Feeding a seemingly permanently unsatisfied appetite for bad news, Al Jazeera recently produced a sensationalist report claiming global warming is increasing Uganda's malaria burden. Not only will credible malaria scientists surely differ in their conclusions, but the report is likely to distract governments and donor agencies from doing the right thing in combating this deadly disease.
Malaria is very complex disease, involving the interaction between parasites, mosquitoes, and human populations. As Oxford University scientists Simon Hay and Peter Gething have demonstrated, there is no simple relationship between climate and malaria. It may be tempting to think that higher temperatures will lead to more mosquitoes and therefore to more malaria. But Hay and his colleagues compiled data on the incidence of malaria in 1900 and 2007 and found the opposite: despite rising temperatures during the twentieth century, malaria has lost ground.
The malaria scientist Paul Reiter has exposed serious deficits in the thinking behind climate change and the spread of insect borne diseases. It has long been thought that malaria has increased recently around Nairobi thanks to climate change. Reiter however notes that Nairobi grew up around a camp, set up in 1899 during the construction of a railway, the famous 'Lunatic Express'. He explains that although there may have been fewer mosquitoes in Nairobi in recent years there certainly mosquitoes there in the 1800s. Reiter states, "From the start, the place was plagued with malaria, so much so that a few years later doctors tried to have the whole town moved to a healthier place. By 1927, the disease had become such a plague in the 'White Highlands' that £40,000 (equivalent to about R4.9 million today) was earmarked for malaria control". Reiter goes on to note that, "The authorities at the time understood the root cause of the problem: forest clearance had created the perfect breeding places for mosquitoes".
Indeed far from worsening, malaria rates have been declining. Widespread insecticide use and bed nets have far outweighed the influence, if any, of climate change. "Malaria is still a huge problem," says Gething. "But climate change per se is not something that should be central to the discussion. The risks have been overstated."
Bjorn Lomborg from the Copenhagen Consensus Centre exposes the skewed priorities of those linking insect-borne diseases and climate change. "Warmer, wetter weather will improve conditions for the malaria parasite. Most estimates suggest that global warming will put 3% more of the Earth's population at risk of catching malaria by 2100. If we invest in the most efficient, global carbon cuts - designed to keep temperature rises under two degrees Celsius - we would spend a massive $40 trillion per year by 2100. In the best case scenario, we would reduce the at-risk population by only 3%."
In contrast, we know that malaria can be overcome by combining effective control strategies, such as sleeping under mosquito nets and spraying tiny amounts of insecticides on the inside walls of households, coupled with the use of highly effective anti-malaria treatments. Simply put, Lomborg's assessment of trying to control unpredictable weather patterns as opposed to introducing proven strategies that have successfully eradicated malaria from large swathes of regions across the globe is would be an awful investment. But perhaps most importantly, history has demonstrated that the most effective strategy for overcoming malaria is to grow economies and boost incomes.
Uganda is one of the poorest countries in the world with an average GDP per capita (PPP) of only $1,400. People can barely afford to sustain themselves, let alone protect themselves against the deadly bites of malaria carrying mosquitoes. Uganda has the third highest number of deaths from malaria in Africa, with an estimated 47,000 people succumbing to the disease each and every year. Uganda also has some of the highest recorded malaria transmission rates on the continent, particularly in the areas around Lake Kyoga in central Uganda where a person living in the Apac district would receive more than 1,500 infectious bites per year on average.
According to Transparency Internationals Corruptions Perceptions Index Uganda is ranked 130th out of the 174 countries that comprise the index. In July, and in the latest of a series of scandals, three Ugandan officials from the Ministry of Health were arrested for the 'mismanagement' of a US$51 million malaria grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria. In September, the Global Fund called for the refund of any ineligible expenses under the grant and the strengthening of safeguards to prevent future misappropriation of funds.
In order to overcome malaria in Uganda, the country ought to focus its attention on using scarce taxpayer and donor resources for the best available strategies that have proven, without a doubt to clear vast swathes of regions across the globe from the deadly scourge of malaria. Hyping claims about climate change and disease is a deadly distraction from the important work developing country governments have to do to grow their economies and create healthy, wealthy societies.
Jasson Urbach is a director of Africa Fighting Malaria. This article may be republished without prior consent but with acknowledgement to the author. The views expressed in the article are the author's and are not necessarily shared by the members of AFMs board.