Since the Trump administration came into office, there are real uncertainties about the long-standing US Presidential Malaria Initiaitive (the PMI), which I helped start in 2005. Firstly, the Administrator Tim Ziemer, who has given the Initiative real stability for 8 years, has resigned. Secondly it appears that the very conservative Newt Gingrich will take over USAID which funds the PMI within the US State Department. Gingrich is opposed to USAID and might dismantle it. Fortunately the new US Secty of State Rex Tillerson has gone on record as favoring the health programs of USAID.
So what will happen? The PMI currently works in 19 African countries with a budget of over $600 million annually. Unfortunately their strategy has been based on the ephemeral methods of indoor spraying, bednets and drugs. Thus suppression of transmission could soon end if PMI ceases operations. Then the people in those African countries will fall into the Immunity Trap, as transmission has been reduced in their countries for several years, and they have likely lost their immunity. Thus a resurgence of malaria could have severe consequences. If WHO were a competent organization with adequate funding, they might step in. But alas, they probably can do little.
Perhaps we should contact the new Secty of State Tillerson and urge him to continue the PMI, with a more durable strategy, one that includes improved housing and window screens, as well as permanent Larval Source Management.