When spraying may not hit malaria

The Ghanaian Chronicle has reported on a good example of public-private partnership, in this case between the Ministry of Health and a Waste Management fiim. “ZOOMLION Ghana Limited, the country’s waste management experts, in collaboration with the Ministry of Health, has begun a mass mosquito spraying exercise in the Western Region, which would cover all the 17 districts.”

The question arises as to whether this will really have any effect on malaria.  According to an official from the company, “This is part of a nationwide routine spraying exercise, which targets public toilets, urinal sites, container sites, refuse evacuated sites, drains and ditches, stagnant water, market places and finally, disposal sites, which we intend to spray to be able to control diseases and vectors.”

The sites listed above may serve as breeding grounds for Culex, Aedes and Anopheles mosquitoes – and in fact the operation is dubbed the “Nationwide Mosquito Control Programme (NAMCOP).”  Anopheles like clean, usually sunlit and stagnant (i.e. not moving) sources of water for breeding, and this being the rainy season, such places may be found among those listed.

dscn2552a.JPGSince the program is aimed at larviciding, it will is challenged in the case of anopheles by the multitude of tiny water puddles over wide expanses of territory.  These may not even be stable with the heavy rains being experienced now. It is unlikely in 33 days during this season that all mosquito breeding in the region will come to a halt. The article notes the valuable employment opportunities offered by the exercise as jobs will be available on the 420 spray teams, but these teams might be better employed distributing insecticide treated bednets throughout the region to guarantee universal coverage.

In the long term there are important lessons to learn from Aedes control in Latin America. Communies have played a major role in reducing the breeding of Aedes aegypti mosquitoes and dengue fever in Cuba, Argentina and Honduras, for example. Communities can maintain efforts over time, which is needed for sustained vector control.

While there are more resources for malaria control today than ever, they are not enough to achive elimination.  We should focus our efforts for now on the few key interventions that are known to work.

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