Malaria is still one of the most important public health problems in the world, especially for children in endemic areas. Although there have been great advances in malaria control in recent decades, there remains a significant risk of serious malaria infection for many millions of children, particularly in sub-Saharan Africa. Appropriate legislation and policy are central to advancing malaria control and ensuring that children receive the protection they need. Despite significant advances in malaria control in the past few decades, this disease remains a serious threat to millions of children in endemic areas of the world, particularly in sub-Saharan Africa. Appropriate legislation and policy are central to advancing malaria control and ensuring that children have the protection they need.
Understanding Malaria’s Impact on Children
The Plasmodium parasites that cause it are transmitted by the bites of female Anopheles mosquitoes, which can be particularly deadly to children under five years of age; in some cases, it causes anemia, cerebral malaria, coma, and even death. Malaria can also lead to long-term health impairment, such as cognitive impairment and stunting.
Even though effective preventive tools such as insecticide-treated nets (ITNs), indoor residual spraying (IRS), and antimalarial medications exist, prevention coverage is highly unequal in the world, putting children at risk if they can’t access and use these interventions correctly.
The Role of Legislation and Policy in Malaria Prevention
Legislation and policy can lay the foundation for public health approaches to malaria, creating the conditions that enable practitioners to provide vital services to the public. Strong policies can encourage widespread adoption of preventive measures, strengthen health infrastructure, and empower local communities to participate and take charge. Here is how legislation and policy can help:
1. Establishing National Malaria Control Programs
For example, it’s necessary to have national malaria control programs (with centers in endemic countries being key) to engage different regions and sectors, coordinate efforts, and reach the right audiences. Legislation can mandate such programs and their funding, as well as their specialists being able to access and deal with local challenges and adapt available strategies accordingly.
Example: in 2007 the Roll Back Malaria (RBM) Partnership launched its multi-pronged strategic plan for malaria control, the Global Malaria Action Plan (GMAP). For countries that have adopted similar national plans, the improvement in malaria-related health indicators is likely due to better coordination.
2. Mandating the Distribution of Insecticide-Treated Nets (ITNs)
Indelible markings and insecticide-treated nets are two of the most cost-effective defenses against malaria for infants and young children. Penal law can stipulate the use of ITNs and their distribution at no cost to needy populations.
For instance: National health policies of several countries now incorporate ITNs as a regular distribution scheme. In Kenya, the 2001 National Malaria Strategy has provisions to distribute ITNs to all pregnant women and children under five; a major cause of falls in cases of malaria.
3. Improving Access to Diagnosis and Treatment
Early diagnosis and rapid treatment would go a long way to lower its impact on children, and acts of legislation at the highest level can play a role in ensuring that diagnostic equipment and antimalarial drugs are readily available and affordable, as well as supporting the training of health workers and the maintenance of diagnostic and treatment facilities for hard-to-reach locations.
For instance: The Affordable Medicines Facility – malaria (AMFm) initiative was designed to subsidize the procurement cost of artemisinin-based combination therapies (ACTs) to expand their affordability and accessibility. AMFm helped to expand access to effective treatment for millions of people in endemic areas.
4. Supporting Research and Innovation
Furthermore, investment in research and innovation is needed so that countries can find new tools for preventing malaria. Funding for research into vaccines, new insecticides, and other prevention tools can be allocated through legislation. Policies can also facilitate partnerships that bring together governments, international institutions, and private-sector actors to move malaria research forward.
Example: the Malaria Vaccine Initiative (MVI), itself funded by the Bill Melinda Gates Foundation, has aided in the creation and testing of malaria vaccines. Research funding and collaboration bolstered by legislation help accelerate great innovations.
5. Enhancing Community Engagement and Education
Malaria prevention is greatly dependent on community participation. Additionally, legislation can help to promote public education on malaria prevention and ITN use and support local environmental controls.
Example: Community health workers in many countries educate families about malaria and provide them with preventive tools. Enhancing community health programs and funding them ensures they can have a broad reach and contribute to their effectiveness.
Advocating for Policy Change
Advocating for legislative and policy changes in malaria prevention involves several key strategies:
1. Building Awareness and Mobilizing Support
Raising awareness of children and the pervasive impact of malaria, using data on the prevalence of the disease, and calling for the implementation of policy changes will encourage uptake. By making this story known, advocacy campaigns can promote campaigns, share data on prevalence, and unite this group for change.
For instance, the ‘Nothing But Nets’ campaign has raised awareness of the role of ITNs and mobilized resources to distribute nets to at-risk populations. Advocacy efforts can influence policy and funding for malaria prevention through programs like PMI.
2. Engaging with Policymakers
Direct engagement with policymakers helps promote legislative changes. Advocates can provide evidence-based recommendations, share narratives and testimonies from communities directly affected, and help in creating and pushing for appropriate policies.
For example, the Global Fund to Fight AIDS, Tuberculosis and Malaria makes grants to governments and policymakers to enhance or expand malaria control, so the Fund helps to shape national and international programs as well as global policy. As with any form of power, philanthropy is legitimate when it remains within the public interest. Philanthropy enhances government action by funding complementary and sometimes unpopular programs; persuading governments to spend more; leveraging its funds, requiring governments to match them, and expanding the capacities of policymakers.
3. Collaborating with International Organizations
International organizations such as the World Health Organization (WHO), UNICEF, and the Global Fund are crucial institutions for malaria prevention and control. Partnership with them brings additional resources, expertise, and leverage that can help to accelerate policy changes.
E.g.: WHO’s Global Malaria Programme assists countries to develop and implement national malaria strategies. Collaboration with WHO can help to make national policies more effective and incorporate best practices from all countries.
4. Monitoring and Accountability
Monitoring policy implementation and pressuring governments to follow through on their commitments is how advocates keep policies moving forward. Advocates can track policy impacts, report on implementation shortfalls, and push back for corrective action.
For example: ‘Using data on malaria prevalence and intervention coverage from the Malaria Atlas Project, you can help advocates and policymakers assess the impact of malaria control activities and critically assess and identify how to do better.’
It is legislation and policy that will truly make the difference in childhood malaria prevention, as we must have national control programs in place, as well as mandated distribution of preventive tools, improved access to good diagnosis and treatment, and increased effort to support research and engage with communities.
Evidence in hand, advocacy can lead to policy change and keep malaria prevention high on the political agenda. Through advocacy, to imbue malaria prevention with political power, its agenda actively involves policy; the worlds of science and politics can come together in awareness building, outreach to policymakers, multi-lateral organizations, and mechanisms to monitor and hold governments accountable. Through these means, advocacy can mobilize a shrewd strategic process to empower children, and generations to come, to a world free from the harm of malaria.
Going forward, maintaining pressure through continued legislative and policy actions will be critical for eliminating malaria and ensuring that all children can grow up enjoying a healthy life free from the threat of this devastating disease. In addition, sustained advocacy and engagement with stakeholders will be essential to secure the necessary resources and support for these efforts. Ultimately, a robust commitment to policy action will pave the way for a malaria-free future for our children.
