A Resurgent Epidemic in a Complex Humanitarian Emergency
This situation report is produced by the International Council of AIDS Service Organizations (ICASO) and Global Development One (GDO).
It focuses on the malaria situation in Venezuela from January 2000 to June 2019, underscoring the role that the complex humanitarian crisis has played in more recent years. www.icaso.org
By Leopoldo Villegas and Mary Ann Torres
In the 1960s, Venezuela was the first country in the world that eliminated malaria in 70% of its territory. This achievement helped reshape the public health landscape of the country.
The malaria morbidity and mortality rates are staggering. Between 2000 and 2018, there were 1.97 million cases reported – a 1260% increase, from 29,736 cases in 2000 to 404,924 in 2018. By June 2019, most federal entities in the country were reporting local malaria transmission. The situation is worsening with time, as several malaria-free areas have been reporting the re-introduction of the disease.
There is a risk of a regional malaria outbreak, affecting multiple countries in Latin America and the Caribbean. This epidemic is affecting cross-border areas with Brazil, Guyana, and Colombia as well as other neighboring countries such as Trinidad and Tobago, Suriname, Ecuador, Argentina and Chile. The flow of Venezuelan migrants and refugees across the region as a result of the political crisis in the country makes the risk of a regional malaria outbreak more likely. It is critical that malaria is appropriately addressed and contained in Venezuela, and that Venezuelan refugees and migrants receive adequate prevention and treatment for malaria in receiving countries.
The malaria epidemic response in Venezuela is ineffective. While the current strategy is focusing on access to prompt diagnosis and treatment, the ongoing malaria epidemic will not be controlled with the “business as usual” approach. The availability, distribution, and access to all antimalarial medicines is significantly hampered by political and economic turmoil in recent years. Vulnerable communities such as pregnant women, infants, children under 5 years of age, people living with HIV, as well as non-immune migrants and mobile populations have been particularly negatively impacted by the poor response.
There is a limited distribution of long-lasting insecticidal mosquito nets and the procurement and supply chain management system is unable to cover the population’s needs. The Ministry of Health and other key stakeholders have limited technical capacities to manage this emergency. Although there are high-level technical staff in civil society organizations, they are not being fully engaged in the response due to political and financial barriers.
The current malaria crisis in Venezuela is the worst epidemic in the Western Hemisphere in the 21st century. This epidemic is progressively eroding the gains on malaria elimination. There is a need for global actions to implement cost-effective, sustainable solutions -adapted to local conditions- and in partnerships with affected populations.
Mary Ann Torres is the Executive Director of ICASO, based in Ontario, Canada. Leopoldo Villegas is director of Technical Services at Global Development One, based in Washington, D.C. Read entire report