Problems of controlling endemic diseases

In a nutshell

Malaria is a disease that is endemic to many tropical and sub-tropical parts of the world. As malaria affects millions of people around the world, the spread of it needs to be controlled. This can be done through a variety of different methods. However, each method comes with its own issues and problems.

Controlling malaria

There are a few ways to prevent malaria, however, they all come with their own issues.

Method	Explanation	Problem(s)
Drain wetlands	This is where mosquitos breed.	It would be very difficult to drain large lakes as this is a source of water for many organisms in that environment. Some people also grow their main food source in wetlands so this could lead to a lack of food and income.
Use insecticides	Spraying endemic areas with insecticides would kill mosquitos before they could spread infection.	The areas where malaria is endemic are very large so it would be difficult to do this everywhere. Use of insecticides in these large areas may also require inter-governmental cooperation which is not always possible. Insecticides can cause damage to wildlife such as beneficial insects needed for pollination.
Use coated-mosquito nets	These trap and kill mosquitos at night as they are placed over beds.	This is cheap and effective at night but mosquitos also bite during the day so this isn't always effective.
Releasing sterilised male mosquitos	These male mosquitos would still mate with female mosquitos but this would not lead to viable eggs and as a result there would be less mosquitos.	This techniques involves releasing more insects into the wild, therefore, many local people are opposed this method.
Vaccination	This would prevent malaria infection as people would be immune.	The vaccine would need to be suitable for babies and young children as they are worst affected. Countries where malaria is endemic are often poor and therefore cannot afford to pay pharmaceutical companies for vaccines. Plasmodium has high antigenic variability and due to the type of immune response it elicits, vaccine development has proved to be very difficult.

Curiosity: In $2021$ , the first malaria vaccine was approved by the World Health Organisation for use in children. In trials, it was shown to be successful $75\%$  of the time.