New Focus on Housing Improvements May Be Key to Reducing the Global Burden of Malaria

We have enough positive indicators to urge that housing improvements be examined carefully as another valuable tool in reducing the incidences of malaria.
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Malaria is one of the greatest perils to global public health. The World Health Organization reports that in 2012 the disease threatened 3.4 billion people -- nearly half the world's population -- and claimed the lives of an estimated 482,000 children under five years of age. That is 1,300 children every day, or one child almost every minute.

This is World Malaria Day, and while Habitat for Humanity has long witnessed how adequate housing can significantly reduce the occurrence of this mosquito-transmitted infection, we continue to see these disturbing statistics.

On a more personal level, I have talked to people like Aya Koffi of Ivory Coast, who, having lost two siblings to cerebral malaria, watched his child exhibit symptoms of the same deadly disease. I witnessed his pain and frustration of knowing that perhaps something could have been done to spare his child.

We believe that housing improvements can be one of the answers -- particularly for those living in unsafe, substandard housing. More than 80 percent of malaria transmission in Africa occurs indoors at night. Those individuals living in homes with cracked walls and thatch roofs -- which make it easy for mosquitoes to fly indoors -- are twice as likely to get malaria compared with those who have access to better housing.

Historically, indoor residual spraying of insecticides and treated bed nets have shown to be effective strategies for reducing the transmission of malaria in many areas around the world. Habitat believes creating healthy homes is another effective approach to battling the disease.

The installation of window and door screens can greatly reduce the number of mosquitos that make it inside the home, as can the installation of adequate ceilings and the screening or sealing of eaves. In limited studies, these interventions have proven to be affordable and effective. Implementing these strategies using local materials and labor is the optimal approach.

For many years, Habitat has worked to create housing solutions that help fight disease and improve the quality of life for families worldwide. As part of this effort, we are collaborating with experts at Durham University and the Centers for Disease Control and Prevention to evaluate how housing improvements can be a supplementary measure for malaria control.

Additionally, Habitat is actively involved with the Roll Back Malaria Partnership, or RBM, which was launched by the World Health Organization, UNICEF, the United Nations Development Programme and the World Bank in 1998 in an effort to provide a coordinated global response to the disease.

We have been working with experts such as Professor Steve Lindsay, PhD, of Durham University, who, along with Mariana Stephens from Habitat for Humanity International, co-chairs a new work stream on housing and malaria as part of the of the RBM Vector Control Working Group. Michael Macdonald, Sc.D., is chair of the working group.

Lindsay has told us about small-scale studies that show promising results when traditional thatch and mud structures were replaced with metal-roofed homes constructed with brick and cement walls and snug-fitting doors and windows. He maintains -- and we at Habitat agree -- there is an extraordinary opportunity for the malaria and housing research communities to come together and tackle this problem.

We know that adequate housing and improved health are inextricably connected. For example, a study conducted by Emory University in 2001 found that children living in Habitat houses in Malawi were 44 percent less likely to contract malaria and respiratory diseases.

Chief Chimaliro, who lives in southern Malawi, can testify to the difference that a Habitat home has made in his life. When he was a young boy, other family members often were sick with malaria, and the disease killed his younger sister. Habitat volunteers from Ireland traveled to Malawi to help build Chief's family a new home, which includes concrete floors and a solid roof, made of iron sheeting. No one in the family has contracted malaria since they moved in.

We believe that adequate housing can improve the lives and health of millions of people. We have enough positive indicators to urge that housing improvements be examined carefully as another valuable tool in reducing the incidences of malaria. We need to bring together experts from diverse fields to develop a large-scale research agenda that makes a clear connection between improved homes and malaria reduction. This may be one of the most cost-effective methods for reducing the global burden of malaria -- and for bringing hope to millions of families worldwide.

For a full copy of the Habitat's malaria and housing white paper, click here.

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