The Road to Malaria Eradication
October 26, 2011
Web and Social Media Assistant, Global Health Policy Center
The October 17-19, 2011 Global Malaria Forum in Seattle hosted by the Bill & Melinda Gates Foundation made the case that malaria control and eventual eradication efforts have entered a new day. This is in contrast to the 1950's when global efforts to eradicate malaria successfully eliminated the disease from 37 of 143 endemic countries, but weren’t sustained and malaria resurged as a consequence. Today leaders have focused the world’s attention again on malaria, leveraged high-level political will, substantially increased resources, and expanded the adoption, use, and distribution of effective, existing interventions.
Eradication, the permanent reduction to zero of all malaria cases, is a complex and difficult goal. In my next piece on malaria, I outline specific reasons for why this is so. Despite multiple challenges though, Forum participants remained both realistic and hopeful. There was consensus that eradication will take at minimum, 40 years to achieve, and will only occur if there is sustained leadership, innovation, financial commitment, and political will. While prerequisites like these may feel overly ambitious in our current environment of constrained budgets and political infighting, there are several reasons to be optimistic looking forward:
- In the year 2000, only $100 million was allocated to malaria research and elimination. Today resources available exceed $1.5 billion. As many people echoed at the Forum, with the shift from millions to billions, important investments in research, development, and innovation become within reach.
- In 2009, there were 200,000 fewer deaths than there were in 2000 due to malaria control efforts.
- Since 2007, four countries – Morocco, the United Arab Emirates, Turkmenistan, and Armenia – have all eliminated malaria. While today there are still 99 endemic malarial countries, 32 are pursuing an elimination strategy, and 67 are expanding malaria control efforts.
- Over 800 million bed nets have been distributed. That's enough to protect 80% of Africa, the continent most heavily burdened by malaria.
- Real collaboration is accelerating, most notably with the Roll Back Malaria Partnership and African Leaders Malaria Alliance (ALMA).
- Today we have a host of proven effective tools: most importantly, insecticide treated nets (ITNs), artemisinin combination therapies (ACTs), and indoor residual spraying (IRS).
Perhaps the most compelling development on the horizon is the development of the RTS, S vaccine. Preliminary results from the ongoing Phase III trial show that the RTS, S vaccine reduces the risk of clinical malaria by 56% and severe malaria by 47% for children 5 – 17 months old. If all goes well, it is predicted that the vaccine could be introduced in 2015 and potentially prevent half of all malaria deaths in Africa. That would mark a tremendous public health feat.
All of these successes solidify a point Melinda Gates made during the Forum: while previous efforts to eradicate malaria have failed, we can’t change the past; there is proof that we can change the future.