December 3, 2019, by msxra37

Malaria can be beaten, and you can make it happen

Every two minutes, 700 times a day, a child under 5 dies of malaria.

It’s thought to have killed half of all people who ever lived – some 50 billion humans – and we’ve been trying to eradicate it for decades.

So far, we’ve made a lot of progress: since 1900, the proportion of the world at risk from malaria has reduced from 53% to 27%, and half of all countries are now malaria-free.  Since 2000, over 600 million cases have been averted in Sub-Saharan Africa, mostly through the distribution of insecticidal bednets.  And the number of kids under 5 who died of the disease plummeted from 440,000 in 2010 to 285,000 in 2016.

While that’s certainly good news, it’s still 285,000 kids too many.

But now, for the first time ever, scientists have gone on record to declare malaria can be eradicated entirely.  Within a single generation.

“For too long, malaria eradication has been a distant dream, but now we have evidence that malaria can and should be eradicated by 2050” said Sir Richard Feachem, Co-chair of The Lancet Commission on malaria eradication, which recently published a report in the Lancet funded by the Bill and Melinda Gates Foundation.

“But to achieve this common vision, we simply cannot continue with a business-as-usual approach,” Feachem added.  “The world is at a tipping point, and we must instead challenge ourselves with ambitious targets and commit to the bold action needed to meet them.”

Lately, our fight against malaria has ground to a halt.  There are still 200 million cases reported across the globe each year, claiming the lives of nearly half a million people.  55 countries reported an increase in cases between 2015 and 2017.  And concerns over parasite and vector resistance to currently available drugs and insecticides continues to rise.  Despite our victories in recent years, our progress against one of humanity’s oldest and deadliest tormentors currently hangs in the balance.

More than a health problem

Malaria isn’t just a health problem – it’s an issue of social justice.  The disease perpetuates cycles of inequality, with 29 countries accounting for the majority of new cases and 85% of deaths in 2017.  All but two of these countries are in Africa, where just two nations (Nigeria and the Democratic Republic of Congo) account for 36% of global cases alone.  While the disease is entirely preventable and reliably curable, low-income and rural people continue to die due to lack of access to simple bednets and lifesaving treatment.

In 2019, with our scientific understanding and global GDP around $80 trillion USD, allowing malaria to continue as a death sentence is morally repugnant.  By fixing this inequity, not only would we honour our responsibility to justice, we’d free up countries to use their resources on other things, ultimately boosting their development and prosperity, and allowing them to fully contribute to the global economy.

Thankfully, the Lancet report brings us validated hope.  The feeling amongst experts is that we could and – most importantly – should eradicate malaria from the world within our lifetimes.

Hope from scientists

The Lancet Commission developed a machine-learning model to capture the complex associations between malaria transmission and a bunch of variables, including socioeconomic factors (like urbanisation) and environmental trends (like climate change).  Using projected global trends, they mapped these factors into 2050 to see how they might affect the future global landscape of malaria.

When they modelled what would happen after increasing the use of solutions like insecticidal bednets, the simulations showed something truly amazing – that we can feasibly eradicate malaria within 30 years.

Bending the malaria curve

If you looked at a graph showing malaria cases over time, you’d see a curve that generally bends downward.  However, because of the recent slowdown in progress, we need to “bend the curve” more aggressively for it to quickly hit zero.  The recent report tells us how to do that.

It offers a roadmap to defeating malaria using three key techniques:

  1. Enhancing the “software” of eradication, such as training national malaria program managers and staff to increase the quality of operations and ensure financial resources are being spent well.
  2. Creating and deploying new “hardware” of eradication, which involves investing in new methods of rapid diagnosis, new long-lasting insecticides, and novel medications, as well as exploring out-of-the-box approaches like nanotechnology and gene drives.
  3. Making the necessary financial commitment, by increasing our annual global spending on the disease from a paltry $4 million to something in the region of $6 billion (this sounds like a lot, but considering that £10 billion is donated to charity by the UK public alone each year, it’s loose change on the global scale).

What does this mean for university students?

I see this as a great opportunity for soon-to-be graduates to step-up and take the challenge head-on.

While the UK is thankfully a malaria-free place, the prospect of safely traveling the world without the need for malaria prophylaxis will save us a great deal of time, money and unpleasant side-effects.  But the potential of a world without malaria should excite us in a very different way – it’s something that we ourselves can make happen.

While the report claims total eradication is possible, it concedes that this is an ambitious goal that will take monumental effort to achieve.   For us to get there, we need to direct the world’s most talented people towards the cause.  This is where our graduates come in.

The knowledge and skills students take from their university programs could be used in the making of history.  Our MPH/GH grads could monitor the disease as our climate continues to warm.  Our biotechnologists could develop new drugs and rapid diagnostics.  Our economists could ensure the huge financial investment is deployed responsibly and efficiently.  And our geneticists could counter increasing drug resistance and explore new gene drive technologies.

But we need more than just the scientists and economists.  Students should seriously consider working for an effective charity in this space – like the Malaria Consortium or the Against Malaria Foundation.  These organisations are consistently recognised by GiveWell as two of the most effective charities in the world.  Charities like MC and AMF need experts in fundraising and marketing.  They need talented logisticians and artists, passionate writers and photographers.  By working with NGOs like these, students will have a hugely significant and positive impact on the world.

Malaria is an insult to the equal and healthy world we all hope for.  But it can be defeated.  Our university students can help in this fight – the greatest fight humanity has ever taken on.

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