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Malaria has continued to be a major health problem in Africa. Report by the WHO indicates that last year, of the 109 countries that were endemic for malaria in the WHO membership, 45 members were countries from Africa (2008).
According to the Global Health Network, the Global Health problem refers to the problems and issues of concern that cut across national health interests and issues, and relates to specific existing experiences and conditions in individual countries but would require cooperative efforts to address or overcome (Supercourse, n.d.).
Malaria can be termed a global health problem because it continues to pose a great threat to many countries across the world, many of who are prone because of poverty, lack of access to interventions, prone environments, and living standards. These conditions have contributed not only to the spread of Malaria but also other problems in health. The issue is even specific to some areas to some extent because of geographical and other reasons.
For example, according to Abeku (2007), conditions are harder to predict in areas like the highlands in parts of Africa and this makes curative and preventive measures not easy because of the decisions that must be made. Another example is the disparities between the developing and the developed countries. Freidman (2000) shares the idea that global solutions are possible if the technological barriers in the developing countries are removed to allow equality not only in health circles but also in other sectors in the local settings. Another reason for the spread of these problems is the lack of education among the poor in developing and poor countries.
This means that those unlikely to receive education are also more prone to malaria, and the problem is more present in poor countries where people cannot afford to pay for education or health education. Education will increase the locals’ awareness to the dangers of epidemics, preventive measures, treatment actions and the need for application of long term measures in the counteracting of such epidemics. The spread of global epidemic challenges also continue to face challenges in developing countries because of insufficient budgets that cannot sufficiently address the epidemic health problems through adopting recent recommendations of research aimed at preventing or treating the epidemics, and acquiring the preventive and treatment equipments.
The need for the elimination of Global Health Problems is high as the illnesses may be expensive to deal with and measures expensive to implement. For example, a report by the TDR indicates that Malaria is responsible for a loss of about 0.5% to 0.1% of gross domestic product in countries where it is endemic, and such a loss could total to about a quarter of the whole over 25 years (2005). Some of the epidemics like malaria takes advantage of the biologically prone, for example, the young children who have not yet developed immune against them, and the pregnant mothers who are not immune to the receptors expressed by the mosquito’s malaria causing agent (p. falciparum) and hence enters through placenta (TDR, 2005).
Although history proves that courageous moves have led to elimination of diseases like polio and small pox, elimination of others such as Malaria has continued to pose a big threat to the livelihood. Poverty is one of the major factors influencing spread of the global health problem. This is because the poor cannot afford to pay for better curative or preventive services against the health danger in question.
For example, according to Malaney (2004; qtd. in TDR, 2005), malaria is more burden to the poor because the “direct and indirect costs of a single case represent a significant portion of a person’s income”. Malaria has also been associated with poverty according to TDR 2005 progress report. Again, because preventive measures may not be there to deal permanently with the problem, they may be required on a continued basis which means that the families will require spending more money which may be hard to get. Resistance of mosquitoes to insecticide and drugs is another problem that may not end at all. This means that historic solutions can no longer be relied upon.
Solution that have been proposed in the counteracting Malaria epidemic which can also be used to counter other global health endemic problems is making easier the accessibility of the curative and the preventive measures. In addition, because resistance to anti-malaria drug has been identified as a continuous problem which may spread at an alarming rate, policies that seek to slow or prevent development of resistance need to be advanced.
In addition, further research will play a major role in identifying the trends and hence the possible solutions. Research also plays a major role in detection of resistance and subsequent development of alternatives where resistance has been identified.
These may appear to be easy alternatives and solutions but they are not. For example, TDR report indicates that although the Roll Back Malaria (RBM) WHO program was launched in 1998, there had been no significant falls in total annual death rates (by 2004). Research will also enable the determination of effective methods and procedures to help implement preventive and treatment procedures, in addition to determining more accurate ways to predict conditions in areas that are topographically favorable to growth of epidemic agents. In addition, collaborative efforts between those who are fighting the epidemic problems are needed so as to decrease the burden.
