Can Malaria Be Eradicated?

Update: Larry Hollon, of the Methodist church and Perspectives, attended the Malaria Summit in Seattle and has a firsthand account on his blog.

I did a double take when I read that Bill and Melinda Gates have just challenged the world to eradicate malaria from the globe. I went back and looked at several news sources. Yes, they all agreed the word "eradicate," not "control" was used. Now that's a tall order, even for a pair of billionaire philanthropists. (Full disclosure, I'm at Harvard on a Nieman Fellowship in Global Health Reporting, which is funded by the Gates Foundation.)

Back in the 1960s, health experts were convinced that widespread use of DDT against mosquitoes plus treatment with chloroquine would eradicate malaria from the world. By the 1970s, however, the environmental damage caused by massive agricultural use of the pesticide caused a sharp reduction in all DDT spraying--including inside homes against mosquitoes. Malaria has been rebounding every since.

And yet, health experts I've talked to over the years have told me that even had indoor spraying continued through the 1970s, 1980s and 1990s, malaria, at best, would have been controlled, not eradicated or eliminated from the face of the earth.

What's changed since the 1970s? A promising new vaccine that appears to be partially effective in children. Insecticide-treated bed nets. New combination drug treatments for malaria. Better education campaigns. The return, in some areas, of indoor spraying with DDT and other pesticides. The realization that there is no such thing as a silver bullet in fighting malaria. You need all of the above to control this disease.

But eradicate?

"Bill and I believe that these advances in science and medicine, your promising research, and the rising concern of people around the world represent an historic opportunity not just to treat malaria or to control it -- but to chart a long-term course to eradicate it," Melinda Gates told a gathering of international scientists and policymakers in Seattle, Washington (quote as reported in Agence France-Presse).

An eradication policy is very different--and much more costly--than a control policy. Just ask anyone who is trying to eliminate polio.