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Pathogens, public health and political will: why sustained leadership is essential

So far, two decades of investments in malaria have saved 7.6 million lives and prevented 1.5 billion cases of malaria. But progress stabilized at the end of 2019 with declining political will and funding. Credit: Mercedes Sayagues / IPS
  • Notice by Joy Phumaphi, Sarthak Das
  • Inter Press Service

In our estimate, one theme is quite clear: Effective management of COVID-19 through consistent public health responses protecting their population is underpinned by strong leadership. For months now, we’ve been operating largely with the same set of public health guidelines such as physical distancing and masking.

From Singapore to Spain, from Mauritania to Manhattan, however, the results have been radically different. Yes, testing, monitoring and treatment capabilities vary widely; the poor are more at risk. Even with these disparities, it is clear that leadership is essential: from the acceptance of scientific advice to the role of communities in translating policies into action.

When national leaders decide to prioritize an issue, there is no doubt that progress will follow; malaria is a prime example. After two decades of strong political commitment and effective interventions, 21 countries in every region of the world have eliminated malaria and many more are on the verge of it. 7.6 million deaths have been prevented since 2000.

How then, in the midst of a global pandemic, can we accelerate the fight against malaria? Indeed, what are the relevant lessons of malaria for public health amid COVID-19?

Three areas are critical to re-building momentum and ensuring that malaria elimination remains a viable goal.

First, we must maintain the political will that drives leadership at many levels – from families to communities to districts to the national level.

Second, we need sustainable financing to fight malaria and to communicate effectively to leaders the return on investment in terms of improved health outcomes.

Third, we need to clearly articulate the link between malaria and strengthening health systems.

  1. Leadership and continuous renewal of political commitment

Progress to date has shown that political will is fundamental for elimination. The leaders of the two regions have demonstrated this political will.

From the 2000 Abuja Declaration, the 2006 Abuja Appeal, the 2012 African Union Roadmap, the 2013 Abuja Declaration to the 2014 Commitment of Summit Leaders East Asia to eliminate malaria in Asia-Pacific by 2030 and to the commitment of African heads of state and government to eliminate malaria also by 2030.

We believe this with continued political leadership; strengthened by increased funding from the public and private sectors to expand access to life-saving tools, we can – and must – end malaria. The creation of the Global Fund to Fight AIDS, Tuberculosis and Malaria, the Presidential Malaria Initiative as well as ALMA and APLMA are due to this political commitment and demonstrate shared responsibility and global solidarity.

To effectively translate political will into action and impact, subnational leadership at district, provincial and state levels is also essential, especially as elimination approaches. Strong local leadership can support subnational adaptation of interventions based on locally available data to maximize impact in both Asia-Pacific and sub-Saharan Africa.

To drive the malaria response, coherently joining the dots between all levels of government, from heads of state to the heart of communities, including the most vulnerable and hard to reach, is the only way to achieve success. ensure lasting change.

  1. Support funding for malaria

Political will translating into financial commitment for malaria must be sustained. We have come this far and have a historic opportunity to end a preventable and curable disease at a time marked by the devastating effects of communicable diseases.

So far, two decades of investments in malaria have saved 7.6 million lives and averted 1.5 billion cases of malaria, dramatically reducing the burden on the world’s health systems, improving health , the survival and prosperity of mother and child.

But WHO World Malaria Report 2020 shows progress capped at the end of 2019 with declining political will and funding. The stakes are too high if we do not maintain the momentum on the gains we have made to date: malaria can take a huge toll on economies, having a detrimental impact on the GDP of some countries by around 5 to 6 %.

It was estimated that the “Penalty” against malaria GDP ranges from 0.41% of GDP in Ghana to 8.9% in Chad, all of which could be recovered after the elimination of malaria. Complete disease eradication would increase Uganda’s GDP by USD 50 million.

In Asia, despite the progress made, eliminating malaria has the potential to save more than 400,000 lives and prevent 123 million cases of malaria, resulting in nearly $ 90 billion in economic benefits for Asia-Pacific.

African countries deploy and lead multisectoral malaria councils and funds, which keep malaria high on political, development and local funding priorities. These institutions have resulted in increased action by the private sector and the public, supporting country responses.

The surge in investments to end malaria is the path to eradication and will strengthen our ability to respond to future threats in this pandemic era. Investments in malaria have supported the strengthening of community health workers who serve as eyes and ears on the ground for millions of children, adolescents and adults with fever that do not reach centers health.

  1. Fighting malaria to strengthen health systems

The fundamental but most critical element in the fight against malaria, the management of infectious diseases and public health in general is to: test, monitor and process. Strengthened surveillance, real-time data and diagnostics are essential for the early detection of malaria and other infectious diseases like COVID-19.

Africa established the Africa CDC and its regional collaborating centers to support African countries in their efforts to strengthen health systems and improve disease surveillance, emergency response, prevention and control. Asia-Pacific countries are seeking to put in place similar mechanisms in the aftermath of the pandemic.

Countries that have invested in frontline malaria capacity and interventions – especially community health workers – are now effectively leveraging them for the COVID-19 response. Last year alone, malaria control efforts prevented an estimated 500 million fevers, and one million community health workers equipped with rapid diagnostic tests for malaria diagnosed 267 million fevers. Seven of the ten symptoms overlap between malaria and COVID-19, driven by fever.

This demonstrates the importance of integrating malaria surveillance into the wider health system. From 40,000 health extension workers and about three million Women’s Development Army volunteers in Ethiopia, 33,000 frontline health workers trained in Uganda, to 1 million village health volunteers in Thailand – all are dealing with COVID -19 while continuing to provide effective management of malaria cases during the outbreak.

If there is no quick fix to eliminating malaria, proof suggests that investments in malaria control can in turn strengthen health system preparedness and help protect against current and future pandemics.

On this World Malaria Day, we must come together as political, social, religious, administrative and economic leaders and reaffirm the political will and combined action to protect our people, to accelerate the gains against malaria and to harness the benefits. investments in malaria to fight COVID-19 and emerging diseases.

We have the tools and technology to test, track and treat the most common forms of the malaria parasite. Countries like Bhutan or Botswana have shown us the possible progress; ranking the ten most affected countries in Africa as well as Asia-Pacific countries like India, Indonesia and Papua New Guinea reveal what remains to be done.

We know that these challenges can be met; seizing this moment to redouble our efforts to accelerate the task of eliminating malaria while strengthening health systems is not only possible, but essential for our planet in the era of pandemics. To support this, platforms that enable the exchange of expertise between leaders across districts and across national borders, which help to monitor policy progress towards the end goal and stimulate accountability, can help make a difference.

Ms. Joy Phumaphi is Executive Secretary of the Alliance of African Leaders Against Malaria (ALMA), former Minister of Health, Botswana

Dr. Sarthak das is DrPH, Managing Director, Asia Pacific Leaders Malaria Alliance (APLMA) & Transmicable Disease Threats Initiative

© Inter Press Service (2021) – All rights reservedOriginal source: Inter Press Service


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