What African governments can do to fight malaria

Almost 20% of all infectious diseases are “vector-borne”. These diseases – the theme of this year’s World Health Day – are transmitted to humans by mosquitoes, ticks and fleas. They include lesser-known conditions such as Rocky Mountain spotted fever, cat scratch disease and sleeping sickness (or trypanosomiasis).

They also include some of the world’s most destructive diseases, like malaria and dengue fever.

They are caught outdoors, when children are at play, or while people are enjoying themselves in some of the most naturally beautiful places in the world. Collectively, vector-borne diseases cause significant damage; Lyme disease now infects over 30,000 people in the United States every year; Rocky Mountain spotted fever caused over 4,000 US cases. Dengue fever affects millions worldwide and is the fastest-growing vector-borne disease. Forty percent of the world’s population is at risk from dengue, according to the World Health Organization (WHO).

The most deadly vector-borne disease, however, is malaria, which kills over 600,000 people annually. Sadly, most of these deaths are African children under the age of five. Over 200 million cases of malaria are reported every year and 80% of these occur in Sub-Saharan Africa, where a child dies every minute from the disease. “The fact that so many people are infected and dying from mosquito bites is one of the greatest tragedies of the 21st^t century,” said Margaret Chan, Director-General of WHO.

Governments around the world have struggled for decades to control vector-borne diseases. The unpredictable habits of mosquitoes, ticks and fleas and the microbes that they carry are significant obstacles.

Climate change hasn’t helped either. We are likely to see an increase in these diseases as the planet gets hotter. Global warming has an escalating influence on biting rates, breeding sites and reproduction rates. And as globalization spreads, the reach of these disease carriers increases with it.

Limited resources in the poorest countries, where the disease is most prevalent, also make controlling the malaria-causing plasmodium – carried in the gut of female anopheles mosquitoes – extremely difficult.

WHO recommends “Integrated Vector Management”, which focuses on the connections between health and the environment. Environmental management (eliminating breeding sites, like stagnant water), biological controls (the use of larvicides where there are few, easily locatable, breeding sites) and chemical methods (indoor spraying) can together prevent the spread of vector-borne disease.

Of course, this should be combined with early diagnosis and treatment of malaria, and prevention using insecticide-treated bed nets.

In Africa, health advocacy efforts to fight malaria have been led mainly by local and international civil society groups. Advocacy at the international level is sustainable and effective only when combined with advocacy at the local level.

Certain traditional advocacy methods such as flyers and billboards should be replaced with more innovative techniques involving celebrities and mobile technology. Friends Africa, a pan-African non-profit that fights AIDS, TB and malaria, uses Nollywood stars and soccer players to educate the public about malaria, and we have found them to be a powerful and effective voice. They can certainly make the use of bed-nets sound much “cooler” to a teenager than any government.

It will take significant innovative financing, leadership and technology to win the battle against malaria. African governments need to play a stronger role in securing finance for malaria programmes, monitoring transmission trends and designing national strategies to control the disease.

Governments also need to increase domestic funding for operational research to ensure locally-tailored approaches are being used. They should also provide effective public outreach to educate people about treatment and control of these diseases. The question is, do already overwhelmed governments in Africa have the capacity to do this?

The Roll Back Malaria partnership has been successful in focusing the world’s attention on malaria, and has shown that significant progress has been made in fighting the disease. Since 2000, the number of people killed by malaria in Africa has been cut nearly in half. The Global Fund to fight AIDS, tuberculosis and malaria partnered successfully with African countries to bring about this change. This shows that our governments do have the capacity to fight vector-borne diseases.

Unfortunately, funding to control mosquitoes is being reduced, while progress in fighting malaria is also threatened by growing parasitic resistance to anti-malarial drugs. The combination of a renewed international commitment to fight malaria with increased domestic financing of malaria programmes and investment in technology is needed to win the battle against this disease. I believe that through successful private-public partnerships in Africa, we can achieve this.

African governments are engaged on the issue. I have witnessed first-hand how excited our presidents are about progress on malaria. But there is a long road ahead, and we must not give up.

Read more blogs about health.

Author: Akudo Anyanwu Ikebma is CEO of Friends Africa and a World Economic Forum Young Global Leader.

Image: Doctors research malaria at a laboratory in the Kenya coastal town of Kilifi, November 23, 2010. REUTERS/Joseph Okanga