Thanks so much for this writeup man, absolute music to my eyes here on the forum I wish we had more like this!
I think I agree (with low confidence) with your top 3 factors. The malaria prevalence graph is quite eye opening and based on that I would guess population growth as the number one factor here—especially given that prevalence has even dropped a little since 2015
I’m going to suggest a couple of other factors that I think are probably less important than your top 3, but I think likely to be more important than the ones you rightly dismiss as unlikely.
Artemisin resistance as I discussed here . Even small amounts of resistance to the drug almost universally used to treat malaria will cause more spread—imagine if the average malaria case was cleared 12 hours more slowly, that’s a lot of extra time for mosquitos to suck up parasites to spread malaria
The reduction in indoor residual spraying programs since 2015, which were expensive but had a big effect, some estimates have them accounting for 10ish percent of recents reduction in malaria prevalence. This does overlap with your “reduced funding” too though.
Thanks for pointing those out to me—I didn’t look into those at all. I’d been thinking drug resistance would mainly affect deaths but now that you point it out to me it’s obvious that it will affect spread as well.
Do you know of any good sources on the history and effectiveness of indoor residual spraying?
Thanks so much for this writeup man, absolute music to my eyes here on the forum I wish we had more like this!
I think I agree (with low confidence) with your top 3 factors. The malaria prevalence graph is quite eye opening and based on that I would guess population growth as the number one factor here—especially given that prevalence has even dropped a little since 2015
I’m going to suggest a couple of other factors that I think are probably less important than your top 3, but I think likely to be more important than the ones you rightly dismiss as unlikely.
Artemisin resistance as I discussed here . Even small amounts of resistance to the drug almost universally used to treat malaria will cause more spread—imagine if the average malaria case was cleared 12 hours more slowly, that’s a lot of extra time for mosquitos to suck up parasites to spread malaria
The reduction in indoor residual spraying programs since 2015, which were expensive but had a big effect, some estimates have them accounting for 10ish percent of recents reduction in malaria prevalence. This does overlap with your “reduced funding” too though.
Thanks for pointing those out to me—I didn’t look into those at all. I’d been thinking drug resistance would mainly affect deaths but now that you point it out to me it’s obvious that it will affect spread as well.
Do you know of any good sources on the history and effectiveness of indoor residual spraying?
I honestly think you have the most important factors so don’t feel obligated, but this nature paper is not bad https://www.nature.com/articles/s41467-018-07357-w