Even as the world grapples with the COVID-19 pandemic, reducing the transmission of an ancient disease that kills an average of 400,000+ every year must remain on the global radar.
So says Dr. Carlos Espinal of the Robert Stempel College of Public Health & Social Work. The infectious and tropical disease expert works with the Pan American Health Organization, under the auspices of the World Health Organization, to reduce the prevalence of a contagious parasitic disease that has dogged civilization for thousands of years.
“It’s endemic in many parts of the world,” Espinal says. “Malaria does still have a heavy disease burden affecting the community and causing a tremendous economic and social impact.”
Malaria is caused by a parasite carried by blood-sucking mosquitoes—it is not transmitted person to person except, rarely, through blood transfusions—and occurs in more than 100 countries and territories, among them large areas of Africa and South Asia and parts of Central and South America, the Caribbean, Southeast Asia, the Middle East and the South Pacific islands. About half of the world’s population is at risk. Infected persons can experience symptoms from mild to severe, among them cough, fever, decreased appetite, skin rashes and mood changes. If malaria is left untreated, it could result in anemia, jaundice and kidney failure, mental confusion, coma, seizures and death.
Espinal, who directs the Global Health Consortium, serves on a committee that promotes efforts to sustain momentum around malaria eradication. By shining a spotlight on those countries making inroads—he currently serves as vice chair of the Malaria Champions of the Americas annual awareness campaign—health officials hope to encourage those on the frontlines of its elimination.
“In Latin America and the Caribbean, we are really progressing,” Espinal says. “The last country [to eliminate the disease] was El Salvador, which was certified free of malaria [in late February]. This is really a great achievement. But still, even if they are free of malaria, they have to continue surveillance and monitoring because neighbors like Nicaragua, Honduras, Guatemala and even the Caribbean, the Andean region, still have a lot of cases of malaria.”
The first cases of malaria are believed to have occurred between 3200 and 1304 BC, based on detection of malaria antigen in Egyptian remains.
Among current challenges is growing resistance to anti-malarial drugs. Such medicine is commonly administered to those traveling from the United States to certain countries. The United States does not harbor the species of mosquito that is the main carrier of the disease but must remain vigilant nonetheless, Espinal cautions.
“We have the right condition for transmission in several geographic areas in the United State, and we have travelers and migrants coming from high-transmission areas. That is a risk to local transmission. That is why it’s one of the disease of concern from the U.S. government.”
Additionally, the ongoing COVID-19 pandemic is believed to have negatively impacted malaria protocols. As communities closed down, infected individuals could not easily seek diagnosis and treatment, for example, Espinal says. In addition, control measures such as distribution of insecticide-treated bed nets and anti-malarial drugs in Africa were likely hampered, say the authors of a study published in January in the medical journal The Lancet.
As a leader of the committee that recognizes local organizations and governments making a difference in Latin America, Espinal plans to share opportunities with Stempel College graduate students. Those pursuing public health degrees will be present, via Zoom, during nominating meetings to determine the 2021 Malaria Champion of the Americas. They will also attend the final event, which will bring together ministers of health, ambassadors representing the Organization of American States and key stakeholders from Geneva, Africa and elsewhere.
The successful fight against malaria will require the collective commitment of a globally minded consortium of dedicated leaders and practitioners, Espinal says. “We are very proud that FIU is a distinguished member of this community.”