Malaria in Sub-Saharan Africa: A Multifaceted Disease

Every year there are around 200 million reported cases of malaria around the world, an infectious disease caused by a parasite and transmitted by mosquitoes. As it stands, 90 percent of all deaths attributed to malaria occur in Sub-Saharan Africa. 

The hot and semi-arid tropical climate prevalent throughout most of the Sub-Saharan region presents an optimal breeding ground for Plasmodium Falciparum, the most common and deadly species of malaria-causing parasites. Though the disease most directly impacts the health and physical condition of those it infects, malaria’s effects are far reaching and impact the existing economic, agricultural, and educational structures in disproportionately affected African countries. 

Although 90 percent of cases occur in Sub-Saharan Africa, death caused directly by the parasite is rare in comparison, largely in relation to the acquired functional immunity of native African peoples. Infection with malaria is almost always universal throughout a population. This does not mean that all individuals who contract malaria will incur a negative cost to their health, but that those who die from the infection are representative of the public health costs of developing immunity at the collective level. Malaria’s health-related impacts disproportionately harm those with poorly developed immunity, particularly younger children, reflecting the age-specific mortality burden of infection. 

Consequently, the burden of increasing structural inequities in many African countries falls more heavily on vulnerable populations, such as young children, pregnant women, rural workers, and travelers or migrants unfamiliar with different regions. Existing inequities are difficult to manage, as vulnerable populations are  continuously failed by lack of accessibility to proper healthcare resources and inherently more susceptible to malaria. At the same time, Malaria continues to impact educational systems. Education systems suffer when infected children, who are already at a heightened risk of contracting complications from infection, miss school and perform more poorly as a result of their gap in education.

In addition to the high mortality rate associated with P. falciparum, the parasite is indirectly linked to the increased likelihood of contracting other infections that cause chronic anemia and undernutrition. The disease spreads when an infected mosquito bites a noninfected person and the parasites mature to infect its host's red blood cells. Because the parasites most significantly affect red blood cells, individuals are also susceptible to catching malaria from exposure to infected blood, which can be transmitted from mother to unborn child, through blood transfusions, and by sharing needles used to inject drugs. Malaria can be fatal largely due to the serious complications sometimes caused by the infection, including cerebral malaria, breathing problems, organ failure, anemia, and low blood sugar. 

For African countries already struggling with the economic burden of treating and preventing malaria’s rapid spread, the increasing fiscal obligation required to combat the infection is now proving more than they can handle. The direct costs of the disease, including illness, treatment, and loss of life, are estimated to cost Africa at least 12 billion USD per year. Examining the state of Africa’s developing economy, the cost to the continent's lost economic growth is much greater than its face value and presents a substantial challenge to necessary structural advancement. Further, economic costs are not distributed evenly throughout African society. The disease is more prevalent in the agriculture sector, where a large proportion of Africa's population is employed, and has substantial negative repercussions in the forms of reduced quality of work ethic and absenteeism from work. 

Consequently, the burden of increasing structural inequities in many African countries falls more heavily on vulnerable populations, such as young children, pregnant women, rural workers, and travelers or migrants unfamiliar with different regions. Existing inequities are difficult to manage, as vulnerable populations are continuously failed by lack of accessibility to proper healthcare resources  and inherently more susceptible to malaria. At the same time, Malaria continues to impact educational systems. Education systems suffer when infected children, who are already at a heightened risk of contracting complications from infection, miss school and perform more poorly as a result of their gap in education.

Malaria’s large reach and high transmission rate makes the infection a problem not only for those living in Sub-Saharan African countries, but also for nearly half of the world's population currently living in high-risk areas across 87 countries. Since the vast majority of vulnerable areas are in developing countries, their respective governments do not have the resources to provide permanent or even temporary solutions to combat Malaria’s spread. Though a recent scale-up of interventions with increased resources and global partners has saved millions of lives and cut malaria’s mortality rate by 36 percent from 2010 to 2020, there is still much more work to be done when trying to mitigate the societal effects of the disease. The inability to take decisive action using resources at hand will maintain malaria’s global prevalence and impact the livelihood of all those who enter areas where malaria can be contracted, as well as the collective welfare of communities around the world.