Blame the Gold Rush: Malaria Keeps Spreading

The 2019 World Malaria Report released by the World Health Organization last week shows that the disease hasn’t been controlled in Venezuela and threatens the regional efforts to tackle it.

Photo: Who.int

An estimate of 228 million malaria cases and 405,000 deaths by malaria were reported in 2018, according to the World Health Organization’s (WHO) most recent report. The vast majority of these come from Africa; malaria incidence keeps rising around most of the tropical world, too, but in Latin America, Venezuela is largely responsible for the phenomenon.

Latin America reported an estimate of 929,000 malaria cases and 580 deaths, and apart from the Eastern Mediterranean region (which includes Sudan, Somalia, and Yemen) it was the only WHO region where deaths have increased since 2010. With 453,041 cases (a 10% increase compared to 2017, and an astonishing 208% increase compared to 2015), Venezuela accounts for half of all the estimated cases in the Americas, with the majority of these still coming from Bolívar. While still heavily focalized in Southeastern Venezuela, incidence rates (new cases per year, per 1000 people) are increasing all over the country.

Latin America reported an estimate of 929,000 malaria cases and 580 deaths, and apart from the Eastern Mediterranean region it was the only WHO region where deaths have increased since 2010.

After almost three years of epidemiological silence, it’s impossible to know the details on how the disease is spreading across the country, but in places like Merida, where indigenous malaria cases haven’t been officially reported since 2003, the disease and its complications are becoming increasingly common. Evidence suggests it may be spreading due to domestic migration and illegal mining in Bolívar.

On a fairly surprising note, the number of long-lasting insecticide-treated bednets (LLINs), the most important vector control strategy against the disease, increased considerably, from 5,000 in 2017 to 81,000 in 2018; the number of rapid diagnostic tests and medication distributed also showed important increases compared to the previous year. This is far from enough, though, since almost 6 million people are considered to be at high risk of getting the disease in Venezuela, according to WHO estimates. More telling is the funding, or rather the lack of funding for malaria prevention campaigns in the country. 

In 2018, Venezuela spent less than $1 per person at risk in malaria control programs, less than countries like Guyana or Haiti, and the vast majority of that money came from international organizations, highlighting the government’s systematic negligence. Argentina, certified by WHO as malaria-free earlier this year, spent almost $11 per person at risk.

The numbers presented in the World Malaria Report 2019 are not as bad as most Venezuelan experts expected, partly due to the few advances made on LLINs and medication distribution.

Overall mortality was reduced compared to 2017 (257 deaths vs 333), still higher than that of any other country in the region, with 44 registered deaths, representing 44% of all registered deaths in the Americas, and a 1,428% increase compared to 18 deaths reported in 2010.

The numbers presented in the World Malaria Report 2019 are not as bad as most Venezuelan experts expected, partly due to the few advances made on LLINs and medication distribution. Nonetheless, the disease keeps rising every year and proper vector control is only reaching a very small percentage of the population. 

Stopping malaria won’t be possible without massive investment and, especially, political will, two things that seem impossible to get in a crisis-struck Venezuela, where the government spends more money romanticizing precarious mining than it does in dealing with its consequences.

Juan Carlos Gabaldón

Medical doctor from Merida, currently studying Medical Parasitology at the London School of Hygiene and Tropical Medicine