This June, the United Nations Foundation’s Nothing But Nets campaign convened experts and leaders on Capitol Hill for a briefing on the fight to eliminate malaria in the important, but sometimes-overlooked, region of Latin America and the Caribbean.
Congressman Himes (D-CT4), who grew up and has worked in Latin America, spoke about his personal interest and commitment to the region. He said, “[Latin America] is an area in which with focus and with resources and with fairly simple technologies, we can dramatically reduce the prevalence rate [of malaria] and the death rate. All it takes is focus.”
Expert panelists from the Center for Strategic and International Studies (CSIS), the Pan American Health Organization (PAHO/WHO), the U.S. Centers for Disease Control and Prevention (CDC), and the U.S. Agency for International Development (USAID) agreed that it is in America’s best interest to support public health institutions in Latin America and the Caribbean. These speakers joined the event to give a report on the countries excelling and lagging on the path to elimination as well as to share what U.S. agencies and partners are doing to ensure greater progress in the fight to end malaria in the region.
Here’s what we learned:
Dr. Luis Gerardo Castellanos, Unit Chief of Neglected, Tropical and Vector Borne Diseases at PAHO/WHO’s Department of Communicable Diseases and Health Analysis, began the panel discussion with an overview of the fight against malaria in Latin American and Caribbean countries. The global community should be proud, he said, because Paraguay and Argentina are on the path to achieve malaria-free certification this year. (Five days later, WHO and PAHO announced the official certification of Paraguay as malaria-free). Furthermore, other countries like El Salvador and Costa Rica are excellent candidates to achieve elimination within the next few years.
On a larger scale, however, Dr. Castellanos noted that progress has been mixed. In 2013, Latin America and the Caribbean saw a record low of 389,000 malaria cases and just 89 deaths – leading many to believe elimination was very close. But in 2016, the region saw over 600,000 cases, with countries like Venezuela, hosting large spikes in prevalence due to the political-economic crises that has diminished the public health system. Especially for teenagers, young adults, and pregnant women, malaria poses a huge threat despite the progress of the last decade.
But the good news, Dr. Castellanos said, is that the solutions are clear: “We know exactly where the malaria is. We know how to diagnose it. Medication is available. We can cure malaria. Countries can reach elimination. Seven of those identified (in WHO’s E2020 initiative) are in Latin America and the Caribbean.”
Katherine Bliss, a Senior Associate at CSIS’s Global Health Policy Center, provided an extensive background behind the explosion of malaria in Venezuela. Venezuela was once a model health system for Latin America and the Caribbean, having eliminated malaria from urban areas by 1961. But the country recently became consumed by political and economic turmoil, causing its public health capabilities to crumble as well. A widespread lack of access to clean, running water and electricity has handicapped hospitals’ abilities to treat patients. Doctors and health workers have left the country en masse. Malaria cases have skyrocketed since 2010 – a ten-fold increase – making the country the worst-hit by the disease in the Americas.
Unfortunately, due to the collapsing public health system, those afflicted with malaria have largely been left to self-diagnose and treat, which can be ineffective and ultimately lead to drug resistance. This trend has led to the region’s largest increase in cases and deaths in decades.
The U.S. has a successful track record of combatting malaria when we work with partners like PAHO/WHO and the CDC on the ground in Latin America and the Caribbean, according to Rebecca Minneman, Malaria Advisor for Latin America and the Caribbean at USAID.
Mrs. Minneman explained that the U.S. works with agencies and partners in the region to support continuous progress on the path to malaria elimination. Those long-standing partnerships, in combination with genuine commitment from regional governments, have produced extraordinary results in ridding much of the region of malaria.
Some pockets in Latin America and the Caribbean, however, remain under siege from malaria. Isolated communities, including rural and indigenous populations, suffer from intense inequities that result in disparate health outcomes. Providing greater support to these communities and sensitizing them about malaria prevention and control will result in great strides forward in the push to eliminate malaria from every corner of the Americas.
Dr. Michelle Chang, Director of Malaria Zero and Medical Epidemiologist of CDC’s Malaria Branch, expressed optimism that the international community is close to eliminating malaria on the last island in the Caribbean, Hispaniola, which is home to Haiti and the Dominican Republic. The Dominican Republic (DR) decreased malaria cases to less than 400 last year, while Haiti has reduced the disease from over 75,000 cases in 2010 to less than 18,000 in 2017, despite a still-lagging national health infrastructure. With increased case management, surveillance, and resources for combatting outbreaks in small pockets, Dr. Chang said Haiti and DR could soon “knock malaria off the map” in Hispaniola.
The benefits to the U.S. of such an achievement would be great, Dr. Chang said. Although the risk is small, she cautioned, the lingering presence of malaria in Latin America and the Caribbean continues to threaten the possibility of the disease’s reemergence in the U.S. Controlling malaria abroad will lessen the burden on the U.S. health system.
As the World Health Organization (WHO)’s announcement of Paraguay’s malaria-free certification and E2020 Initiative report has shown us, progress in the fight to end malaria is possible – but the gains which have been achieved since the turn of the millennium are fragile. As we celebrate incredible progress toward ending this disease we also must sound alarm bells for those countries who are off track in reaching elimination.
Thank you to Congressman Himes and our esteemed panelists for sharing their expertise on this issue. Together, we can end malaria for good – but we need you to raise your voice! Tweet to your Member of Congress and urge them to support U.S. leadership in the fight to end malaria today.
This blog post was co-authored by William Snow and Patty Sanchez Bao.