Zanzibar is a small island of 1.2 million people

I felt the need for a public reminder because it seems to me that people, such as Smith et al. in this Science piece, are forgetting:

 Zanzibar’s early success shows what can be achieved in Africa

It’s great, but unsurprising, that Zanzibar has reduced malaria using drugs and vector control tools of known effectiveness. Of course, the efforts of the control program should at least be maintained or even transitioned into elimination if sustained funding is possible. But Zanzibar’s experience is not relevant to the provinces of most other nations, let alone an entire continent. Political and administrative complexity matter and generally increase with size. Yet, somehow I’ve seen this example, of a tiny and geographically isolated sub-national area, repeatedly paraded as a broader lesson for vast, interconnected regions. Such extrapolation is unreasonable.

PS on an entirely unrelated note, Zanzibar holds a special place in the hearts of many medical students (including myself) who learned the mnemonic “To Zanzibar By Motor Car” for remembering the divisions of the facial nerve



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