In addition to the typical interventions such as mosquito nets, the Papua New Guinea National Department of Health has had some success with medical therapies for people who develop malaria infections while pregnant. Doctors there and in many other malaria-endemic places use intermittent preventive treatment on pregnant people. The antimalarial is administered orally as soon as patients learn they are pregnant and, if taken regularly, can significantly reduce the chances of severe malaria over the course of gestation. The treatment remains difficult to access in highland regions, as malaria has historically been uncommon there. If governments and hospitals pay attention and get these medicines into places where rising temperatures are changing climatic constraints on mosquitoes, they will save lives.
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The smartest solutions are those that address malaria as a symptom of a wider system of inequity. Papua New Guinea is a “patriarchal society where men get the best treatment,” Casupang, who now works for an international emergency medicine and security company called International SOS, said. “Women are pretty much regarded as commodities.” Most married women must seek permission from their husbands to seek medical care at a facility, and permission is not always granted. Many women are also prevented from seeking medical attention by poverty, by the quality of the roads that connect rural villages to cities, and because they don’t recognize the symptoms of malaria or understand the risks the infection poses to themselves and their unborn children, Casupang said. Just 55 percent of women in Papua New Guinea give birth in a health facility, a partial function of the fact that the country currently has less than a quarter of the medical personnel it needs to care for mothers, babies, and children.
“There are quite a number of factors that will determine the outcome of a mother that has malaria,” Casupang said. “The most important thing is access to a health care facility.” He’s one of many experts who argue that better infrastructure, improvements in education, and the implementation of policies that protect women and girls double as malaria control measures — not just in Papua New Guinea but everywhere poverty creates footholds for infectious diseases to take root and flourish.
“Education, a living wage, sanitation, and all of these other very basic things can do so much for a disease like malaria,” John said. “It’s not a mosquito net or a vaccine, but it can make such a huge difference for the population.”
Note: This story originally misstated how many people die from malaria annually.