Tropical Health Matters

First the good news. Roll Back Malaria’s “Saving Lives with Malaria Control: Counting Down to the Millennium Development Goals” report provides encouragement when one reads that, “it is estimated that in the past 10 years, scaling up malaria prevention has saved the lives of nearly three quarters of a million children in 34 malaria-endemic African countries, 85% of these in the past 5 years alone.”

This is the latest report in RBM’s Progress Series and indicates that, “the results suggest that if current scale-up trends are maintained until 2015, another 1.14 million African children’s lives will be saved between 2011 and 2015.”

On the other hand, RBM warns that, “if funding were to cease in 2010 and prevention efforts were to fall, an estimated 476 000 additional children would die in that same period.” Is it possible that a greater focus on future eradication of malaria could distract from saving lives now and reaching the 2015 Millennium Development Goals?

The New York Times reported three years ago that, “challenging global health orthodoxy, Bill and Melinda Gates called for the eradication of malaria.” According to the Times, the Gateses labeled this call to action ‘audacious,’ while some partners called it ‘inspirational,’ ‘noble but quixotic’ and even ‘harmful.’

Now the Seattle Times reports that Bill and Melinda Gates are, “revamping the scientific agenda with their eyes on the controversial goal they set three years ago: driving malaria to extinction”

Justifying the focus, the Seattle Times indicated that, “Although total eradication of the disease may be as much as forty years away, it’s important to start work on drugs and vaccines that could take a decade or more to bring to the field, David Brandling-Bennett, leader of the Gates Foundation’s malaria programs.”

The implications of “The increased focus on the future means the Gates Foundation is ending its support for some efforts to lessen the disease’s current toll. Those include research to improve treatment of the severe infections that strike children and pregnant women, and that are responsible for most of the estimated 850,000 annual deaths from malaria,” according to the Seattle Times. Fears have arisen that this change by Gates, due to its financial influence, may pull resources away from other malaria research and program implementation efforts.

On the programming side, Gates has pledged 3% of the total Global Fund pledges as of August 2009, which is three-quarters of the funds pledged by all non-governmental organizations (foundations, corporations, etc.). While this is important, it is unlikely that even if Gates does not continue its support for programming, the bigger threat to major malaria funding sources – i.e. governments – is the current weak global economic environment.

We can all agree that Bill and Melinda Gates have influence. Currently they are using it to advocate to other wealthy individuals, corporations and foundations to contribute more toward charitable pursuits. In the area of malaria, they can also advocate with governments – both donor and endemic – to maintain and increase their financial support for malaria control and elimination. By then the new malaria tools deriving from Gates-supported research may be ready to carry elimination into eradication world-wide.

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