Why malaria is spreading in Venezuela

By J.R.A.

MOST Latin American countries have impressive records when it comes to tackling malaria. Cases detected in the region fell by a third between 2010 and 2015, according to the World Health Organisation (WHO), thanks in part to increases in spending on health. At the same time, mortality rates for those who have contracted malaria dropped by 37%. Yet there is one obvious outlier: Venezuela. In 2015 the country had 30% of all the cases of malaria reported in the Americas—more than Brazil, which has over six times as many people. According to the Venezuelan government 240,000 cases of the disease were reported in 2016, a rise of 76% on the previous year. José Félix Oletta, a doctor and former health minister, estimates that more than half a million Venezuelans will contract malaria in 2017. What explains the country’s terrible record?

Venezuela has long been plagued by mosquitoes. The country’s savannahs and coastal plains—its malarial zone—provide ideal breeding grounds for the insects, whose name derives from the Spanish word for “little fly”. In the early 20th century the disease was considered endemic to two-thirds of the country. At that time Venezuela had the highest number of malaria cases in Latin America, with 164 of every 100,000 inhabitants dying from the disease each year. But a team of Venezuelan scientists, led by Arnoldo Gabaldón, a malariologist, fought back. In 1945 his team began spraying DDT, then a relatively unknown insecticide, in homes across the country. The sticky substance coated the walls, killing mosquitoes on contact. The programme was a success. By the end of the decade, the mortality rate for malaria had fallen to nine per 100,000. In 1961 the WHO declared that malaria had been eradicated in two-thirds of the malarial zone.

Venezuela’s recent regress owes much to its ailing economy. Import controls and the scarcity of foreign exchange have led to a shortage of the medicines needed to treat the disease. As many as 50,000 Venezuelans have responded to the country’s economic crisis by taking up illegal mining and moving to rural areas where mosquitoes thrive. The holes they dig collect water, providing the insects with an ideal breeding ground. Malaria is rife in these areas—in 2013, 60% of all malaria cases in Venezuela occurred in Sifontes, a mining municipality bordering Guyana. The workers, many of whom travel from across Venezuela, are the perfect incubators for the disease. They move frequently from region to region and are often unable to afford treatment. When they return to cities the parasite can spread quickly.

Nicolás Maduro, the country’s bungling president, has exacerbated the crisis. In May he sacked the health minister, Antonieta Caporale, after she published statistics on reported cases of malaria and other illnesses for the first time in two years. None have been published since. Mr Maduro blames medicine shortages on an “economic war” and has called for the UN to provide support. In August UNICEF announced that it was donating 95,000 anti-malarial drugs to the government for the treatment of children. But there is so far little sign that the disease is being contained. Venezuela’s neighbours are growing concerned. Brazil, with whom Venezuela shares a porous frontier, is particularly at risk thanks to illegal mines operating on its side of the border. Mr Maduro’s incompetence is costing lives and undoing decades of hard work.

Correction (October 13th, 2017): An earlier version of this piece called malaria a virus, though it is a parasite. This has been corrected.