Malaria: The Disease That We Can Halt

When I lived in Lusaka, Zambia, five years ago, fear of malaria was pervasive. When my neighbors fell ill, they blamed malaria; at funerals I attended, the deaths were generally attributed to malaria. And maybe malaria was responsible in each case, though I have my doubts. Because malaria lacks the stigma of HIV/AIDS and other diseases, it was a socially acceptable scapegoat for any death.

Then again, we were living in a country that in 2006 alone counted more than 3.6 million malaria cases and 14,000 malaria deaths. If people constantly mused upon the disease, perhaps it was no surprise, given the deeper mythology that had sprung up around it. Malaria, it seemed, was an inescapable, ungovernable plague.

Except that it's not. And today, World Malaria Day, it's time to explode this notion that malaria is unconquerable — and recognize the significant strides the public health community is making toward eradicating the disease.

In 1998, acknowledging the decades of uncoordinated responses to malaria, the World Health Organization, UNICEF, UNDP and the World Bank created the Roll Back Malaria (RBM) Partnership to present a united front in addressing the disease. From the outset — as if to undermine the idea that malaria couldn't be defeated — RBM set some lofty goals, including:

1). Achieving universal coverage for all populations at risk of malaria;
2). Halving the 2000 malaria burden by 2010 and reducing the number of 2000 cases by three quarters and the number of preventable deaths to near zero by 2015;
3). Eliminating malaria in eight to 10 countries by 2015

With a little more than eight months left to achieve the first two goals, how is RBM doing?

In a new report that focuses specifically on Africa — the hardest-hit continent — RBM indicates that they're partially on track, specifically in reaching the universal coverage targets. This progress has been fueled by a surge in new money dedicated specifically to malaria control (though RBM notes that it's not nearly enough), as well as country-specific plans.

The partnership is focusing on three key prevention measures: increasing the distribution of insecticide-treated mosquito nets, spraying the inside walls of houses with long-lasting insecticides and intermittent preventive treatment during pregnancies. For treatment, RBM encourages better diagnostics — including improved equipment, like microscopes — and increased access to proven antimalarial medication.

That broad-based approach has left RBM open for some criticism. Richard Tren, the director of Africa Fighting Malaria, told the Associated Press that RBM would be better served focusing specifically on proven interventions, like pesticide spraying. He argued that increasing bednet and medicine supplies doesn't necessarily translate into equal access for those who need them most.

And he has a point. Bednets can help prevent the transmission of malaria, but they have to be available and used properly (as Christopher Dunford pointed out on Change.org earlier this week, and as RBM admits in its report). For medicine to be effective, obviously, it has to reach the people who need it. Just upping the number of bednets and medical supplies isn't enough.

The bottom line? To fight malaria, we already have a set of tools that can prevent malaria's spread, keep people from dying and (in the process) demythologize the disease. That, above all, should be the message of today's World Malaria Day.

Photo Credit: Gerald Yuvallos