Malaria is an infectious disease spread by mosquito bites that is prevalent around the world, but most notably in sub-Saharan Africa; half a billion cases and two million deaths are recorded every year, and out of those cases, half of them are children in sub-Saharan Africa. With poor housing, inadequate health care, and the most effective malaria vector– the mosquito Anopheles gambiae– being most widespread in Africa, the disease has yet to be eliminated and continues to negatively affect African communities.
This article explored the idea that improvements to housing may contribute to the reduction of the spread of malaria. Malaria is spread by mosquitoes, therefore improvements in housing could lessen exposure to biting. The scientists in this article tested the hypothesis that the odds of obtaining malaria are lower in modern housing than traditional housing in sub-Saharan Africa. They analyzed Demographic and Health Surveys (DHS). In these surveys,conducted in 21 countries, developed a binary housing variable where houses built using finished wall, roof, and floor materials were classified as “modern,” and all other houses were classified as “traditional.” Across all 284,532 surveys conducted, modern housing was associated with a 9-14% reduction in the odds of malaria infection. From this study, they could conclude that housing quality is an important risk factor for malaria infection. Housing improvements is a promising intervention for sustainable malaria control.
Amartya Sen’s definition of human development explores development as a catalyst for human freedoms and opportunities. The switch from traditional to modern housing in Sub-Saharan Africa would expand people’s freedoms in the sense that without the major threat of malaria, they could spend their time and money on other activities and opportunities.
This article related to many different types of human development topics, including infrastructure, poverty analysis, and resource management and allocation. They conducted their analyses in Stata with variables like housing quality, insecticide-treated net use, household wealth, association between housing quality and malaria infection, and association between insecticide-treated net use and malaria infection. The authors acknowledge that insecticide- treated nets and indoor residual spraying are highly effective methods of vector control, but additional actions must be taken for long-term, sustainable control of the disease. This is where housing improvements could play a part in advancing human development in these areas by providing a sustainable way to reduce cases of the disease. However, housing is not the only solution. There are many options for solutions that must be explored, like any major human development issue.
This article investigated tools (both those that are currently available and ones that must be obtained) in order to maintain and achieve malaria elimination. From the turn of the century, significant advances have been made in malaria prevention and elimination including improved diagnostics, drugs, vaccines, and vector control. However, current methods of controlling malaria have limitations in many areas, therefore it is evident that changes still must be made and challenges still must be met.
The studies conducted, as summarized by this article, tested that in order to achieve malaria parasite elimination across all countries, new tools and strategies must be made to complement existing interventions. The authors of this article are in support of the WHO Global Technical Strategy for malaria goals from 2016-2030 and tracking this progress of this R&D agenda. They also believe that reevaluating the research needs will be required over time as new developments are made.
Rather than specifically asking a scientific question and testing it, this article created an detailed agenda for malaria advancement while sharing some data and information. The article summarized some most important recent advances in malaria prevention and treatment. In 2015, the pre erythrocytic candidate vaccine received a positive scientific opinion by the European regulators through the Article 58 procedure. This was important to the advancement of treatment by identifying a regulatory pathway and demonstrating that the large clinical trials necessary for approval could be conducted in Africa. Other studies are in progress to define how to improve the vaccine’s efficacy and how these data translate to the field of disease prevention and treatment. For example, a small study with RTS, S found that fractional dosing resulted in high efficacy. Another study demonstrated transmission-blocking activity. They argue that the validation of surrogate end points for transmission-blocking activity that translate to known effects in the field is necessary for efficient development of new interventions. The article shared data about different types of assays for assessing this transmission-blocking activity.
Improving vaccines relates to Amartya Sen’s definition of freedom in human development due to the obvious advancement on quality of life. When patients diagnosed with malaria can be treated in an effective, timely manner, they can go back to their lives without the mystery of if they will get sick again. Vaccines with high efficacy give people the liberty to live their lives without the burden of illness. This type of development is truly human development “for the people ‘’ by improving the condition of thousands of people. The authors are addressing the sustainable development goal of making human settlements inclusive, safe, resilient, and sustainable. They investigated the precision epidemiology area of human development. Conclusions can be drawn from this that there are overarching areas in which greater knowledge and research is required to understand how to effectively blend current inventions with new technology. The authors believe that novel tools may allow improved investigation of the shortfalls of current solutions.
The prevalence of malaria in Africa and other countries around the world most greatly affects women and children – they are most vulnerable to the disease. Pregnant women have a notable risk when being diagnosed with malaria due to the possibility of adverse pregnancy and birth defects that accompany malaria in pregnancy (MiP). Recently, attention has been drawn to intermittent preventive treatment of malaria in pregnancy, a process which has historically had low coverage in impoverished countries. The study conducted used an existing mathematical model of MiP combined with estimates of the changing endemicity of malaria across Africa with maps of SP resistance mutations and current coverage of antenatal access and IPTp with DP across Africa. Using estimates of relationships between resistance mutations and the parasitological efficacy of SP during pregnancy, they estimated the varying impact of IPTp with SP across Africa and the value of enhancing its uptake to match current antenatal care coverage.
