Abstract
Land use and land cover changes, such as deforestation, agricultural expansion and urbanization, are one of the largest anthropogenic environmental changes globally. Recent initiatives to evaluate the feasibility of malaria eradication have highlighted impacts of landscape changes on malaria transmission and the potential of these changes to undermine malaria control and elimination efforts. Multisectoral approaches are needed to detect and minimize negative impacts of land use and land cover changes on malaria transmission while supporting development aiding malaria control, elimination and ultimately eradication. Pathways through which land use and land cover changes disrupt social and ecological systems to increase or decrease malaria risks are outlined, identifying priorities and opportunities for a global malaria eradication campaign. The impacts of land use and land cover changes on malaria transmission are complex and highly context-specific, with effects changing over time and space. Landscape changes are only one element of a complex development process with wider economic and social dimensions affecting human health and wellbeing. While deforestation and other landscape changes threaten to undermine malaria control efforts and have driven the emergence of zoonotic malaria, most of the malaria elimination successes have been underpinned by agricultural development and land management. Malaria eradication is not feasible without addressing these changing risks while, conversely, consideration of malaria impacts in land management decisions has the potential to significantly accelerate progress towards eradication. Multisectoral cooperation and approaches to linking malaria control and environmental science, such as conducting locally relevant ecological monitoring, integrating landscape data into malaria surveillance systems and designing environmental management strategies to reduce malaria burdens, are essential to achieve malaria eradication.
Highlights
Malaria continues to be a major public health burden globally, with over 200 million cases in 2018
Many major malaria elimination successes were underpinned by land use and land cover changes (LULCC), including, famously, the extensive hydrological and agricultural modifications conducted by Italian malaria control programmes following World War II [8]
Wildlife reservoirs Origin of malaria P. falciparum originated from non-human primates Spatial overlap with wildlife hosts Increased contact between people and non-human primates hypothesised as main driver of human infections with P. knowlesi and P. cynomolgi in Asia and P. simium and P. brasilianum in South America Maintenance of malaria infections Human malaria species circulating in great apes and gorillas in West and Central Africa section outlines how LULCC impacts vector, human and wildlife systems, highlighting the linkages between these
Summary
Malaria continues to be a major public health burden globally, with over 200 million cases in 2018. United States drug policies have led to “narco-deforestation”, extensive forest loss in Central America fuelled by the development of landing strips, need to launder money and influxes of cash from the global narcotics trade [27] These complex economic and social forces driving LULCC may have unintended consequences for malaria transmission, disrupting both ecological and human systems (Table 1). Socio-demographic changes Population at risk Influx of susceptible populations into endemic areas in response to increased economic opportunity Increase and movement of migrant worker populations in the Amazon and Southeast Asia Occupational changes, such as forestry and extraction activities bringing people into vector habitats Socioeconomic status Increased income following agricultural development leading to decrease in malaria risk Improved housing structure due to development reducing malaria risks. Wildlife reservoirs Origin of malaria P. falciparum originated from non-human primates Spatial overlap with wildlife hosts Increased contact between people and non-human primates hypothesised as main driver of human infections with P. knowlesi and P. cynomolgi in Asia and P. simium and P. brasilianum in South America Maintenance of malaria infections Human malaria species circulating in great apes and gorillas in West and Central Africa
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