More than half a million children still die from malaria every year. Any day a child dies of a preventable disease is not a happy day, but those working to fight malaria – and that number includes activists like you and I – should give ourselves a pat on the back for being a part of the political action that has increased funding for the work on the ground, enabling a 25 percent drop in malaria deaths globally since 2000.
It wasn’t that long ago that kids here in America became ill and died from malaria. Atlanta’s history as a global health research center actually grew out of the efforts to fight malaria in the US in the early 20th century. The Centers for Disease Control and Prevention (CDC)- formerly known as the Office of Malaria Control in War Areas- had its headquarters planted in Atlanta beginning in 1947 due to the prevalence of malaria throughout the southeastern US. Malaria was declared eliminated from the US in 1951.
Although one may not be working directly on the ground in Africa to eradicate malaria, every phone call, in-district meeting or public event one participates in to further the progress of the Millennium Development Goal #6 (fighting HIV/AIDS, TB and malaria) really does add up.
The progress that has been made in fighting off these diseases has been phenomenal. Dr. Emerson (who is Dr. Emerson???) says that in his work in places like Ethiopia, you no longer see “two or three children to a bed” stricken with malaria, thanks to better distribution of insecticide-treated bed nets and other preventative measures.
Now is a crucial time in the fight against malaria. Even though much progress has been made, the last stretch of the race is still before us. As long as we can push through and continue to fight this disease effectively, we can see the eradication of malaria in the relatively near future. Let’s finish malaria for good.
In 2001, when African leaders met in Abuja, Nigeria and each pledged to take measures to halt the spread of HIV, tuberculosis (TB) and malaria in addition to increasing their country’s funding for health to at least 15% of their annual budget. This pledge provided hope for many that a turning point in Africa’s history- a point where the continent would be able to emerge from decades of watching the potential of the citizens, communities, and countries be stunted by disease.
But, pledges do not pay doctors, nurses or community workers, they do not buy medicines, and they do not keep the lights running in hospitals.
In July, the leaders of Africa will gather once again in Abuja, Nigeria, to review progress made on HIV, TB and malaria and discuss the state of the continent’s health.
We hope that as Africa’s health reaches a critical crossroads, the African leaders use this opportunity to follow through with their commitments with concrete action and plans for the future that include effective monitoring of the implementation at country level.
There has undoubtedly been progress. A handful of African countries have reached the 15% target, with 27 African countries having increased their domestic investments in health. The U.N. Millennium Development Goals have catalyzed improvements on development across countries. Due to international investments channeled through the Global Fund to Fight AIDs, Tuberculosis and Malaria, we are now at a point where we can see the end of all three diseases.
However, Africa is still behind on reaching the U.N.’s goals related to improving maternal health and reducing child mortality, while our progress on the goal of fighting HIV/AIDS, TB and malaria and other diseases is uncertain as the Global Fund looks to raise $15 billion to continue its life-saving work for the next three years.
Leaders can no longer look back on the 2001 Abuja Declaration and pat themselves on the back. It is crucial that they only look forward to the work that must be done, and turn pledges and promises into action and resources.
The leaders today will write the history of tomorrow, and they must keep the trust of the citizens who elected them to power. It’s not just promises at stake; it is the lives of millions of people.
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Friends of the Global Fight Against AIDS, Tuberculosis and Malaria, better known as “Friends”, is an advocacy organization that is working to expand and sustain U.S. support for the Global Fund to fight AIDS, Tuberculosis, and Malaria. The Global Fund was created in 2002 to support countries and programs in the fight against the three pandemics. From those distributing mosquito nets to protect families from malaria in Honduras, to those training peer counselors of teenagers diagnosed with HIV in South Africa, partners in tackling the deadly infectious diseases get support from the Global Fund. Friends has grown to become the leading source of information about the Global Fund in the United States, becoming its much needed voice in Washington, D.C.
Friends shares information with policy leaders and decision makers on the direction the Global Fund takes and the achievements it makes. Friends also ties together the two organizations’ communications and education goals by providing the Global Fund’s Secretariat, based in Geneva, Switzerland, with legislative counsel and strategic direction. Through these efforts, Friends is able to foster collaboration and mutual support between the Global Fund and the U.S. government’s AIDS, tuberculosis, and malaria efforts.