Their study concluded that despite the continuous decline of malaria transmission in Africa, the burden of MiP in the lack of effective prevention remains significant. Even accounting for the resistance of SP, extending IPTp with SP to all women attending antenatal care would have a substantial impact on maternal and infant health in most malaria- endemic settings in sub-Saharan Africa. They used geospatial data to show percentages of mutations across Africa and expose highly affected areas.
This study related to the precision epidemiology and disease burden estimation areas of human development where data science methods are being developed. Improving the methods by which pregnant women are being vaccinated relates to the sustainable development goals of good health and well-being, reduced inequalities, and sustainable cities and communities. By keeping unborn babies safe and healthy, this area of development would lead to a better future for the communities. Less money would have to be spent on medical fees, and more healthy people would be able to contribute to society. This relates to Amartya Sen’s human development definition. Creating a better future for the young generations of humans in Africa by improving their health at birth will give them more opportunities and freedoms in the future.
Well-organized efforts are vital to the elimination and prevention of malaria parasites across international borders. Country programs and international donors have been increasingly focused on regional approaches, with initiatives established in southern Africa, the Arabian Peninsula, Asia Pacific, Eastin Europe, and Latin America. However, like most initiatives relating to malaria, there are always improvements to be made. Despite the growing attention on regional initiatives, there is a lack of structure and guidance to key activities and organizational components. This article argued that in order for regional initiatives to be effective, they need to follow a specific and effective structure.
Regional approaches are important because they prevent the flow of malaria across borders, find solutions for tackling the disease in the final stages of elimination, and ensure political and financial support once it becomes a completely rare disease. Regional initiatives (RIs) are defined as multi country and multisector partnerships with governmental support that work towards elimination. The WHO-led Global Malaria Eradication Programme (GMEP) highlighted many benefits from international collaboration including: regular data sharing and coordination, special border zones for intensified activities, and administrative systems for health personnel from each country to readily transit borders. GMEPs structures were widely successful in its efforts to decrease malaria in many regions. The new WHO Global Technical Strategy for Malaria takes after that and highlights a need for a deeper regional collaboration. To prove this need, they used modeling data techniques and studies that confirmed malaria elimination will only be possible in a country like South Africa through collaboration with their better-off neighbors like Mozambique. The author states, however, that these models do not address the structure in which a country could follow to have an effective regional approach. To investigate this issue, a semi-systematic review of publicly available reports was performed using Google Scholar and PubMed and on applicable RI websites. Among the RIs reviewed, a number of key conclusions were made. RIs must prioritize building a region-specific evidence base to better inform national policies, focusing on providing local answers to local problems.
Designing and implementing data-sharing systems is also vital to the success of an RI. This type of data analysis to benefit the health of an overall community is a perfect example of using data science to advance human development for personal freedoms. By collaborating across countries for disease treatment and prevention, these solutions provide greater opportunities for a mass population of people. This relates to the sustainable development goals of good health and wellbeing, sustainable cities and communities, and most relevantly, partnerships for the goals. Though it can be complicated for less developed and sometimes dangerous countries in Africa to effectively collaborate with each other, it is pressing for these countries to take action.
Many countries have elected to help Africa in the fight against malaria with resources and financial contributions. The United States of America has made substantial monetary contributions to the United States President’s Malaria Initiative (PMI) since 2006, but no studies have investigated how this program has actually affected important population-level health outcomes. The authors of this article utilized many publicly available data sources to try to find and analyze the association between introduction of PMI and child mortality rates in sub-Saharan Africa (SSA).
The authors used difference-in-differences analyses to compare trends in the outcome of under-5 mortality rates and secondary outcomes in population coverage of malaria interventions in 19 PMI recipient countries and 13 non-recipient countries between 1995 and 2014. The analysis controlled for presence and intensity of other large funding sources, individual and household characteristics, and country and year fixed effects. The authors concluded that PMI program implementation was associated with a significant reduction in the annual risk of under-5 child mortality. Each dollar of per-capita PMI expenditures in a country was also associated with a reduction of child mortality.
These findings highlight an important aspect of Amartya Sen’s definition of human development in which Sen believes that improvements of GDP and income are not the only indicator of a country’s human development advances. It is evident that intervention and aid from better-off country’s can be vital in the advancement of the freedoms and opportunities available in impoverished areas. The United States has the means to create sustainable futures for other countries, and these data show that it is effective and efficient when they do so. This type of collaboration relates to the sustainable development goal of partnerships for the goals. When eliminating deadly diseases becomes a global or even simply a multi-country effort, more advances are made than if a specific area is left to deal with the issue alone.