Are bed nets continuing to be effective? Are bed nets the solution? Are we in danger of falling back and giving ground to a more virulent form of the parasite?
These questions are important and deserve a careful response. They are especially relevant to United Methodists who are closing in on raising $75 million for the Imagine No Malariacampaign.
From the outset of the current initiatives against malaria, it was clear that bed nets would be effective for a period of two to three years. It was also clear that resistance to existing medications and pesticides is one of the most frustrating capacities of the malaria parasite.
So the questions raised by the BBC story have been anticipated by malaria specialists for a number of years.
However, in my view the story emphasizes the importance of continuing to raise funds for several angles of attack against this resilient parasite. Bed nets do need to be replaced. Therefore, continuing to fund the manufacture and replacement of nets is part of the whole approach necessary to continue the fight. It's not the only part but one of the multiple steps that need to be taken.
Research and education are needed
In addition, it's important to continue to fund research into various prevention methods. Research at Vanderbilt University in Nashville, Johns Hopkins in Baltimore, and facilities inSeattle among other places must be continued and strengthened. These approaches range from finding ways to alter the reproductive abilities of the female mosquitoes that carry the parasite, to altering mosquito DNA and even to immobilizing the parasite itself through creative genetic manipulation, which goes beyond my layperson's understanding.
It's also necessary to continue to educate people in malaria-affected regions to keep their environment free of standing water and trash that serves to catch rainwater.
It's important to educate children (and adults as well) about wearing clothing that will protect them from mosquitoes when the insect is most active in the morning and evening. This, along with environmental cleanup, is known in the malaria world as behavior change communication.
Those who are fighting this disease have been addressing behavior change for many years, reinforced by the communications efforts of United Methodist Communications. The task is ongoing.
It's important to continue research into more effective pesticides because the parasite has shown an amazing ability to adapt and resist. This may be the greatest challenge.
Artemisinin resistance was identified by the World Health Organization in some regions several years ago. The agency warned of the spread of the parasite into new areas and called for increased containment efforts.
Health workers in the field need to continue their efforts at quicker diagnosis and treatment of those suspected of contracting malaria. The sooner appropriate medications can be provided the more likely the worst of the disease's effects can be addressed.
And research must continue into effective drugs for treating the disease. These efforts, as others I've listed above, are taking place in many locations around the world.
Lives are at stake
One of the reasons this disease has persisted is its ability to adapt, but the effectiveness of these various inputs from the highly sophisticated to the most rudimentary have resulted in significant progress in reducing deaths and suffering in recent years. But the battle is not over, and it certainly isn't lost.
We must continue the fight, keeping our eyes wide open to the challenges the BBC has accurately identified.
And we must not lose heart and yield to the thought that the disease cannot be conquered. To do so is an invitation to an even greater calamity. The world experienced that about 30 years ago, when progress against the disease was made and the fight was abandoned prematurely.
The result was that the parasite came back even stronger and was more difficult to contain, causing many more deaths and posing a challenge that was far more difficult to treat.
The fight against this disease is challenging, but what is at stake are human lives. We have seen many places around the world, the United States and Panama for example, where malaria once claimed lives with impunity but is now under control.
This is not the time to let the challenges cause us to hesitate. It's time to redouble our efforts to enjoin the fight
After service in the British SAS Regiment the author became a physician and then an orthopaedic surgeon.
He has held professorial positions in Canada, Vietnam and the United States, practiced and taught orthopaedic surgery in three continents and in several wars.
He has extensive experience as an expert witness in court. Somewhere along the way, time was found to operate a four hundred acre mixed farm, a one hundred seat restaurant and to obtain a licence as a flying instructor.
The author's books are available from bookstores, the publishers, or from on-line bookstores such as Amazon, Barnes and Noble, and Indigo/Chapters.