Not long ago, India set out a target of eradicating malaria by 2030, but the threat of the vector-borne disease still looms large. According to a 2020-22 report by The Global Fund, malaria is one of the major public health problems in India. It was reported that 2 per cent of global malaria cases are reported from India, with the same percentage of deaths reported every year. However, the country continues to make efficient efforts to combat the disease. Meanwhile, the global load of malaria cases is also extremely high with Africa being the worst-hit country.

A robust strategy needed to eradicate malaria

On World Cities Day 2022, the World Health Organisation (WHO) stated that as more people will start living in cities by 2050, we need proper strategies to combat health problems like vector-borne diseases. The report read that living in cities can be advantageous, but unplanned urbanization can “have negative social and environmental health impacts.”

Regarding malaria, WHO said that the burden of malaria is currently high in rural areas but people living in mosquito-endemic countries will soon reside in urban areas. Hence, it is crucial that there is a proper response to address malaria. In light of the chances of increasing cases of malaria across the globe, WHO has issued new guidelines to combat the disease.

WHO strategies that have worked against malaria

In the global framework for the response to malaria in urban areas by WHO, the following are some approaches and interventions that worked to prevent malaria:

Environmental management

• Urban agriculture without surface water accumulation
• Better water storage or installation of piped water
• Improved drainage
• Improved housing with screens
• Improved sanitation and waste management
• Filling of stagnant water sources and swamp areas
• Other construction activities that eliminate potential breeding sites

Chemical and microbial control

• Proper ground surveillance of possible larval habits to help direct larviciding
• ITNs and IRS in pockets of moderate and high transmission
• Reactive IRS for outbreak response

Chemo-prevention

For the unintiated, chemoprevention is the use of medication and other supplements to prevent cancer from happening. According to WHO, it can help in areas where P. falciparum transmission rates are moderate and high :

• In some settings, targeted reactive drug administration
• Intermittent preventive treatment in pregnancy
• Depending on seasonality, perennial or seasonal chemoprevention where there is a clear indication of a high burden of severe disease in children under the age of 5 years

Vaccine

• WHO recommends the use of of RTS,S malaria vaccine in areas with moderate to high P. falciparum transmission to protect children under the age of 5. Other vaccinations under development might also be useful.

Behavioural change

• Social and behavioural change messaging, such as the proper application of preventative and case management interventions, are used to raise public awareness of malaria and to engage the public in the response.
• Messages aimed at business and industry to encourage their participation in and support of the fight against malaria in urban areas