As of December 2012, the Global Fund had approved about $23 billion in grant funding. These resources are provided to in-country partners that have donated HIV/AIDS treatment to 4.2 million people, detected and treated 9.7 million cases of tuberculosis, distributed over 310 million insecticide-treated nets, and reached 1.7 million HIV-positive mothers with services to prevent transmission to their children. Overall, efforts around the globe have reduced tuberculosis deaths by more than 40%, HIV incidence by more than 20%, and malaria deaths in Africa by 33%. In turn, communities have stabilized, human rights have improved, economic productivity has increased, and partnerships have been built.
Friends of the Global Fight was founded in 2004 to help advocate on behalf of the world’s largest public health financier. Since its founding, Friends has played a significant role in helping the Global Fund to increase funding from the U.S. government over the past few years. U.S. support for lifesaving programs increased from $345 million in FY2005 to $1.65 billion in FY2013. The following are just a few of the milestones that have led to Friends’ success:
2004 – Philanthropist Ed Scott and Adam Waldman found Friends, led by well-known D.C. influencer Jack Valenti
2004 – The U.S. Congress approves $435 million for the Global Fund for FY 2005
2006 – The U.S. Congress approves $724 million for the Global Fund for FY 2007
2008 – Friends collaborates with congressional office to facilitate the Global Fund’s Access to Life photo exhibit at the African American Museum and Library in Oakland, California and at the Corcoran Gallery of Art in Washington, D.C.
2008 – The U.S. Congress approves $1 billion for the Global Fund for FY 2009
2010 – The U.S. Administration makes an unprecedented pledge of $4 billion to the Global Fund for FY 2011 through FY 2013
2010 – The U.S. Congress approves $1.05 billion for the Global Fund for FY 2011.
2012 – Friends hosts highly attended event on Capitol Hill highlighting the Global Fund’s public-private partnerships with Coca-Cola, Chevron, (RED) and PEPFAR.
2012 – Friends hosts high-level dinner timed during the International AIDS Conference in Washington, D.C, resulting in a total U.S. contribution of $1.3 billion to the Global Fund for FY 2012
2012 – The U.S. Congress approves $1.65 billion for the Global Fund in a continuing resolution for FY 2013
2013 – Friends hosts Dr. Mark Dybul for his first official visit to the U.S. after his appointment as the new Executive Director of the Global Fund, planning and executing a four day roll-out in Washington, D.C., that included meetings and events with the U.S. Congress, the Administration and the global health advocacy community
2013 – The House and Senate State and Foreign Operations appropriators allocate $1.65 billion for the Global Fund in their bills for FY 2014, a record funding level in the House
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Highlight Quote: “One is the gap in opportunity – this gap that President Clinton last night called uneven, unfair and unsustainable – and, out of that, comes poverty and illiteracy and disease and all these evils that we see around us. But perhaps the other, bigger gap is what we call the hope gap. And someone, at some point, came up with this very bad idea that an ordinary individual couldn’t make a difference in the world. And I think that’s just a horrible thing. And so chapter one really begins today, with all of us, because within each of us is the power to equal those opportunity gaps and to close the hope gaps.”
Many TED talks focus on the real, the practical and the pragmatic – on harnessing the abstract powers of good and common sense of humanity in a real life way. Yet many of these talks can leave us, as ordinary citizens feeling somewhat inadequate and unable to make an impact. Jeff Skoll, producer of films including An Inconvenient Truth, Murderball, North Country, Good Night and Good Luck, and Syriana, gives us a talk about how he, as an ordinary citizen, worked his way slowly to Hollywood. Once there, he was able to make a difference by inspiring and spreading awareness through films.
Mosquitos, Malaria and Education, Bill Gates
Highlight Quote: “But I – I’m optimistic. I think people are beginning to recognize how important this is, and it really can make a difference for millions of lives, if we get it right. I only had time to frame those two problems. There’s a lot more problems like that — AIDS, pneumonia – I can just see you’re getting excited, just at the very name of these things. And the skill sets required to tackle these things are very broad. You know, the system doesn’t naturally make it happen. Governments don’t naturally pick these things in the right way. The private sector doesn’t naturally put its resources into these things.”
Perhaps the world’s most recognizable philanthropist, Bill Gates is characteristically shrewd, practical, clear, forward thinking and unexpectedly funny. By asking us to consider how to solve two big problems: malaria and education – Gates shows us how businesslike thinking and determination can solve widespread social problems. In only 18 minutes, Gates gives us a TED talk that is small in stature but big in ideas.
