Studies examine costs, prospects of ending malaria

Women cover their faces as a health worker fumigates a slum to prevent malaria in Mumbai December 15, 2009.

LONDON (Reuters) - Eliminating malaria can be achieved only with repeated investment over the long term and will require a major shift in policy and funding now focused on control of the disease, experts said on Friday.

In one of a series of studies in the Lancet medical journal about the prospect of trying to eradicate the often deadly infectious ailment, scientists said that for many countries, eradicating malaria will not be a quick win.

Like immunization, it would require long-term investment over and over to make sure the disease does not come back, even after the intense activity of wiping it out is over.

"Successful elimination will need a fundamental shift in the perception of malaria investment from a so-called quick win to a routine expenditure," said Oliver Sabot of the Clinton Health Access Initiative in the United States, who led one study.

According to the World Health Organization, about 3.3 billion people -- half of the world's population -- are at risk of malaria, which is spread by mosquitoes.

There are about 250 million malaria cases and almost a million malaria deaths each year, and people living in the world's poorest regions are most vulnerable.

SHRINKING THE MALARIA MAP

In a commentary on the findings of the papers, Lancet editors Richard Horton and Pamela Das said they showed that countries should not set their sights on malaria elimination without careful analysis of the costs and implications.

Focusing on trying to eradicate the disease when that goal is too far off could lead to dangerous swings in funding and political commitment, they said, and may jeopardize the success of efforts to control malaria.

"The quest for elimination must not distract existing good malaria control work," they wrote. "If existing control efforts were indeed scaled up, by 2015, 1.14 million children's lives could be saved in sub-Saharan Africa alone."

In another paper, scientists said that the most practical way forward in fighting the disease was to continue shrinking the "malaria map" of countries where it is endemic.

During the first half of the 20th century, 178 countries had endemic malaria, the scientists found. Since 1945, 79 have eliminated malaria, including Britain and the United States in 1952, Australia in 1970 and, most recently, Morocco in 2005 and Turkmenistan in 2010.

But 99 countries still have endemic malaria, and of these 32 are moving from controlled low-endemic malaria to elimination, while 67 are controlling the disease short-term, the study found.

The 32 countries seeking to wipe out malaria have more than 2 billion people and include China, Argentina, Iraq, Mexico, South Africa, Turkey and North Korea.

(Editing by Mark Heinrich)