The Gambia is the smallest country on mainland Africa — located on the western tip of the continent — with a population of almost 2 million people. Malaria, which is caused by parasitic Plasmodium species has been endemic in the country. The incidence of malaria is especially high during the rainy season (June to September), when the insect vectors carrying Plasmodium species, Anopheles mosquitoes are able to breed easily.
The past 8 years has seen a sustained decline in the rates of malaria infection and mortality in The Gambia. Malarial infections have decreased by close to 50% from 2010 to 2016. This continued decline has led experts to forecast that The Gambia will be the first sub-Saharan African country to eradicate malaria.
How did The Gambia get here?
First, there has been massive malarial awareness, prevention and sensitization campaigns led by both government and non-governmental organizations (NGOs). The Gambia’s national malaria control office (National Malaria Control Programme) has provided community based sensitization programs. Catholic Relief Services (CRS), an NGO, has provided insecticide treated bed nets to rural communities. Youth groups such as Your Change For a Change (YCFaC) have also provided insecticide treated bed nets, organized health fairs to raise awareness about malaria prevention, cleaned out mosquito reservoirs regularly and most importantly held digital sensitization campaigns via social media.
Second, through help from donors, The Gambia embarked on a mass malaria drug administration program that targeted pregnant women and children under 5, who are among the highest risk groups. All these efforts have helped lower the incidence of malaria from 4% in 2010 to 0.2% in 2014.
What’s the way forward to eradication?
The Gambia government and NGOs should continue with their sensitization, awareness and prevention programs. The reservoirs of malaria-mosquitoes should be wiped out through proper drainage infrastructure. The introduction of genetically modified mosquitoes — similar to what Brazil did with Zika virus carrying mosquitoes — should be considered. All stakeholders should ensure proper training of public health personnel especially doctors, scientists and epidemiologists. Scientific research at the local level should be encouraged, as this will lead to the discovery of new malarial drugs and vaccines. The Gambia government should invest in disease surveillance systems, which will ensure lower incidence and mortality of malaria. Donors should continue to provide support, as all the initiatives listed above require resources.
The future is promising for malaria eradication in The Gambia. The current efforts should continue. Others countries where malaria is endemic can learn from The Gambia model.