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In Equatorial Guinea, the authorities have launched a vast campaign of spraying insecticides in homes in Malabo, the country's main city, in order to reduce the presence of mosquitoes and the risks of transmission of the parasite responsible for malaria.
According to them, this large-scale campaign undertaken with the support of several non-governmental organizations should enable the country to accelerate its economic and social development program by 2035.
According to a World Bank report published last July, 57% of the Equatorial Guinean population will live below the poverty line in 2024, due to inflationary pressure, among other reasons.
Food prices have increased significantly by 4.1% and the country remains in the grip of major economic difficulties due to its dependence on revenues from oil exports representing 46% of its GDP and 80% of its income, underlines Amnesty International. The organization adds that oil exports are in increasing decline.
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The government has launched an economic and social development program for 2035 through the diversification of the economy and with investment in tourism.
According to the Minister of Health of Equatorial Guinea, the eradication of malaria in the next four years is a big step in achieving this objective. Malaria specialist and associate professor of medicine at the Johns Hopkins University School of Medicine, Matthew Ippolito, also highlights the role of economic development in combating this disease, which is closely linked to rural poverty. It warns that a resumption of transmission after a period of decline can have particularly serious consequences, with the reduction in population immunity exposing more people to severe forms.
Malabo wants to multiply its control strategies
The main measure put in place for the short-term eradication of malaria is the spraying of insecticides in households and towns. This ambition was born from the historic success on the Island of Bioko where a spraying campaign made it possible to obtain a drastic reduction in the prevalence of malaria and mortality among children under five years old, Doctor Makhtar NIANG, research director and head of the scientific center of parasitology at the Pasteur Institute in Dakar, Senegal, told BBC News Africa.
Building on this success, the government wants to reproduce the same initiative throughout the country. But if the results were achieved without major constraints on the island of Bioko due to its isolation, the Senegalese parasitologist warns that a large-scale campaign and within a national strategy is not necessarily a foregone conclusion.
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In addition to this mass campaign approach, Equatorial Guinea is also planning the deployment of the R21 malaria vaccine, recommended by the World Health Organization (WHO) to vaccinate 300,000 children nationally. In addition, the government is considering the use of drones as a surveillance method to identify areas of high concentration of mosquitoes with a view to eliminating them. Finally, authorities are evaluating the possibility of using genetically modified mosquitoes which have the capacity to render mosquitoes sterile and prevent them from transmitting the parasite responsible for malaria. According to Guillermo Garcia, director of international programs at MCD Global Health, the success of the program will depend on the country's ability to sustain its efforts over time, while adapting interventions to lessons learned from other elimination experiences. A relaxation of prevention and control could encourage a resurgence of the disease.
Equatorial Guinea aims for the top 5 countries having defeated malaria
The country will become the 5th on the continent to obtain malaria elimination certification from the World Health Organization. It will join in particular Mauritius which had its certification in 1973, Algeria in 2019, Cape Verde and Egypt in 2024. “To do this, the country must prove irrefutably that it has not recorded any case of local transmission throughout its territory for at least three consecutive years,” explains Dr Niang from the Pasteur Institute in Dakar.
The parasitologist adds that to grant its certification, the WHO will send an evaluation mission to the country during which experts will be responsible for evaluating the robustness of the detection systems, checking the registers at the level of laboratories and health posts to ensure that no case has been hidden or omitted. “It is following this mission that a report will be submitted to the WHO so that it can grant, on the basis of the evaluation reports, officially certification of malaria elimination.”
The challenge of eliminating malaria in African countries
According to the WHO, Africa bears a large and disproportionate share of the global malaria burden. In 2024, 95% of malaria cases out of a population of 265 million will be recorded in Africa. The same year, 579,000 people on the continent, more than half of whom were children, died, adds the UN agency. Paradoxically, progress in the fight is stifled by several constraints. Despite political will and scientific expertise, the fight on a continental scale is hampered by insufficient financial and logistical resources, underline researchers from the scientific center of parasitology at the Pasteur Institute in Dakar. According to Dr. Niang, the head of the center, “the four African countries that have so far obtained WHO certification combine a manageable geography, with island cities on one side and heavily desert areas on the other; facilitating the surveillance and control of transmission: this is the case of Cape Verde and Mauritius, for example. Conversely, the climate in sub-Saharan countries such as Nigeria, the Democratic Republic of Congo, among others, favors continuous transmission almost all year round and the size of the population poses a major budgetary constraint. » We must still remain optimistic in view of the results obtained in recent years on the continent, assures Makhtar Niang who recalls having worked with many countries including Senegal on a plan to eliminate malaria by 2030. Faced with the asymmetry of financial and logistical resources, African leaders should invest a significant part of public finances in eliminating the obstacles inherent to the fight against malaria while strengthening regional solidarity in the face of the disease.
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