By Shanon Smith

Drug resistance malaria is not a new concept. Scientists have been working for decades developing anti-malarial medication and attempting to devise an effective vaccine. These efforts have not been futile. The WHO reports a near 50% decrease malaria related deaths from 2000 to 2015. In addition to pharmaceutical interventions, vector control interventions such as bed-net and insecticides usage have been estimated to have averted 663 million cases in the past 15 years.

However, despite global efforts to eliminate malaria, the prolonged exposure to these antimalarial medications and insecticides has only allowed this parasite and vector to develop widespread resistance. Christopher Plowe, a microbiologist at the University of Maryland School of Medicine, told the Washington Post “We are really close to having a truly untreatable malaria.”

Malaria is a life threatening disease that is caused by a parasite that is transmitted to humans via bites from an infected female mosquito. Therefore interventions not only focus on the treatment of the disease but also the prevention of transmission via mosquito bites.

Researchers have recently publishing studies about increased drug resistance in more than one common anti-malaria medication.  Other studies show increased resistance among mosquitos to pyrethroids which are used in bed-net treatment and insecticides as means for vector control to reduce malaria transmission. Failures in malaria treatment and transmission are a cause for concern. Scientist have been working to develop more proactive strategies for not only malaria but other vector-borne diseases such as Zika.

Some people have looked into alternative means of vector control, such as introducing genetically modified mosquitos with a “self destruct gene” to breed with and kill off wild mosquitos. Others have been working hard in vaccine development. But there is currently only one vaccine with low efficacy approved in Europe, and others still in early trial phases.

Scientists are under significant pressure to keep up with malarial mutations and try to find a means to end the disease for once and for all. However, many, including Bill Gates, who has contributed millions to the elimination efforts of Malaria, are concerned about how the new Trump administration may effect global efforts on Malaria Elimination. The United States is a crucial source of funding for Malaria control and elimination project internationally. US funding accounted for 35% of total funds in 2015, and the US government-funded President’s Malaria Initiative has been a powerful contributor in the past decade.

After meeting with President Trump, Gates reported to Business Insider that “I wouldn’t say we see a huge risk of those funds going away, but (this is) a time when we’re trying to raise the ambition. Whenever there’s transition it’s an opportunity. We want to step in and work with the new people.”

With the looming uncertainty of the Trump administrations, Gates has convened a strong team to focus on plugging funding gaps for the continuation of malaria elimination. We are currently in a difficult government transition especially in regards to science and human health. As for malaria, Christopher Plowe described it best to the Washington Post, “Countries have made progress, but the danger is if we let up on that effort, [malaria] will come roaring back.”

Only time will tell if the Trump administration will continue to fund global malaria initiatives or if these endemic countries will be left to struggle on their own.