Dear Colleague:
To me, malaria is a very personal disease.
I first came face to face with malaria during the war of my time: Vietnam. I was plucked out of residency after my first year, with only an internship under my belt, and sent as a Navy Medical Officer to war.
Medical school and residency prepared me well for much of the trauma I encountered medically, but I was totally unprepared for the large-scale
emotional trauma, and for the tropical diseases I had encountered only in books.
I was overwhelmed by the young children with malaria, some of whom literally died in my arms while treating them.
Yet, I also witnessed bona fide miracles: children at death's door, comatose and unresponsive, who responded dramatically to treatments, and ultimately went home to their families.
To address malaria, we focused on promoting prevention (long-lasting insecticidal nets [LLINS] for families and intermittent preventive treatment [IPT] for pregnant women),
early detection, and early treatment in the
community -- what is now called community case management.
That was 40 years ago.
Despite decades of effort addressing malaria and reductions in disease and death rates over the past ten years, malaria remains a major killer around the globe -- especially in Africa.
Each year, there are approximately 219 million malaria cases and about 660,000 people die from malaria- related causes. Sixty-eight percent of malaria-related deaths occur in the world's ten high-burden countries -- nine of which are in Africa.
We know that investing in fighting malaria is money well spent.
Since 2000, these investments have helped to save over 1.1 million lives and reduce Africa's malaria-related mortality rates by one-third.
The principles I learned in Vietnam still hold true today. Addressing malaria in pregnancy is critical for reducing both maternal and newborn malaria-related mortality.
Malaria in women contributes significantly to miscarriages, premature birth, labor complications, low birth weight babies, maternal anemia, chronic anemia, and maternal and newborn death.
By integrating malaria prevention and treatment into existing maternal health programs, we ensure that pregnant women receive the care and information needed to keep themselves and their babies healthy.
Countries have committed to eradicating malaria, and MSH is helping them to implement evidence-based tools and develop new approaches. Specifically, we work with local, national, and global partners to:
- Train community health workers in integrated
community case management of malaria, diarrheal diseases, and pneumonia in countries such as Afghanistan, South Sudan, Democratic Republic of the Congo, Haiti, and many others;
- Improve tools for distributing LLINs through integrated primary health care services, such as antenatal care and expanded programs on immunization (EPI) services;
- Introduce artemisinin combination therapy (ACT) into malaria programs worldwide (a strategy that has contributed to significant reductions in incidence and mortality from malaria during the last decade);
- Develop innovative monitoring and evaluation approaches to ensure progress is measured and activities adjusted to meet the ever-changing epidemiology of malaria; and
- Build community outreach and behavioral change communications
strategies to enlist active community participation in malaria control.
All our gains could be wiped out in a few years if we do not maintain our vigilance, invest in the future, and support active malaria detection and treatment interventions in both health facilities and communities.
April 25 is World Malaria Day.
Please join me, MSH, and the World Health
Organization (WHO)'s Roll Back Malaria Partnership in calling for an investment in the future to defeat malaria.
We must prioritize integrated programming for malaria, particularly in the face of the current economic crisis and funding cutbacks. Malaria is always lurking, waiting to seize any opportunity to spring back, even in areas where we have controlled the disease.
Let us learn from history and "sigue la lucha"---continue the fight. A. Frederick (Fred) Hartman, MD, MPHGlobal Technical Lead for Communicable Diseases and Epidemic Preparedness Management Sciences for HealthP.S. Do you have a story about malaria to share, or comments about my note? Post your comments and ideas on our blog.
