Dr Vincent Pagiwa

Vector-borne diseases like malaria impose a heavy burden on human health, especially on vulnerable populations like those in the Okavango Delta in Botswana. Despite global efforts over the past decade, the World Health Organisation reported an estimated 241 million cases of the disease and some 627 000 malaria-related deaths in 2020. Half of the world’s population is vulnerable to malaria, with sub-Saharan African countries bearing the highest risk.

While Botswana has seen a remarkable decline in confirmed cases, current malaria control successes and elimination targets are threatened by several factors – including climate change. An increase in temperature is a crucial variable for determining the range of disease transmission in a swampy area like the Okavango Delta. Temperatures above the optimal range of 25 to 27°C risk the breeding of mosquitos carrying malaria parasites in places that were previously “clean”. This may result in an increase in malaria cases in the region, which is a popular tourist destination.

Another boost in the expansion of malaria-prone areas comes from social and economic pressures resulting from population growth, population migrations, drug and pesticide resistance, and the deterioration of health service delivery systems.

Thus far, vulnerability assessments in the area have focused on the biophysical influences of malaria transmission, but have overlooked the impact of socio-economic factors and the health system’s adaptive capacity to climate change. There is also a need to assess household and health system factors that expose communities and individuals to malaria infections.

Dr Vincent Pagiwa plans to tackle this issue with his Future Africa Research Leader Fellowship (FAR-LeaF) research project, ‘Climate change and malaria variability in the Okavango region of Botswana: A social vulnerability and adaptive capacity assessment’. His objectives are to identify socio-economic factors associated with malaria transmission in the target region, measure the variability of malaria in relation to these socio-economic exposures and determine the health system’s adaptive capacity to climate change.

A vulnerability assessment will help the researchers to understand the people and places that are most susceptible to malaria associated with climate-related exposures. With this data, they will be able to aid policymakers in targeting interventions and the strategic allocation of resources to reduce the malaria burden in Okavango and other regions newly prone to the disease in Botswana.

Dr Pagiwa will make use of a series of data sources, including health registries; the population census register; self-administered knowledge, attitudes and practices (KAP) surveys; key policy documents; and in-depth interviews with key informants to create a cumulative vulnerability score for the geographic units within the target area.

Using an overlay analysis approach, a social vulnerability and adaptive capacity assessment will identify communities and places that are susceptible to climate-sensitive malaria transmission. By identifying social vulnerabilities, the Ministry of Health and Wellness can develop health interventions and health adaptation strategies explicitly tailored to the Okavango region, and help identify communities and individuals that were not previously considered susceptible to malaria.