1. This year (2016) the health concern is the Zika virus and its impact on human health. Like malaria, Zika is transmitted by mosquito bites. Compare and contrast Zika with malaria, in terms of its threat, biology, and prospects for effective mitigation.
The Zika virus has existed for hundreds of years. However, recently, it draws particular attention due to the media and recent outbreaks in the Americas, including the concern about the 2016 Summer Olympics in Brazil. Because it is mainly transmitted by mosquito bites, similar to malaria, it is worth to compare the two diseases. Although there are some parallels, the two diseases are vastly different. Primarily, concerns are raised regarding the threat of the Zika virus, its biology, and how world organizations and governments will handle the pandemic.
Both the Zika virus and malaria can pose a serious threat, particularly to pregnant women; however, the possible birth complications they can cause can differ. The Zika virus can result in birth defects, such as brain damage and defects in eyesight or hearing, and even impaired growth. Malaria is much more dangerous to a fetus as it can result in low birth weight, premature delivery, stillbirth, and even spontaneous abortion (Marchione n.p.). Zika fever has symptoms much milder than those of malaria. Zika fever is often a low fever accompanied by muscle and joint soreness, red eyes, or headaches. Malaria, however, is much more serious with a severe fever, chills, and other flu-like symptoms, and can even result in death (Centers for Disease Control n.p.). In some aspects, Zika can certainly be more dangerous than malaria. This is due to the fact that the Zika virus can be spread through sexual contact and blood transfusions (Zika Virus, WHO n.p.) when malaria cannot. Although, overall, malaria can be much worse, the Zika virus is still a serious problem since its peculiarities and differences from malaria can make it even more problematic.
Biologically, the Zika virus and malaria have many similarities despite their differences. As mentioned above, although both are transmitted via mosquito bites, this is done by different types of mosquitoes. The mosquitoes that transmit Zika virus bite mostly during the day while the malaria mosquitoes prefer dusk, night, and dawn (Marchione n.p.). The Zika virus can cause Zika fever, which is the disease, while malaria is a disease caused by parasitic protozoans. While both Zika and malaria occur primarily in the equatorial belt from Africa to Asia, they have vastly different histories concerning their effect on people. While Zika is a relatively new problem for humanity as the first human infection occurred in 1952 (Zika Virus, WHO n.p.), malaria has affected the humanity for thousands of years. Because it is a new problem, Zika is less prominent and cases have been reported in only 41 countries or territories compared to 93 countries or territories that report cases of malaria (Marchione n.p.). As such, research and prevention practices for Zika are trying to catch up to options available for malaria.
Both the Zika virus and malaria are considered serious threats by world organizations and different countries. Currently, there are no vaccines to prevent either; however, the serious effects of malaria can be treated if it is early detected (Centers for Disease Control n.p.). Diagnosis of both diseases is made based on their symptoms and the travel history of the patient, with confirmation by blood or fluid tests. The Zika virus has a shorter incubation period (3-5 days) as compared to malaria (10-15 days), so it can be quicker to detect it if a fever accompanies the virus (Zika Virus, Ministry of Health). However, as this is not always the case, Zika can be more difficult to diagnose as symptoms might not be apparent. Measures to combat both diseases are similar insect repellents, sprays, and nest removal to control mosquito populations and risk exposure. Additionally, safe sex practices are encouraged in Zika-exposed areas to reduce transmission by sexual contact.
While Zika is the newer threat, malaria poses a higher danger currently due to the greater number of cases and deaths that it causes. Fortunately, treatment is available for malaria, and there are numerous programs in existence to combat it. The primary mode of transmission for both is similar, though not completely identical. Research continues to develop vaccines; hopefully, a breakthrough will arise to help combat both of these horrible problems.
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2. You are the program director for the malaria grant portfolio of the Bill & Melinda Gates Foundation. That is, your job is to decide the different types of projects in which to invest those millions of dollars. You can invest all of the money in one particular subject area, spread it around evenly among several disciplines (10% in subject A, 10% in subject B, etc.), or anything in between. Please explain how you will allocate this money so as to best use your resources to reduce or eliminate the disease. Define your specific goal(s), why you have made those choices, and why you believe this is the most efficient means of achieving your goals.
The focus on malaria is of primary importance for the Bill & Melinda Gates Foundation. While it is vital to diagnose and treat the disease, our objective is to eradicate the disease so that millions of lives can be saved. According to the World Health Organization, in 2015, malaria caused an estimated 438,000 deaths in the 214 million cases reported (10 Facts on Malaria n.p.). With this is mind, the malaria grant portfolio will be allocated into three main categories: elimination, prevention, and treatment/support. By dividing the funding between these three areas, we hope to obtain our goal more quickly.
As eliminating malaria will naturally result in less need for prevention and support in the future, 50% of the funds available will be invested into this field. Research areas of concern in elimination are more effective vaccines, faster-acting drugs combining prevention and cure, and diagnostic tools for patterns of infection (Malaria n.p.). By addressing the rising resistance to insecticides, elimination rates which are currently declining can be increased again. These measures will continue to decrease mortality due to malaria, but in order to eradicate the disease, the goal is to reach zero transmission, especially in regions most prone to outbreaks. Accomplishing this requires funds to develop more efficient monitoring strategies and elimination campaigns. Therefore, this category will receive the bulk of funding available to drive the actions necessary for success.
In order to achieve the goal of complete elimination, it is also essential to prevent outbreaks and transmission of the disease. As such, areas of prevention will receive 30% of the total funds in the malaria grant portfolio. There are currently several programs for prevention in practice depending on the region and malaria transmission level. Practices include insecticide nets, preventive treatment, and indoor spraying (Centers for Disease Control, How Can Malaria Cases Be Reduced). Other interventions such as larval and vector controls, as well as drugs and fever treatments, are sometimes employed. While many sources are working on developing a malaria vaccine, nothing effective is currently available. Although research for eliminating malaria is paramount, prevention is presently the best option for regions affected by this blight. As preventing further spread of the disease will contribute greatly towards its eradication, this field also receives a significant portion of the available funding.
Along with the elimination and prevention, treatment and support for populations, particularly in high-risk regions, will receive the remaining 20% of the funding. Drug treatment for malaria depends on several factors such as the species of the parasite, the clinical status of the patient and their condition, and so on (Malaria Treatment n.p.). However, support measures such as education and control are critical as they will decrease the number of reported cases each year. The health impact on an infected community can be enormous, and loss of productivity is extremely important. Therefore, treating patients and supporting communities through education, medicine, and other resources is a primary concern. Even though this category is allotted the smallest amount of funding, enormous assistance can be provided to communities to combat endemic areas.
This three-pronged approach divides funding according to the rank of importance to achieve the eradication of malaria. While the Bill & Melinda Gates Foundation seeks to help those afflicted by the disease and reduce the chances of the outbreak in areas prone to high-level of exposure, our primary focus is research that will lead to saving millions of lives over the years to come. Each area will receive funding sufficient to achieve reasonable goals, and assessments will be included in each category to measure program success. Hopefully, these methods will prove fruitful, and malaria will no longer be a threat to humanity.