Although its origins are shrouded in mystery, it comes as no surprise that malaria, the lethal parasitic disease passed on by the bites of infected mosquitoes, continues to plague the world’s inhabitants, causing millions of deaths every year. Despite heroic attempts at prevention and treatment over the preceding decades and centuries, malaria continues to threaten and afflict hundreds of millions of people. And its biggest victims children continue to have comparatively few options to elude this scourge. Young children stand a higher risk than older people due to their immature immune systems, but a host of other factors, such as poverty, inadequate health infrastructure, and environmental hazards come into play as well. This article examines the profound social consequences of giving antimalarials to children.
Understanding Malaria and Its Impact on Children
Plasmodium falciparum and Plasmodium vivax, the most prevalent malaria parasites, cause fever, chills, and other flu-like symptoms that can progress to more severe outcomes such as anemia, cerebral malaria, and death if not treated quickly. The vast majority of deaths from malaria occur in children under five years of age who are at increased risk of serious illness or death.
But beyond health, chronic exposure to malaria begins to impact a child’s life: more frequent episodes can lead to chronic anemia that hampers physical growth and development; chronic infection affects school attendance and participation in activities; and obviously, the disease contributes to mortality, especially as a cause of poverty, which perpetuates the cycle of infection and suffering.
The Role of Anti-Malaria Medicines
Anti-malaria medicines, such as artemisinin-based combination therapies (ACTs) and other effective antimalarial medicines, make it possible to treat and cure malaria. For children, fast and effective treatment can mean the difference between life and death. Children who receive the right treatment have a lower risk of severe disease and death.
The Social Benefits of Providing Anti-Malaria Medicines to Children
1. Improved Health Outcomes
In the shortest and most direct sense, more drugs mean better health outcomes for kids. Quick treatment of malaria in children reduces the severity of illness and improves chances of recovery. This saves lives and prevents the body’s wear and tear that recurrent malaria infections cause over a lifetime, such as chronic anemia and impaired cognitive development.
2. Enhanced Educational Opportunities
Second, the ability of children to concentrate and participate in school is lowered if they have malaria. Children who are sick with malaria often miss several days of school, resulting in school absenteeism and impeding their education. When children receive timely treatment, school attendance will normalize within a day or less, such that the same children achieve better educational outcomes. Third, academic outcomes suffer in communities with large numbers of infected children. Healthier children will be more likely to attend school regularly, participate actively, and perform better in school. Therefore, giving children appropriate and timely treatment will produce another cohort of better-educated and more productive members of the community.
3. Economic Benefits
The cost of malaria on the economy is twofold: for families and entire communities. Families are hit hard by the expenses of medical treatment and lost productivity, which can keep a family on the knife’s edge of extreme poverty. For example, a child suffering from diarrhea and malnutrition might not be able to attend school, which has implications for ensuring the child grows up to be a productive member of society and, subsequently, for the health of the entire community.
4. Strengthened Healthcare Systems
Could it also strengthen local health systems? Often for the same children who are receiving malaria medicines, improving local health systems means ensuring access to health facilities, training health worker capabilities, and improving supply chains for medicines. ‘All that investment benefits health delivery in general, for a range of conditions, not just malaria,’ Nicholls said. When the entire health system works well, any increases in one area support the stability of the entire health system.
5. Community Empowerment
Distributing the drugs helped ‘to narrow the social distance between the drug providers and the porters’, and ultimately increased ‘the confidence of the community to manage the disease and their well-being’. As time went on, health indicators improved. Communities became more involved in their health-related initiatives, branched out to other projects, gained a better knowledge of and access to resources, and evolved into more effective advocates for their health rights. Their empowerment reached beyond health and played a larger role in their overall development. When communities are more involved in their health, they’re better placed to take action in more places.
Case Studies: Success Stories from Around the World
1. The Roll Back Malaria Partnership
Just consider the impact of The Roll Back Malaria (RBM) Partnership – a partnership between global networks, ministries, and development agencies that works to ‘alleviate human suffering and poverty’ by distributing anti-malaria drugs and improving healthcare infrastructure all around the world. Malaria cases and mortality rates have fallen since the launch of the RBM. Children in countries that have instituted RBM strategies have improved health and educational outcomes.
2. The Global Fund’s Malaria Programs
The Global Fund to Fight AIDS, Tuberculosis and Malaria supports a range of programs worldwide, such as a program that has been reducing both prevalence and mortality in Mozambique through targeted distribution of ACTs as well as other interventions. Overall, the result has been healthy children, better school attendance, and stimulation of the local economy.
3. The PMI Malaria Initiative
For example, the main goal of the President’s Malaria Initiative (PMI), which operates in 20 countries in Africa and Latin America, is to reduce the mortality due to malaria by using highly targeted interventions such as distributing anti-malaria medicines. By focusing its assistance in specific places, PMI-supported programs have succeeded in malaria-endemic countries such as Uganda and Kenya in decreasing malaria morbidity and, more generally, improving child health, attendance at and performance of children in school, and family and community economic stability.
Challenges and Considerations
Despite the positive impact of providing anti-malaria medicines, several challenges remain:
- Access and availability: reaching remote and underserved areas with anti-malaria medicines can be difficult. Improving distribution networks and supply chains is essential.
- Resistance to Medicines: The expansion of drug-resistant strains of malaria is of increasing concern. New treatments and improved use of existing medicines will both be needed to combat resistance.
- Education and awareness: Raising the community’s awareness about the need to treat malaria quickly and the benefits of prevention measures can be achieved through ongoing public health campaigns and community outreach. Ensuring that families seek timely treatment and follow their prescribed therapies helps protect patients.
- Integration With Other Health Services: Linking malaria interventions with other health services can improve health service delivery. For example, combining malaria interventions with immunization programs, maternal and child health services, and other health programs can strengthen malaria control efforts.
The social impacts of these anti-malaria medicines for children – improved health outcomes, better school enrolment and economic growth, strengthened healthcare systems, and more resilient communities – far exceed the immediate benefits of individual health. The challenges ahead are great, but they will be met if we renew our commitment to expanding access to all medical arts and deliver integrated health strategies that aim to eliminate malaria once and for all – and ensure that our children never have to fear it again.
