Managing malaria in changing times
Over the past decade, global malaria control has proven to be one of the best buys in public health.
Since the year 2000, child death rates from malaria have been cut in half and a total of more than 3.3 million lives have been saved. The malaria map is shrinking, with 26 of the remaining 97 endemic countries now working to eliminate the disease altogether. However, thirteen years into the new millennium, the problem of malaria has not faded in global significance.
Although preventable and treatable, the disease remains a health risk for more than half of the world’s population, while thwarting economic and social progress across the global South. Today the malaria community is making progress against the backdrop of considerable landscape changes.
The economic climate has changed
Endemic countries can no longer rely mainly on international funding to maintain progress in malaria control. Low-gear global economic growth and large national deficits have affected international aid budgets. Donor funding hovered around the US$ 2 billion mark last year, while government spending was estimated at half a billion. About twice as much (US$ 5 billion) is needed annually to tackle malaria worldwide.
The Global Fund, malaria’s main financier, was thankfully generously replenished at the end of 2013, as international donors reaffirmed their commitment to fighting the three major infectious diseases of our time – HIV/AIDs, tuberculosis and malaria. However, continuous technical support from partners will be needed in countries to ensure that the Fund’s new funding model functions well for malaria control.
Going forward, the malaria fight will need a new focus: strengthening country ownership, empowering communities, strengthening data quality for decision making, engaging multiple sectors outside health in the malaria fight and exploring ways to do things better at all levels, with maximum value for money.
Donor funding hovered around the US$2 billion mark last year. Twice as much is needed annually.
The disease has changed
Emerging parasite resistance to the world’s most powerful antimalarial drug is a major threat to progress. In the four South-East Asian countries where it has been detected, efforts to contain its spread have intensified. The World Health Organisation and RBM partners have deployed an emergency plan to fight resistance and secure the efficacy of the world‘s best cure for life-threatening malaria. This work must continue in the years to come. Investing in innovation and research to develop the next-generation drugs, diagnostics, and vaccines is also critical.
The global political framework is changing
As the MDG deadline approaches, a new set of international goals is being discussed and developed. The Partnership needs to reinvent itself, perfect new ways of doing business to continue delivering similarly strong results in a different context. In the midst of all change, however, one certainty remains. Humanity’s quest for a sustainable, more equitable and healthier global society cannot succeed without systematic, effective, long-term malaria control measures in endemic countries.
We have come a long way since malaria was first placed on the global agenda, but the job is far from finished. The push to roll back malaria must continue, so that a maximum number of malaria-endemic countries reach the MDGs. Beyond 2015, it needs to stay on the bold path, charted in the Global Malaria Action Plan, to near zero global malaria deaths and disease elimination. As this vision turns into reality, millions among the world’s poor will get a better chance to not only survive but also thrive.