Office of Malaria Research, South African Medical Research Council, Durban, South Africa.
S Afr Med J. 2019 Dec 5;109(11b):53-56. doi: 10.7196/SAMJ.2019.v109i11b.14250.
A high-level review was conducted of the literature pertaining to the challenges and opportunities for eliminating malaria on the African continent. Although malaria mortality and morbidity are on the decline, the disease remains one of public health importance. Africa has invariably borne the brunt of the disease, recording the highest number of cases and deaths. However, with greater emphasis being placed on the disease by the international community, partnerships have developed to boost malaria elimination efforts on the continent. One such initiative is the Roll Back Malaria (RBM) partnership which aims to facilitate malaria elimination through increasing resources and awareness. Many cross-border initiatives have been established which treat malaria as a regional problem rather than a country-specific one. Accelerated malaria control efforts have led to a 37% decrease in cases and 60% reduction in deaths. Multi-country efforts have resulted in marked reductions of transmission in the region. Although there have been noteworthy gains in curtailing the disease, new challenges have arisen. The main among these are residual malaria and outdoor biting. One of the main drivers of residual malaria is insecticide resistance. Adding to the burden of residual transmission is the discovery of new vectors that may exist at low densities. To exacerbate these issues is the challenge of malaria imported from high- to low-transmission areas. Nevertheless, compared with the historical picture, we are winning the battle against malaria. Countries in Africa are being certified malaria-free. Partnerships have been developed to take forward the RBM Global Malaria Action Plan. Elimination agendas can only be successful if funding remains sustainable, with greater reliance on domestic funding.
对与非洲消除疟疾的挑战和机遇相关的文献进行了高级别的综述。尽管疟疾的死亡率和发病率正在下降，但该疾病仍然是公共卫生的重要问题。非洲始终首当其冲地受到该疾病的影响，记录了最高的病例和死亡人数。然而，随着国际社会更加重视该疾病，已经建立了合作伙伴关系，以加强非洲大陆消除疟疾的努力。其中一项倡议是“遏制疟疾伙伴关系”（RBM），旨在通过增加资源和提高认识来促进疟疾消除。已经建立了许多跨境倡议，将疟疾视为一个区域问题，而不是一个特定国家的问题。加速的疟疾控制努力导致病例减少了 37%，死亡人数减少了 60%。多国努力导致该地区的传播明显减少。尽管在遏制该疾病方面取得了显著进展，但新的挑战也出现了。其中主要的挑战是残留疟疾和户外叮咬。残留疟疾的主要驱动因素之一是抗药性。新发现的可能以低密度存在的新传播媒介增加了残留传播的负担。使这些问题恶化的是从高传播地区输入的疟疾的挑战。然而，与历史情况相比，我们正在赢得抗击疟疾的战斗。非洲国家正在获得无疟疾认证。已经建立了合作伙伴关系，以推进“遏制疟疾伙伴关系”的全球疟疾行动计划。如果资金保持可持续，并且更加依赖国内资金，消除议程才能取得成功。
