Guest Post: Making Progress

by Rev. Larry Hollon
General Secretary, United Methodist Communications 

In the last three years, thanks to global donations, it’s been possible distribute 300 million bed nets in sub-Saharan Africa. That’s enough to cover three quarters of the continent. More than a million lives have been saved. At least 11 countries where malaria is a high burden have seen their caseloads and related deaths fall by half. Funding for malaria has increased tenfold in 10 years. The Global Fund to Fight AIDS, Tuberculosis and Malaria has provided $6 billion in the last decade.

These gains are cause for optimism. They have come because nations and people around the world have been generous, public policy advocacy has been persistent and on-the-ground implementation of sound community-health practices has worked. It now appears that the vision of a malaria-free world could be achieved.

This is the good news.

The bad news is that these gains are fragile, and continued progress is not assured. Even with the substantial gains in funding, a significant gap exists between the current level and future needs. Melinda Gates told participants in the Gates Foundation Forum on Malaria funding will need to double in the next 10 years. Examples exist of countries that  nearly eliminated the disease only to fall back and experience increases mostly because they did not continue surveillance and stopped short of achieving universal coverage of all of their citizens. Single-dose malaria treatment (now banned in most countries) has proven extremely harmful in Southeast Asia. A single dose of a malaria drug may relieve symptoms but also result in drug immunity, rendering the drug ineffective in new cases. The parasite is highly adaptable and capable of changing to resist drugs and insecticides. A new parasite strain has been identified and is uncontrolled in a small region of Cambodia, for example, causing researchers to look for new combinations of drugs to treat it and new ways to contain it.

Adriana MoisŽs sits with her son, Verissimo Jo‹o Quintas, who is being examined for symptoms of malaria by Dr. Malaquias Kapawba, at the Benifica Alta health center in Huambo, Angola. An effective malaria vaccination would dramatically change the landscape of malaria treatment. Photo by Mike DuBose, United Methodist News Service.

Thus, as the theme of Gates Foundation Forum suggested, it’s a time for optimism and urgency. The goal of a malaria-free world looks more achievable than anyone would have expected a decade ago. But the action plan to success will require continuing commitment, attention and funding. Malaria experts say long-lasting, insecticide-treated nets are necessary as a first-line defense. Residual indoor spraying must expand beyond urban areas to rural districts, especially remote places. Prevention in pregnancy must be stepped up; rapid diagnosis of cases and treatment must increase. Systems for monitoring and reporting must be more effective. Community-based health workers must be trained. New drugs must be produced and distributed. And research on the biology of the parasite and host mosquito must continue.

Perhaps the most difficult challenge isn’t within the skills of public health, medical or research professionals; it’s in the hands of development professionals, government and community leaders. Malaria is a disease of poverty. Those living in poverty get this disease. If we are to conquer the diseases of poverty, we must help people overcome poverty. To do less is to prolong the fight.

To ensure that the investments that have been made are not lost, we must not allow the gains to cloud our vision so we don’t see the realistic challenge that remains. Some experts contend it will take 40 years to eradicate malaria. As we celebrate remarkable gains, it is a time for optimism. But it’s not the time to slow down, pull back or rest on accomplishments. It’s a time urgently to commit to ending this killer.