IN PURSUIT OF ANOPHELES MOSQUITOES

A humble trickle of water from a wet land, deep into Miombo woodland, in north-western Zambia, heralds the birth of a river system, whose drainage basin (1,390,000 square kilometers) in Africa can only be rivaled by that of the great Nile River. It was within the course of this mystic river that the world would be mesmerized by a natural formation, which exhibits both beauty and terror. Beauty, for the first European explorer to set his eyes on the feature between1854-1856, David Livingstone, remarked “scenes so lovely must have been gazed upon by angels in their flight”. Terror, for the locals who showed the explorer the formation told him that the feature was called, Mosi-a-Tunya, the smoke that thunders. Today, the falls straddling the border between Zimbabwe and Zambia, indeed have two names, one Victoria Falls, after the then Queen of England and Mosi-a-Tunya, its African name known by many generations gone by.

The majestic Mosi-a-Tunya (Victoria Falls) 

It was on a location upstream on the banks of the Zambezi River, some 10 km from the falls, where early European settlers established a colonial outpost in 1897, close to now Livingstone town, Zambia. Majority of them perished due to unknown disease. There lay a graveyard of early settlers who succumbed to the parasite called Plasmodium falciparum which causes malaria. At the heart of the transmission, particularly in Africa, is a type of mosquito called Anopheles gambiae. Malaria transmission is made possible when a female Anopheles mosquito harvest blood from a host, a human who is infected by the parasites which causes malaria. The parasites undergo development within a mosquito, a period ranging from 10-21 days, depending on parasite species, temperature and humidity. It is critical to note that if the mosquito life span is shorter than the period the parasites take to develop to become infectious, then malaria would not be transmitted. In tropical Africa Anopheles gambiae is known to live longer than the 14 day extrinsic incubation period with two tragic consequences for Africans: first it can reproduce many other potential killers, given that it produces eggs in 2-3 days if it can secure sufficient food- human blood and secondly the parasites can fully develop to cause malaria before the end of the life of the Anopheles mosquito.

Anopheles Mosiquito harvesting human blood, courtesy of CDC.

Since 1897 until today, about 115 years later, Anopheles mosquitoes have decimated African population at the scale of 1 million deaths per year, mostly children (every 30 seconds a child dies of malaria) and pregnant women. Simple arithmetic indicates that close to 115 million Africans, excluding the unborn fetuses (God bless the souls of these lives), have succumbed to early deaths caused by treatable and preventable malaria. Prior to 1897 African population had been severely depleted by slavery, which caused deaths and forced removal of people from their ancestral lands. The impact on African communities and suggested remedies of such a tragic episode shall be articulated further in future installments.

But Anopheles mosquitoes are not only resident in Sub-Saharan Africa. These killer mosquitoes were and still prevalent in temperate regions and even in the vicinity of the polar regions. So why is that the malaria epidemic appear to be now concentrated in Sub-Saharan Africa, which sub-region contributes between 89-91% of the malaria deaths world-wide? There is no doubt that malaria deaths are linked to national income per capita, wherein there is causal effect relationship between poverty and malaria. Lack of sufficient national health budgets has crippled efforts by African countries to offer comprehensive malaria control programs. Communities in malaria prone areas are usually isolated and have low income to afford medication and transport to ferry the sick to the nearest health institution, which could be 40-60 km away.

There is no doubt in my mind that there is great scope for the world citizens to do more to reduce and ultimately end the bloodshed. If the world managed to eliminate the parasite in other parts of the world, then it can be done in Africa.

Great work has been done so far in malaria control and among the notable initiatives are the Global Fund to fight AIDS, TB and Malaria and Bill and Melinda Gates Foundation. It is proper to highlight that when UN and its partners managed to eliminate the disease in other parts of the world in the 1940s, Africa was conspicuously left out. According to Jeff Sachs the proponent of the global fund mentioned above, “…Africa, alas, was neither part of the programme (to eliminate malaria) at the time, nor a beneficiary of its results until today.”

