Orals East Africa>The persistence of mosquitos requires affordable interventions At the hut of the story

Written by Oscar Ochieng

As the world marks World Mosquito Day in Memorium of British Medical Officer Ronald Ross discovery of the link between this persistent vector and malaria we need to assess our response over the years.

Through globalization, urbanization and climate change, Aedes aegypti and Aedes albopictus continue to proliferate almost unchecked. More than 3.9 billion people live in areas where there is a risk of Aedes-borne viruses, such as dengue, Zika, chikungunya, and yellow fever. These viruses are transmitted primarily by Aedes aegypti and Aedes albopictus mosquitoes, which thrive in tropical and subtropical regions around the world, including parts of Africa, Asia, the Americas, and the Pacific.

Since Officer Ross, working in India, changed the course of history by discovering the malaria parasite in the 'dapple-winged' mosquito, scientists have made considerable gains at ending malaria with varied levels of success and failure.

Malaria remains a crushing burden in many communities with an estimated 249 million cases globally in 2022 according to World Malaria Report 2023, leading to 608,000 malaria deaths in a single year.

The African continent endures the highest fatality rate due to malaria, a deadly disease transmitted by mosquitoes. Approximately 94% of the cases and 95% of the related deaths occur on this continent.

Kenya is among the countries most affected by malaria, particularly in sub-Saharan Africa. According to the World Health Organization (WHO), four African countries—Nigeria, the Democratic Republic of the Congo, Tanzania, and Mozambique—accounted for just over half of all malaria deaths worldwide in recent years, with Kenya also being a significant contributor.

From an economic perspective, direct economic cost of malaria in Kenya and concluded that the total economic cost of malaria to children as young as 5 years of age for 2009 was approximately at 1% of GDP (US$251 million). The total direct costs of malaria account for 44% of the total estimated costs, with indirect costs, including mortality making up about 57%.

The share of malaria treatment expenditure by the government accounts for 27%, of which private households bear about 68%. The total cost of malaria hospitalization in Kenya is approximately US$ 58 per infected person in Kenya, 72% of which is borne by the government.

Malaria affects wages in Kenya as well, according to an article published in 2023 by the Institute of Economic Affairs. It is estimated that a 10% increase in malaria prevalence reduces monthly individual wages by 3.3%. Furthermore, the entire economic burden of malaria amounts to (on average) 1% of household income. Although this is a substantial amount on its own, it takes on enormous proportions when only a small portion of households bear this burden, accounting for a large portion of their incomes.

Malaria control efforts have rapidly increased over the past ten years due to an increase in partners and resources from the likes of Global Fund, Bill and Melinda Gates Foundation. Millions of lives have been saved worldwide thanks to the expansion of interventions and the development of new malaria prevention technologies, which reduced malaria mortality by 36% between 2010 and 2020. This has raised hopes for elimination and, eventually, eradication of the disease. But recent years have seen a plateau in progress, underscoring the necessity of ongoing observation and investigation.

The good news is that the disease, which is transmitted by mosquitoes, is preventable and treatable. The development of an effective and affordable malaria vaccine is a glimmer of hope for millions as this would complement the existing interventions some of which only offer partial protection.