Deficiencies in disaster funding

BMJ 2005; 330 doi: https://doi.org/10.1136/bmj.330.7493.733-b (Published 24 March 2005) Cite this as: BMJ 2005;330:733

Malaria epidemics are predicted in tsunami regions from El Niño conditions

  1. Annemarie ter Veen, research student (Annemarie.terVeen{at}lshtm.ac.uk),
  2. Menno Bouma, honorary lecturer,
  3. Michel van Herp, epidemiologist,
  4. Kace Keiluhu, assistant medical coordinator,
  5. Budi Subianto, head
  1. London School of Hygiene and Tropical Medicine, Department of Infectious and Tropical Diseases, Disease Control and Vector Biology Unit, London WC1E 7HT
  2. Medical Department, MSF-Belgium, rue Dupre 94, B1090 Brussels, Belgium
  3. MSF-Belgium-Indonesia, Jln Kemang Utara No 32, Jakarta 12730, Indonesia
  4. Health Section, Unicef, PO Box 8318/JKSMP, Jakarta 12083

    EDITOR—Walker et al describe the deficiencies in disaster funding.1 The association between the El Niño southern oscillation and health has been documented extensively, and it is now possible to predict these events with increasing accuracy. The National Oceanic and Atmospheric Administration concluded in late 2004 that El Niño conditions have developed and are expected to last through early 2005.2 Expected impacts included drier than average conditions over Indonesia and northern Australia until February 2005,2 followed by a period of raised temperatures.

    An association between El Niño and malaria epidemics has been predicted for Papua New Guinea and West Papua, Indonesia.3 4 Historical records indicate that highland malaria epidemics in Papua follow periods of drought, evident during 1997-8 when a widespread epidemic affected many highland villages, some with extremely high death rates owing to lack of immunity and complete absence of treatment.3 5 Highland epidemics often exhibited two peaks: one towards the end of the drought resulting from increased vector breeding, and one four to six months later, when increased temperatures shortened the sporogonic cycle.

    Humanitarian attention is rightfully directed towards aiding victims of the tsunami in the region, but in the light of such a massive effort, possible events of seemingly lesser importance are often neglected. In view of the risk of focal epidemics in drought affected areas, it would be advantageous if healthcare professionals in the Papuan highlands were vigilant for possible malaria epidemics and had preventive or curative resources at their disposal.


    • Competing interests None declared.


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