Africa today calls for a paradigm shift in pursuit of Anopheles mosquitoes. It is agreed that the mosquitoes that cause malaria live longer in Africa and therefore can produce offspring during their life span. Thus a potent approach to prevent malaria is to eradicate Anopheles mosquitoes and not the parasite alone. This might look grotesque, in terms of budgetary requirements, but it can be done. Already the bulk of funds destined for Africa to combat malaria have not put a dent on the death toll, meaning that the issue is not about money but approach.

Every year resources are mobilized to treat same patients who were treated the previous year and that definitely can cause donor fatigue. What is required now is to create a fund called the Global Fund to Eradicate Anopheles (GEFA). That fund will ensure extensive research about the vector and pathogen behavior particularly in Sub-Saharan Africa and recommend ways of totally eliminating this insect once and for all. The fund will also superintend, together with governments and communities, practical ways of hunting the anopheles and vanquish it. According to the Centres for Disease Control and Prevention (CDC), “Larval mosquito control for the prevention of malaria in Africa has not been attempted on a large scale.” Why? It would appear Anopheles gambiae has mastered the skill of intimidation. This Anopheles mosquito is highly versatile, for it breeds in numerous small pools of water after a heavy downpour. The larvae develop within a few days, escaping their aquatic environment before it dries out. So for many it is difficult, if not impossible, to destroy the mosquito larvae.  But surely humans, clever as they are, should find ways of finding the larvae and adult mosquitoes wherever they are and just eliminate them before they spread malaria parasites.

If the status quo remains, African children would be forgiven when they conclude that other world citizens are indifferent to their predicament and are not willing to stem the deaths of Africans from treatable and preventable diseases.

The death burden on African families, especially in rural areas, is immense. Death knocks on rural families’ doors as frequent as once a year because disease, hunger and witchcraft stalk them. HIV and AIDS killed a total of 1.2 million souls in Sub-Saharan Africa in 2010 alone, a staggering 67% of the total deaths attributed to the virus world-wide at 1.8 million. About 30 million human beings have since perished due to AIDS since it was discovered, meaning that a crude estimate: 67% of that figure means that almost 20 million Africans lost their lives due to the pandemic.

Witchcraft has resulted in deaths far greater than that of Malaria, HIV AIDS and other diseases, civil wars and hunger combined. The figure is therefore quite scary and is a subject of future conversations.

So for sustainable population growth in Africa and to alleviate the burden of death on African communities, it is wise and therefore recommended to focus on quick wins. It is from these achievements that we can tackle what seem to be insurmountable challenges which lay ahead. A quick win to reduce the death rate in Africa is to eliminate Anopheles gambiae and to grow enough food within the continent. Once hunger and disease have been eliminated, it is easier to fight issues like poverty, illiteracy, infrastructure, etc.

The issue of witchcraft is urgent and African communities know how to tackle that issue. The problem at the moment is that politicians are not empowering communities through appropriate legal frameworks to confront such a social ill. Useless and retrogressive colonial laws imposed by European settlers are still being used to deal with witchcraft cases, often with spectacular failure. African governments should just allow community leaders to deal with witchcraft cases, only intervening to allow the rule of law and to ensure that laid down procedures and processes of prosecuting perpetrators are followed.

The man who “opened” the African interior in the minds of residents of England and Scotland and other western areas, David Livingstone, succumbed to malaria in 1873. His dear wife, Mary, had died earlier, on 27 April 1862, also due to malaria. While the heart (the other remains are interred at Westminster Abbey) of David Livingstone is buried on upper Zambezi, Mary, the daughter of a Southern and Central African missionary, Robert Moffat, is buried at Chupanga, in Mozambique on the lower Zambezi. Their lives and many of Africans were lost due to Anopheles mosquitoes. It is only proper that people outside Africa and Africans themselves join hands and find the way of stopping the deaths which have occurred for so long. The unity between the Livingstones and the locals can be replicated today as we implement the GEFA fund and totally defeat and destroy Anopheles mosquitoes and the protozoan pathogen, Plasmodium falciparum.

David Livingstone statue at Victoria Falls, on the Zimbabwean side; His heart was and is in Africa