Malar J. 2016; 15: 419.
Published online 2016 Aug 18. doi: 10.1186/s12936-016-1470-8
Towards malaria elimination in the MOSASWA (Mozambique, South Africa and Swaziland) region
Devanand Moonasar, Rajendra Maharaj, Simon Kunene, Baltazar Candrinho, Francisco Saute, Nyasatu Ntshalintshali, and Natashia Morris corresponding author.
This recent article about progress against malaria in southern Africa is very encouraging, but could use some clarifications and also a more stable strategy. The authors recognize that sustained funding of USD $39 million for 2016-2020 is needed, and not necessarily assured. The precariousness of funding was demonstrated when the previous malaria initiative in this region (LSDI) was abruptly terminated in 2011 for lack of funds. Nonetheless the strategy for the new MOSASWA region will utilize temporary ephemeral methods such as drugs and biocides whose impacts evaporate as soon as the money does. A more rational approach would be to use the initial funding for permanent improvements in housing and breeding sites, gradually building out malaria transmission. Then, if funding stops, the impacts remain.
Another ecological comment. Examining the map of southern Africa and the malaria distribution described in this excellent article, it is clear that malaria transmission is related to mean temperature or NS Latitude and Altitude, It is also very likely that the large swings in malaria in southern Mozambique observed since the year 2000 are related to changes in rainfall. These factors should be analyzed and then included in the long range strategy, if elimination is to be pursued.
One final point: the value of activities of the US PMI. Mozambique gets some help from this US malaria initiative. These activities should be coordinated with the plans for malaria elimination by South Africa and Swaziland, even if they get no direct aid from the US PMI. PMI is also helping the neighboring countries of Zimbabwe and Zambia, and could thus help to eventually expand the Regional Attack.
Although the PMI impact is being drastically reduced due to resistance developing by the mosquitoes and the parasite, their funding is quite stable. Naturally that will depend on the results of the US elections in November. Let us Pray.
Bill - a US voter