For decades, the Americas region has led the world in the elimination of infectious diseases. It was the first to eliminate the transmission of smallpox in 1971, followed by the elimination of poliomyelitis in 1994 and rubella in 2015.
These successes occurred because many countries committed to using a Primary Health Care approach to respond effectively to the health needs of the communities.
A first level of strong care serves as the backbone for effective surveillance and notification of diseases, which are essential elements to create safeguards against other diseases transmitted by mosquitoes such as Dengue fever, Chikungunya, Zika and yellow fever. In addition, they can play a key role in eliminating what was once one of the deadliest diseases in the region: malaria.
When scientists discovered that this disease was caused by a parasite transmitted by mosquitoes, effective treatment and prevention tools could be developed. By 2000, almost half of the Member States of the United Nations had eliminated the disease within their borders.
Today we are closer than ever to eliminating malaria in the Americas. Earlier this year, the World Health Organization certified Paraguay as malaria free. We hope that Argentina and El Salvador are the next to join this success. Belize, Costa Rica and Suriname have made great progress, registering less than 100 cases of local transmission in 2017. Ecuador and Mexico are on a list of 21 countries with the potential to eliminate malaria in the coming years.
But as we get closer to elimination there is a new danger: Governments that trust that the end is near could slow down their efforts.
History shows that when countries look away from malaria, elimination takes a step backwards. This is what we have seen recently in the region in countries in crisis. Failures in providing primary health care and migrant flows have led to a dramatic upsurge in the incidence of malaria, which threatens control efforts in several nations. And the longer the elimination is delayed, the more likely it is that resistance to our most effective medicines and insecticides will emerge.
History shows that when countries look away from malaria, elimination takes a step back
The latest World Malaria Report by the World Health Organization shows that global progress has slowed down. We urge all countries to commit to freeing this continent from malaria.
Countries in Central America and South America are giving good models of how to wage this fight. In 2015, Haiti and the Dominican Republic launched the Malaria Zero Alliance, with support from PAHO, the United States CDC, the Carter Center and other partners.
USAID has also supported PAHO in implementing technical cooperation for the 2016-2020 Action Plan for the Elimination of Malaria. This year, the IDB and partners created a new financing and technical assistance mechanism – Regional Initiative for the Elimination of Malaria – that seeks to help Belize, Costa Rica, the Dominican Republic, El Salvador, Guatemala, Honduras, Nicaragua and Panama with the elimination for 2022.
These efforts could also be accelerated with innovations in diagnosis, treatment and vector control, such as the introduction of what could be a revolutionary new treatment for malaria P. vivax, which represents 80% of all cases in the region. The current treatment for vivax It requires taking pills for a period of 7 to 14 days at a very specific time. A new treatment in testing has shown the potential to completely cure the vivax with a much simpler dose.
One in 10 people in the Americas is still at risk of contracting malaria. If we work together, we have the opportunity to do something that was once considered impossible: we can end malaria forever.
Carissa F. Etienne is director of the Pan American Health Organization
Chris Elias is president of the World Development of the Bill and Melinda Gates Foundation