Most people think of malaria as a problem only in humid, hot countries. But just over a century ago, the disease thrived as far north as Siberia and the Arctic Circle and was endemic in 36 states of the US.
Much of the developed world eliminated malaria in the 1950s through increased prosperity and housing and breakthroughs in medication and insecticides.
Wealthier, people drained mosquito breeding ground marshes as increased livestock meant mosquitoes had animals to bite instead.
Improved nutrition made people healthier and less vulnerable as increased incomes afforded better homes and insect screens. Quinine, then synthetic chloroquine, gave developed countries affordable treatment and insecticides wiped out many mosquito populations.
Outside of sub-Saharan Africa, annual deaths plummeted from more than three million in 1930 to fewer than 30,000 today. Yet, much of the malaria problem has stubbornly remained in Africa, killing more than half a million people yearly: Kenya had 3.4 million infections and 12,000 deaths in 2021.
There are two key reasons. First, the malaria parasite found in Africa is the deadliest and strains have developed resistance to the common medicine, chloroquine.
Secondly, the prevalent malaria-spreading mosquitoes in Africa almost exclusively bite humans. There was progress against malaria in Africa at the start of the 2000s but Covid-19 disrupted basic medicine and caused 60,000 more deaths.
In a setback to ending malaria, the Global Malaria Eradication Program of 1955 was deemed unachievable and abandoned in 1969.
In the UN’s global promises of 2015, Sustainable Development Goals (SDGs), all nations undertook to fix global problems, including malaria, by 2030. But in one of the spectacular failures, glacial progress means the malaria goal will be achieved 400 years later—yet the world is at halftime for SDGs that are not even halfway.
My think tank and several Nobel laureates and more than 100 leading economists have been fighting malaria for years. Our new research by Rima Shretta and Randolph Ngwafor, of the University of Oxford, proposes a 10 per cent point scale-up and use of bednets in the 29 highest-burden African countries alongside insecticide resistance management strategies by the end of 2030 promises.
Ensuring people sleep under an insecticide-treated bednet, which costs less than $4 (Sh540) each, is one of the most effective ways to prevent malaria. Mosquitoes are blocked by the netting and killed by the insecticide.
This requires social behaviour change and communication and information sharing. The cost across this decade is about $1.1 billion a year—a third of what Americans spend on lipstick yearly. That will save 30,000 lives and, in a decade, malaria deaths will be halved, saving 1.3 million lives in all.
The research shows 242 million fewer people will get sick in 2030, dramatically reducing healthcare costs. Moreover, reducing the number of sick people means adults can work, children go to school and caregivers are not stretched, increasing productivity. Every dollar spent would yield societal benefits worth $48—a phenomenal return on investment.
Dr Lomborg, PhD, is the president of the Copenhagen Consensus and Visiting Fellow at Stanford University’s Hoover Institution. [email protected] . @Bjorn-Lomborg www.lomborg.com.