RBM Editorial: Anti-malaria efforts must expand in a recovering global economy
When Tanzania's semi-autonomous island of Zanzibar first started to effectively protect and treat its population from malaria, optimism grew in the international community but skepticism remained as to whether such success can be replicated on a larger scale - in more populous endemic areas and in mainland countries across Africa.
Today, malaria has been reduced by 50% in 10 countries in Sub-Saharan Africa, the disease's central stronghold. A report, released by the Roll Back Malaria Partnership this week confirms that in a mainland country such as Zambia malaria interventions have saved the lives of an estimated 33,000 children under five since 2001, with overall child mortality dropping by 29% between 2001 and 2007.
Zambia's and Zanzibar's results belong to a body of mounting evidence that control interventions can work wonders for malaria-endemic countries. Over the past decade, malaria control has been repeatedly shown to be an effective and economical means of improving health and bolstering development in malaria-endemic countries. Simply put, anti-malaria interventions save lives at a lower cost than most other public health measures.
Paradoxically, however, today's successes in malaria control, can spell trouble for high-performing countries. An article, entitled "Solving the Sisyphean Problem of Malaria in Zanzibar" and published today in the Science magazine paints a realistic picture of the choices and challenges countries face once they significantly reduce their malaria burden. In some countries pursuing elimination strategies would make scientific and financial sense whereas in others control efforts will have to continue until elimination becomes feasible. Regardless of whether countries choose to sustain control or eliminate though, they will continue to need sufficient annual financing over the next decades. For if today’s efforts are scaled down for lack of funding and the disease comes back resistant to currently available control tools, the international community may find itself faced with a bigger job than the one it originally set out to do.
Data from this week's Zambia report illustrates the predictable consequence of failing to secure sufficient funding for control efforts. When three districts in Zambia ran out of funding and reduced coverage between 2008 and 2010, cases of malaria and severe anaemia quickly resurged. "Zambia's experience is proof of the significant progress that can be made against malaria in a relatively short period of time, but it also illustrates the fragility of those gains," notes Prof. Awa Coll-Seck, Executive Director of the Roll Back Malaria Partnership.
The estimated yearly cost of global malaria control and elimination is approximately $ US 6 billion. Only a third of this amount has been secured through international funding. RBM partners are currently exploring sources of innovative funding and working at both global and country level to sway new donors to join in and governments of endemic countries to invest a larger percentage of their GNP in health. Notwithstanding these efforts, malaria control efforts will likely continue to depend on development aid in the foreseeable future.
As the global economy recovers steadily from an unprecedented recession, donor states mustn’t forget what it took for malaria-endemic countries to get to where they are today. Financing the successful work against malaria in the coming years will help ensure that countries continue implementing without interruption effective strategies that keep their populations safe from malaria, not only today but also tomorrow and for decades to come.
Written by RBM Secretariat
The Roll Back Malaria (RBM) Partnership is the global framework for coordinated action against malaria. It provides a neutral platform for consensus-building and developing solutions to challenges in the implementation of malaria control interventions and strategies. RBM is a public-private partnership that also facilitates the incubation of new ideas and lends support to innovative approaches.
The Partnership promotes high-level political commitment and keeps malaria high on the global agenda by enabling, harmonizing and amplifying partner-driven advocacy initiatives. Founded by UNICEF, WHO, the World Bank and UNDP and strengthened by the expertise, resources and commitment of more than 500 partner organizations, the Partnership secures policy guidance and financial and technical support for control efforts in countries and monitors progress towards universal goals.
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