What are the Investments needed to Achieve Zero Malaria?
I do not remember how many times I have taken antimalarial medications in my life. It is like Vitamin C in many Nigerian homes. The advice given to most persons is to give at least a 3 month gap before self treating. For those living below the poverty line, these tablets which should be easily affordable can be a scarce commodity.
Malaria is a disease that is several millennia old, about 20–30million years. This harmful threesome between the plasmodium parasite, the female anopheles mosquito and man has gone on for way too long.
One of the major constraints in the fight against malaria in the world today, is the lack of sufficient funding. A 17 year study published in the Lancet Infectious diseases journal showed a shortage of 2 billion USD on global spending on malaria based on targets sets by the World Health Organization (WHO).
National and international resources directed in the fight towards malaria have stalled in recent years, with COVID 19 setting the fight backwards.
In 2016, Nigeria was one of the highest spenders on malaria in Africa, spending up to $424.4 million with most of that financial capital coming from out of pocket spenders.
How malaria thrives?
The plasmodium parasite is injected through a bite of the female anopheles mosquito into a human’s bloodstream. The parasites travel to the liver, multiply and rupture, infect red blood cells and destroy them.
When someone gets sick with malaria, they need to see a doctor, diagnostic tests need to be carried out, after confirmation, medication is given and the incidence ought to be reported to the overseeing health body.
What Investments are needed? Investments Aimed at Preventing Malaria
Investments relevant to attaining zero malaria, center around the solutions to malaria and its repercussions. These solutions are mainly preventive strategies which have worked in the past and and ere being improved upon.
Prevention of malaria centers on vector control, chemotherapeutic innovations aimed at preventing or treating the disease, the building of resilient health systems and efficient surveillance networks.
Vector control interventions. These are interventions aimed at eliminating the malaria parasites or its vector, the female anopheles mosquito. Vector control can be achieved through the destruction of Malaria breeding sites with insecticide spraying, the use of insecticide treated mosquitos nets, drainage works and environmental sanitation. Also gaining momentum is the use of genetically modified mosquitoes to control the fertility and population of identified vector mosquitoes.
Chemotherapeutic Innovations. These include the innovative medications aimed at preventing primary or secondary complications of malaria such as arthemether. There is increasing resistance to artemisinin by the plasmodium parasites and mosquitoes. Newer substances and modifications are being sought out to handle the issue of resistance. RTS,S and Matrix-M are two vaccines currently approved for use in the world. Several others are still in the development and trial phases.
Malaria Surveillance networks. Efficient methods are necessary to monitor and respond to malaria trends at local, national and global levels. Many Countries today are need of improved surveillance methods. This will help health parastatals determine which groups of people and areas are most vulnerable and act upon changing disease patterns. Secure surveillance systems also enable the design and implementation of health interventions suitable to local populations.
Resilient Health systems. Resilient health systems help to protect patients, and to advance and sustain progress against malaria. Priority must be given to building these systems where they are inexistent and strengthening already existing ones.
Usually when the topic of investments is broached, the first resource or capital that comes to mind is money. However, as far as the control, elimination and eradication of malaria are concerned, there are other resources that are indispensable.
These include time, effort, money, assets, connections.
How can these Investments be Secured?
1. Time and Effort: These two go hand in hand. Often times before a strategy can be implemented, the vision must be written down and goals drafted. A lot of work goes on beyond the scenes in crafting guidelines, setting up collaborations, holding and negotiating with stakeholders.
Stakeholders must work on inclusivity and transparency to enable your team understand the importance of the background work that must be done.
2. Assets : Seek collaboration with state and local governments. Sometimes a company’s building at a locality may be available, there is also the idea of getting access to their data in a particular area. If enterprises can’t offer money, they may have assets that can be put to use for a bigger cause.
3. Money: One cannot over emphasize the importance of money in getting things to work anywhere in the world. Substantive resources have been used by malaria free countries in the past to achieve elimination, much more will be needed now due to inflation costs and newer transmissible diseases such as COVID which proved the fragility of many health systems and other complex problems which did not exist in the past.
The population of Nigeria makes the eradication of malaria seem like an impossible task, but the example of China being declared free in 2021 serves as evidence that with focused and sustainable efforts, attaining zero malaria status is possible.
The Global Fund is responsible for over 60% of all international financing for malaria programs all over the world. Other organizations dedicated to delivering zero malaria include: WHO, gates foundation, Roll back malaria and the big pharma companies.
To reach the goals set for 2030, more partners and enterprises need to be sought out to join in the fight against malaria. Stakeholders can talk to the government to give some kind of incentive to businesses or enterprises supporting non profits in the fight against malaria.
4.Networking : Networks and connections make future collaborations possible. A community health worker today who is given a chance to make some change in his/her community could be the minister of health 30 years down the line so treat your connections well. It might seem impossible, but that’s an investment. It is a risk that must be taken although there is no guarantee of appreciation. The most important resource is human Resources. Individuals and organizations must value the connections they make in their journey to eliminate malaria.
My advice to stake holders engaged in the fight against malaria is to not give up when a resource such as money isn’t forthcoming, Start with what is available and build.
Malaria is a disease of poverty and inequity.
Locals, stakeholders, governments must get on the same page with a goal to provide better and equitable access to health care and invest in new approaches and improve the use of existing tools in the fight against malaria.
Investments must be increased and sustained in order to reach the 2030 goal to end the disease as a public health threat.
What other ways do you think investments can be secured in delivering Zero Malaria? I’ll like to hear your thoughts below.
SOURCES
1. https://www.who.int/news-room/questions-and-answers/item/malaria
