Do post-disaster public health interventions impede malaria eradication?

Abstract

In this paper, we hypothesise that public health interventions aimed at controlling post-disaster malaria epidemics may in fact impede malaria eradication efforts in the longer term. A major factor hampering malaria eradication efforts is the development of resistance to antimalarial drugs in the Plasmodium parasite. Following natural disasters such as flooding, public health responses includes a massive influx of antimalarial drugs that may facilitate the development of resistance. Resistance is common in areas with frequent natural disasters, and if such an association could be shown to be generalisable and causative, there may be direct implications for the way that future disaster-related malaria risks are managed. Because the frequency and severity of climate-associated disasters is likely to increase with global warming, it is timely to study the possibility that well intentioned public health action may in fact exacerbate the disease burden from the very parasites that it sets out to control.