Assessment of the health risk and analytical epidemiological literature review
Data plays a very important part in the analysis, evaluation and drawing of conclusion in the analysis of malaria transmission and epidemic cases. Various challenges relating to collection of data especially at the local level in order to determine the spread and transmission, and the appropriate models should be implemented. Assessment of the health risk of any type of disease is important in designing the control and measures aimed at reducing or eliminating the risks. There is needed an appropriate study design, logistics and time analysis to be able to collect useful and valid data for achieving more exact results.
Learning of the priorities of the community, knowledge of the study area is very important. Those attempting to map the risks for malaria have been indicated to use crude geographical and climate isolines, combination of expert opinion, and limited data. Their comparative value is limited because they lack clear and reproducible numerical definition. Currently, there has been increased availability of set of data for topography, population climate, for example, which have made possible more interest in the mapping of the diseases which are vector-borne and “whose distribution and transmission is mainly influenced by environmental and climatic factors” (e.g. Gesler, 1986; qtd. in Cox, Craig, Sueur & Sharp, 1999).
The linkage between malaria and climatic conditions has caused a focus on malaria even in the non-epidemic areas including where it has been controlled before (Cox, Craig, Sueur & Sharp, 1999). Areas in the sub-sahara Africa formerly thought as of little transmission for malaria have been focused. Little transmission was previously linked to the presence of “low environmental temperatures on parasite sporogony and vector development” (Cox, Craig, Sueur & Sharp, 1999).
However, differing trends have been registered with increasing stability of transmission in highland fringes and increased number of malaria epidemics in the highland areas being evidenced. Analysis of the risks of malaria epidemiology in highlands areas has been weakened by lack of reliable malaria data for most of these areas, although mechanisms implicating ecological and climatic change with the malaria epidemiological change have been put forward.
Local populations at highlands have higher risks of malaria infection because of poor equipping of national malaria control programs to identify and respond to epidemics, and having a low level of functional immunity to malaria as a result of exposure to this infection. In addition, allowing of previous outbreaks without being dealt with has worsened the situation.
The academic and operational aspects of highland malaria which includes mortality in children and adults, control programs and exposure to the risk are dealt with by the Highland Malaria Project (HIMAL) a wider international collaboration of ‘Mapping Malaria Risk in Africa’. The assumption that temperature is the principal limiting condition for malaria may not hold for more ‘marginal’ fringe areas where other factors may also play to determine the extent of occurrence of transmission like it may hold for high attitude areas.
Other areas of risk through favorable malaria transmission includes areas with relative humidity of 60% (Molineaux, 1988; qtd. in Cox, Craig, Sueur & Sharp, 1999) and low relative humidity when temperatures are suitable for transmission as indicated for the case of India (Gill, 1923; qtd. in Cox, Craig, Sueur & Sharp, 1999).
References
Abeku, T. (2007). Response to malaria in Africa: emergent infectious disease perspective. Centers for Disease Control. Web.
Cox, Craig, Sueur & Sharp, 1999. Mapping Malaria Risk in the Highlands of Africa Mara/Himal Technical Report 1999. Web.
Freidman TL. (2000). The Lexus and the Olive Tree: Understanding Globalization. New York, NY: Farrar Straus & Giroux.
Gestler, W. (1986). The uses of spatial analysis in medical geography: a review. Social Science and Medicine 23, 963-973.
Gill, C.A. (1923). The relation of malaria to altitude. Indian Journal of Medical Research 11. 511-542.
Molineaux, L. (1988). The epidemiology of human malaria as an explanation of its distribution, including some implications for its control. Malaria: Principles and practice of malariology, Wernsdorfer W.H. and McGregor I. (Eds.). pp.913-998. Edinburgh: Churchill Livingstone.
Supercourse. Global Health: Global Health Network. Web.
TDR. (2005). Seventeenth Programme Report. Progress 2003-2004.
WHO. World Malaria Report 2008. Summary and Key Points. Web.
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