WIPING OUT MALARIA
A global disease requires a global response
Every 30 seconds, an African mother watches helplessly as her child dies of malaria. This adds up to about 3,000 children a day, making malaria one of the world’s deadliest diseases. The World Health Organization reports that for about half the world’s population, this mosquito-borne disease is one of the greatest threats to public health.
Until about 50 years ago, malaria was prevalent in the United States; foreign diplomats who lived in Washington, D.C., received hardship pay because of malaria along the Potomac River. But in the 1950s and 1960s aggressive efforts by governments to prevent malaria through the use of sprays (such as DDT) and other prevention and treatment methods eradicated the disease in the United States and other developed countries. In the developing world, malaria was left unchecked.
Malaria is often referred to as a disease of contradiction because we know its causes, prevention and treatment, yet close to 1 million people die from it every year. Mosquitoes and the deadly parasites they carry have proven to be dangerously adaptable to control methods. Resistance to drugs such as chloroquine and insecticides challenges our efforts and increases the threat of malaria endemic areas.
Malaria afflicts mostly those who are least able to afford prevention and treatment services. About 90 percent of malaria cases occur in sub-Saharan Africa. In Nigeria alone, malaria accounts for 60 percent of health facility visits, 30 percent of childhood deaths, 25 percent of infant mortality and 11 percent of maternal deaths. Economic losses due to malaria in Africa are estimated to be about $12US billion per year. Men and women are kept from work and children from school, and many families are forced to use much of their modest discretionary income to pay for expensive malaria treatments.
An Effective Response
Under the Bush administration, the U.S. government responded to this health crisis through the President’s Malaria Initiative (PMI), led by the U.S. Agency for International Development. In 2005, $1.2 billion was committed with the goal of reducing malaria-related deaths by 50 percent in 15 of the most malaria endemic countries in Africa. In addition to a dramatic increase in funding, there was a focused commitment to expand highly effective interventions to 85 percent of the most vulnerable populations—children under five and pregnant women.
On the prevention side, the U.S. global malaria strategy involves the spraying of homes with insecticides to keep deadly mosquitoes at bay and the distribution of insecticide-treated bed nets. This is one of the simplest technologies imaginable, but is also one of the most effective. All nets are provided either free or at highly subsidized prices consistent with the policies of national malaria control programs in African countries. On the treatment side, the initiative provides the most effective drugs for treating malaria today.
In just two years, more than 25 million people have benefited from the initiative. Houses have been sprayed in 10 countries, protecting more than 17 million people. More than 12 million medicinal treatments have been purchased, more than 30,000 health care workers have been trained and more than 10 million long-lasting insecticide-treated bed nets have been distributed to needy mothers and families. In Zanzibar, the percentage of children who tested positive for malaria dropped from 22 percent in 2005 to less than 1 percent following the distribution of long-lasting nets and indoor residual spraying.
In Malawi, where coverage with insecticide-treated nets has increased rapidly over the past several years, a 2007 household survey in six districts showed a 43 percent decline in just two years in malaria infections and severe anemia among children aged 6 to 30 months. The president of Rwanda reported a 62 percent drop in malaria cases, which parallels the 50 percent drop in cases reported by the Minister of Health in Ethiopia.
Faith-based Partnerships
Given the enormous burden of malaria and the ambitious target of reducing malaria deaths by half by 2010, effective partnerships are essential to reach maximum numbers of people. Partnerships are the heart of the U.S. global malaria strategy. Community, faith-based and nongovernmental organizations (NGOs) are crucial to the success of malaria control efforts in order to achieve and reinforce the awareness of the disease and actions to prevent and treat it. Former First Lady Laura Bush established the Malaria Communities Program, which is designed to solicit and fund new community-based partners indigenous to the countries where we work. At the end of 2008, the PMI was partnering with more than 110 NGOs, 38 percent of them faith based.
The U.S. government’s commitment to fight malaria is a key component of our foreign assistance strategy and has been strongly endorsed by President Barack Obama and his administration. We have enjoyed strong bipartisan support from both the House and Senate. Congress reauthorized the President’s Emergency Plan for AIDS Relief (PEPFAR) and institutionalized the malaria initiative, keeping our nation boldly at the forefront of efforts to reduce poverty and enhance the lives of people around the world for years to come.
Improving the health of populations and reducing the spread and impact of diseases are not only important in their own right, but they also result in greater productivity and economic growth and contribute to peace and political stability. Healthier populations are able to pursue education and employment opportunities, making them better able to contribute to and benefit from economic growth and to participate in community affairs and governance. Addressing global health issues thus not only improves the lives of the people of developing nations but also directly impacts the interests of American citizens.
Tim Ziemer, Rear Admiral USN (Ret.), is the son of C&MA missionaries Bob and Marie Ziemer, who served in Vietnam. Tim grew up in Asia, attended the C&MA boarding school in Dalat and graduated from Wheaton (Ill.) College. After serving as a naval aviator, he was executive director of World Relief before being asked by George W. Bush to lead the President’s Malaria Initiative as the U.S. Global Malaria Coordinator. He has been asked to continue to serve in this position by the Obama administration
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A year ago in November I had the opportunity to go on a short term missions trip to Kuotiala. Barry Newman was battling malaria at the time and Bob Braffhart told me that he had malaria approximately 5 times in the last 20 years. Thanks for this informative article.