”Malaria cannot be eradicated, but it can be contained. Parts of South Africa, Swaziland and Botswana are now malaria-free, and there is hope for Namibia, and maybe Zimbabwe. North of the Zambezi, though, transmission of malaria and the number of cases truly escalate,” Root said.
EK Njelesani, the WHO’s representative in Zimbabwe and leader of the Southern African malaria control team, said: ”The WHO works with the World Meteorological Organisation and the Drought Monitoring Centre to set up an early-warning system for weather conditions that will influence the spread of malaria. By September the summer weather patterns will be in place and we will target our preparations for containment.”
Root lists ”treated bed netting, spraying of homes and yards, and especially the availability of drugs in clinics” as the most important measures to prevent malaria. If those fail ”treatment must begin in a timely manner, within the first 24 hours”.
This year preventive measures lowered by up to 20% the 20-million malaria episodes and 200 000 malaria deaths originally projected for Southern Africa.
However, the drought-induced food crisis affecting the region may reverse this year’s improvements when the rains return. Near starvation has weakened millions of people and has made their bodies less able to withstand disease. The people most at risk live in urban slums without adequate water drainage, where stagnant pools allow mosquitoes to breed.
Assuming the rains do come, the crops they nourish will not be harvested until mid-summer, months after malaria would have been unleashed on hunger-weakened people. In South Africa, the peak malaria transmission period begins in November and runs through to May. About 10% of South Africans live in malaria areas and more than 4,5-million are considered at risk.
”We are also mindful that a large body of tourists will be coming to the region in December to observe the solar eclipse,” Marugasampillay said.
Health officials say malaria and Aids are equal public health crises. Each merits attention that does not come at the expense of the other. But as Africa’s worst killer reasserts itself, malaria is expected to command more public awareness in the months ahead.