Aid versus Trade, Ngozi Okongo-Iweala
Highlight Quote: “But we are talking about “Africa: the Next Chapter” because we are looking at the old and the present chapter – that we’re looking at, and saying it’s not such a good thing. The picture I showed you before, and this picture, of drought, death and disease is what we usually see. What we want to look at is “Africa: the Next Chapter,” and that’s this: a healthy, smiling, beautiful African. And I think it’s worth remembering what we’ve heard through the conference right from the first day, where I heard that all the important statistics have been given – about where we are now, about how the continent is doing much better. And the importance of that is that we have a platform to build on.”
In 2007, Okongo-Iweala, the former finance minister of Nigeria and director at the World Bank, had the unenviable task of summarizing four days of TED talks. In 22 minutes, she draws from personal experience, global leaders, real-life examples and observations to illustrate the lessons from the conference regarding effective aid, morality, and the pitfalls in the current methods of development assistance.
Cheetahs vs. Hippos, George Ayitteh
Highlight Quote: “Africa is more than a tragedy, in more ways than one. There’s another enduring tragedy, and that tragedy is that there are so many people, so many governments, so many organizations who want to help the people in Africa. They don’t understand. Now, we’re not saying don’t help Africa. Helping Africa is noble. But helping Africa has been turned into a theater of the absurd. It’s like the blind leading the clueless.”
Many ask the question, why is Africa still in the state it is, with so much money being poured into it and so much work being done by so many different organizations? In this talk, Ayitteh addresses some of the problems in development; some coming from Africa itself and others with foreign sources – and more importantly, how to address them. Ayitteh’s talk can be applied to a number of other scenarios and teach us that aid is a practice that needs close monitoring and attention in order to be effective.
A team of international researchers has recently developed a new vaccine that demonstrates great progress made in the fight against malaria. The vaccine effectively protects against multiple strains of the deadly disease, creating better protection for the immunized.
The investigators have not yet started trials of the newly developed vaccine in humans, but research on how the vaccine works in the red blood cells of mice is promising. Vaccinated mice that were exposed to malaria showed low levels of parasites in their blood. Researchers even say that the vaccine was so effective that “some of the mice had so few parasites that we were unable to see them when we looked at the blood under a microscope.”
The investigators also found that their vaccine was effective in protecting against malaria regardless of the specific strain of the disease that the mice were exposed to. They stated that, “even though mice were immunized with only one strain of malaria and infected with a different strain, they were also protected by our vaccine. That means that our vaccine protects against all strains of malaria.”
The new vaccine was developed after researchers considered modifying the way that previous malaria vaccines were made. In previous research, investigators used low doses of the dead parasite in vaccines, which proved effective in protecting against malaria. In development of the new vaccine, researchers decided to use whole parasites to immunize against the disease. To produce the vaccine, the malaria parasite is treated with a drug that “binds to the parasite’s DNA and prevents it from multiplying.” After immunization, the vaccine works by turning on an immune response in white blood cells, which can recognize proteins hidden in the malaria parasite. Researchers believe that immune recognition of hidden proteins in the various strains of malaria may be what is making the vaccine effective across all strains of the disease.
Each year, malaria infects nearly 250 million people across the globe and is responsible for one million deaths. The developers of the new vaccine hope that their new findings will help reduce the suffering that is caused by the disease in the future. In the next few months, the team will begin trial testing of their vaccine in humans. If the vaccine proves to be as effective as anticipated, use of the vaccine will be expanded to areas where malaria is present.
The fight against one of the major hindrances of Malaria prevention, Insecticide Resistance (IR), has recently gained a major asset, the IR Mapper. As an interactive online mapping tool, it tracks IR in malaria-carrying mosquitoes.
The IR Mapper “consolidates reports of insecticide resistance in malaria vectors onto filterable maps to inform vector control strategies.” Collected throught the cooperative efforts of Kenya Medical Research Institute (KEMRI) and the US Centers for Disease Control and Prevention (CDC), the information was brought together by Vestergaard Frandsen, a Swiss company. Lastly, design for the interactive map came from ESRI Eastern Africa.
Today, insecticide plays a valuable role in the prevention of malaria. Spraying a house with insecticide ensures mosquito prevention within homes lasting from 3-6 months. Similarly, insecticide treated bed nets are extremely valuable and, as the CDC found, these bed nets reduced deaths of children under 5 from all causes by roughly 20 percent.
