Despite real progress in much of Africa, the two big elephants left in the room are Nigeria and the Congo. Because of poor infrastructure, continuing civil war, and very unstable political conditions, it is hard to imagine how we can attack malaria in the Congo. Although the US PMI has added them to their list, we all know it will be a long time before anything significant can be organized there.
Organizing indoor spray programs or bednet distribution takes a stable MOH, and is difficult in the midst of civil war.
However, there is a project bouncing around the halls of the World Bank in Washington and the African Development Bank in Tunis to investigate a huge hydroelectric dam on the Congo River, upstream of Kinshasa. South Africa has already offered to buy their electricity if and when the project is developed.
With a transmission line from Kinshasa going South to Pretoria, a lot of people along the way could also be supplied with affordable electricity. This could be one way to start development that could eventually include malaria suppression.
Do you think the countries of the Congo River Basin ( which they call DRC Congo and Congo-Brazzaville) have a chance of building that enormous dam? It would be the largest in Africa, and in fact the whole world. It would be about twice the size of the Three Gorges Dam on the Yangtze River in China. One proposed size is 30 Gigawatts. Three Gorges is about 17 Gigawatts, the largest for now.
There is a fairly good history of decreases in malaria transmission after hydroelectric power development.
What do you think?
Bill, the engineer