Yesterday I gave a talk for the Dialogues house in Amsterdam, which is affiliated to the ABN-AMRO Bank. The audience consisted of people that have no background or experience in malaria. But something funny happened there...
My talk focused on the history of malaria and its control, how the world map of malaria distribution shrunk until the end of the 1960s, and that major successes since have been lacking.
I gave them the DDT story, we talked about bednets, drugs and drug resistance, the usual items you would present to a lay audience.
But then I couldn't resist chipping in the story about Fred Soper, the invasion of Brazil by African malaria mosquitoes, and the massively successful campaign that was waged against it seven decades ago.
This was a turning point in the talk. People started speaking up, were astonished about this story, never thought that something like this was possible. Could malaria elimination really be that simple?
Then I gave them an example of what happened to me in northern Sudan six years ago. Of how simple it can be to control malaria vectors and have a huge impact. By just filling a breeding site with sand.
I guess there is little doubt, based on historical facts, that the tools at hand for vector control (nets and indoor residual spraying) will not be sufficient to eliminate malaria. Ultimately, area-wide tactics that involve source reduction and larval control will have to come into play.
But the strategy needed for larval source modification (LSM) in the context of elimination is still to develop. Who should do it, and how should we do it?
I wonder how MalariaWorld members look at this. Following on from the previous blog about Soper, we welcome your thoughts and ideas.