Yet, the successes of insecticide are in danger if insecticide resistance is not combated. IR has been found in two-thirds of malaria prevalent countries. This large percentage of countries hindered by IR displays the importance of the IR Mapper.
Estimated that 26 million more new malaria cases might occur if action doesn’t occur against IR, this interactive map will provide the needed knowledge to health-care workers on the ground.
These IR Maps provide a new means of knowing where insecticide is facing confrontation with IR strains of malaria. This new map of information allows users to “guide the deployment of insecticidal tools to ensure the right tool is used in the right place at the right time,” according to IR Mapper’s homepage.
With maps that are armed with data spanning 1954 to present with detailed information on the current susceptibility situation with the mapped pinpoint.
To gain the information necessary to fill the maps the team acquired data from scientific articles and reports and from the IR focused database IRBase.
With this information public, more policies will be constructed with better knowledge and more research will be widespread to excel the deterrence of malaria.
The Promoting Malaria Prevention and Treatment (ProMPT) Project in partnership with USAID and the Ghana Health Service has developed an innovative way to distribute mosquito nets in Ghana. The ProMPT project has delivered over 12 million mosquito nets to prevent the spread of malaria in Ghana. The four year project has given households training on how to use treated mosquito nets that are covered with insecticide to kills the mosquitoes. USAID was a major donor of the $20 million dollar project and support from the U.S. and Ghana governments was strong.
The Ghana Health Service has worked hard to educate citizens against malaria. The ProMPT project strengthened malaria prevention through door-to-door mosquito net distribution, increasing prevention efforts geared towards pregnant women, and improving malaria treatment in health care facilities. The project also utilized community volunteers to educate households on the proper way to hang a mosquito net.
USAID acknowledged the success of the project was only possible through the collaborative efforts of the USAID, the Ghana Health Service, and the government of Ghana. The holistic nature of the project and the inclusion of factors relating to prevention, education, and treatment led to a drastic reduction in malaria-caused deaths. Program officers encourage other organizations to adopt the collaborative model in other malaria prevention projects.
In Ghana, malaria is a major problem for the country’s overall health. Over 40% of outpatient illnesses and visits in health care facilities are contributed to malaria as well as a third of all admissions. The World Health Organization attributed around 14,000 annual childhood deaths in Ghana to malaria as well. The goal is to reduce the impact of malaria in Ghana by 75% by the year 2015.
The program worked to put at least one net in every dwelling place as well as educate health care workers on proper malaria management and prevention. Areas of focus were especially on women who are pregnant and health care facility management of malaria care. The program has so far trained 21,000 health care workers in over 2,000 health care facilities. The ProMPT project officially ended in March,but Ghana plans to continue the efforts began in the prevention of malaria.
China’s reputation as a producer and exporter of low-quality, counterfeit goods like shoes, clothing and jewelry make it a likely target for global medical experts looking to assign blame for the tremendous increase in counterfeit medications in Africa.
Doctors, pharmaceutical companies and NGOs with an eye on Africa rejoiced when China came out with a cure for malaria in the form of artemisinin a few years ago, believing this medical marvel would be instrumental in alleviating the woes of global poverty and high mortality rates in the developing world.
After the initial excitement died down, however, disparaged global medical experts began to realize the obstacles that still lay before them in the form of global drug counterfeiting. Maverick manufacturers around the world have begun to view the African malaria problem as a free-for-all chance to make some money by selling placebo pills labeled as artemisinin to suffering patients who are unable to tell the difference.
In Uganda and Tanzania, the two countries with the highest malaria death rates in the world, the widespread, faulty drug regulation and corrupted business practices have allowed an influx of counterfeit drugs to enter the market alongside the true, lifesaving doses of artemisinin. Oxford University’s Wellcome Trust, a group that researches and spreads awareness about the counterfeit malaria drug problem, estimates that one-third of malaria drugs in Uganda are fake or of poor quality.
This alarmingly high rate is cause for concern, especially since medical workers in Uganda and Tanzania are often aware that they may be selling counterfeit drugs but can “do little to tell which are real and which won’t work.” Fake pills can even bear the same inscriptions as the drugs they counterfeit but contain no real medication, thus duping even the local pharmacists that are dispensing them.
So, whose job is it to make sure those suffering from malaria in Africa are getting the drugs they need? Many are looking towards global aid organizations to step in and make sure that the billions of dollars they are putting into malaria pills are being spent on authentic drugs.
