A Malaria-Free World? Bring Back Public Health Entomologists

Malaria incidence and mortality rates continue to rise due to many interconnected factors. Current efforts to dampen this increase include innovative interventions such as a trial of the RTS, S malaria vaccine in Africa, using dual insecticides to impregnate mosquito nets, and the release of Wolbachia-infected Anopheles mosquitoes, malaria’s vector. The present review focuses on global efforts to control Anopheles mosquitoes, briefly reviewing the history of world-wide programs led by the World Health Organization, and emphasizing the need for qualified personnel to design, implement, and evaluate vector control interventions. Although incidence of malaria has declined in some areas between 2015 and 2022, the global incidence and mortality rate continues to be much higher than the target outlined in the sustainable development goals. Despite the geographical reduction in malaria-endemic regions, surveillance shows disturbing trends including the invasion of species to other areas, the presence of species once thought to be eradicated, the discovery of Anopheles stephensi, a day-biting efficient vector from Asia, and a severe shortage of healthcare workers and field public health entomologists in malaria-endemic areas, with the highest burden continuing to be in the WHO African region. Factors including adaptation of vectors, territorial expansion of new vectors, insecticide resistance, and climate change have complicated the worldwide situation. At the heart of malaria control and elimination, Anopheles control is of undisputed importance. Malaria continues to be a significant global health burden and goals for its reduction have not been met. The scarcity of properly trained public health entomologists and a lack of properly managed vector control programs is a challenge that must be addressed. Countries suffering from a high burden of malaria need field entomologists to provide technical information and guidance on vector control activities so that communities can have simple and practical approaches to controlling malaria.