Others are looking to China itself to fix what it may have started, and to use this as a chance to redeem themselves in spite of their reputation as a global counterfeiting hub. Discovering the cure for malaria has been one of the country’s crowning medical achievements, and malaria-focused aid groups around the world lament that “the intriguing tale of the drug’s invention in China and its eventual emergence as a first-line treatment is getting lost in the deadly battle against fakes and counterfeits.”
Deciding to take action against the counterfeit market could be China’s chance to reverse its reputation and settle into a role as a key global player.
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A country two thirds the size of Europe, and rich in mineral and agricultural resources, the Democratic Republic of the Congo is also the site of the “deadliest conflict since World War II,” which has killed more than 5.4 million people. The country is recovering from this civil war, but its infrastructure has been nearly destroyed. As a result, poverty in the Democratic Republic of the Congo is widespread and severe, and it requires urgent attention.
Breakdown of Poverty in the Democratic Republic of the Congo
Effects of the War
Today, the effects of the conflict in the DRC are extremely apparent. Life expectancy is 49 years compared to the global average of 70 years, and 168 children born out of every 1,000 die before reaching the age of five. In 2011, more than a quarter of the population was sickened by malaria. More than 2.3 million citizens remain displaced from their homes within the country, and thousands more have fled to neighboring countries for refuge from the ongoing violence.
Present Challenges
Though these statistics have improved slightly since the peak of the civil war in the mid-1990s, 71 percent of the DRC’s population continues to live below the poverty line. Experts say that the country’s scale is a primary factor causing many to die from “easily preventable conditions” such as malnutrition, malaria, and pneumonia. Humanitarian and aid organizations struggle to serve the DRC’s large population as “renewed rebel activities” in eastern provinces continue to displace large segments of the population.
Addressing Poverty
The World Bank reopened in the DRC in 2001 after operations were suspended for almost ten years because of political instability and corruption in the country. The Bank has committed $3.1 billion to the DRC, aiming to rebuild the country’s infrastructure, decrease corruption in public and private sectors, and rehabilitate the country’s health and education systems.
The United Nations has also been instrumental in the DRC’s recovery. The Security Council established MONUSCO in 1999, supplying peacekeeping troops to the region. In addition to the UN’s peacekeeping efforts, USAID provides emergency assistance to the displaced and has established long-term programs to address food security, democracy, education, the environment, and global health in the DRC.
Results
Since late 2010, USAID has given a comprehensive malaria prevention package in 70 health zones in the DRC, greatly reducing the incidence of malaria in the country. USAID also provides health services to pregnant women with HIV/AIDs, preventing them from passing the virus on to their children. The DRC happens to be one of the five countries in the world that accounts for half of all child deaths, but USAID recently provided health services to more than 12 million people who previously lacked access to healthcare.
The situation in the DRC remains one of the most urgent humanitarian crises in the world, but efforts to relieve the widespread poverty are proving successful. In order to maintain this trajectory, though, continued funding for USAID will be critical.
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The Better World Fund was founded in 1998 by media mogul, philanthropist, and humanitarian Ted Turner. The man who brought us the cable station CNN started the Fund as an umbrella organization to facilitate public-private partnerships to address a range of global concerns, including health crises and environmental problems. The fund also serves as an advocacy and outreach organization to support the work of the United Nations, and to lobby for the US Government to provide political, financial and sometimes military support for UN humanitarian and peacekeeping efforts.
The major initiative of the Better World Fund is the Better World Campaign, whose publicity and advocacy work currently focuses on what the organization calls its “key issues.” The top three of those issues are climate change, global health, and international security.
In each of these areas, the Better World Fund and the Better World Campaign work to build support for UN initiatives. On climate change, they advocate for adoption of the Copenhagen Accord, which establishes a registry to keep track of the ways that different nations are responding to climate change. The Accord also commits developed countries to providing up to $100 billion per year by 2020 to reduce emissions and take other measures to address climate change.
In the area of global health, the Better World Fund supports UN education and treatment efforts to combat HIV/AIDS and malaria, and it supports vaccination efforts to eradicate polio. In the area of international security, the Fund advocates for UN efforts to end nuclear proliferation, to combat international terrorism, and to enforce maritime laws governing the activities of governments and businesses, and the management of marine natural resources.
The Fund’s Board of Directors includes former UN Secretary General Kofi Annan, civil rights leader Andrew Young, and Her Majesty Queen Rania Al-Abdullah of Jordan.
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