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On the occasion of World Malaria Day, we would like to take you on a journey to a town in northern Senegal, along the western coast of Africa, that looks like many other thriving communities around the world: the children are happy and healthy, many of their parents are employed at a large sugar company, and the local economy is growing. But there is something important that sets this town, called Richard Toll, apart from other communities: its battle with a devastating disease.
Transmitted by the bite of a mosquito, malaria kills hundreds of thousands of people each year – most of them young children in Africa. Although the disease is endemic in Senegal, and the irrigated sugar cane fields (where many of Richard Toll’s residents work) are ideal breeding grounds for mosquitoes, the area has only recorded a handful of cases of locally transmitted malaria in over a year. Thanks to coordinated efforts by the Ministry of Health and the sugar company itself, proven tools recommended by the World Health Organization have been used to roll back the disease. This includes ensuring the availability of effective treatments in health facilities, along with the introduction of handheld rapid diagnostic tests and the mass distribution of free mosquito nets. Now, malaria has been nearly eliminated in the area.
After years of investment and an incredible effort, Senegal now has committed to eliminating the disease across the entire country. It’s an audacious, long-term goal, and one that is being made possible with a strong partnership between the leadership and funding of the Senegalese government in coordination with faith- and community-based organizations, and support from major external funders like the U.S. President’s Malaria Initiative, the Gates Foundation and the Global Fund to Fight AIDS, Tuberculosis and Malaria.
Although Senegal has significantly increased resources to combat malaria, eliminating the disease requires partnership. The story of Richard Toll illustrates how Global Fund funding has helped “jump start” successful national malaria programs – and how investing in the development of durable health programs can rapidly bring down malaria cases and deaths. Coupled with the use of innovative new tools and strategies, Senegal has everything it needs to eliminate the disease. Well – almost everything.
Certainly, World Malaria Day is a time to consider the great progress we have made globally against the disease. But it is also an opportunity to consider what remains to be done to truly defeat it once and for all. Though malaria mortality has decreased by 26 percent globally over the past decade, there are some sobering facts to consider: In countries that have reduced malaria transmission in the last century, 75 resurgences have been recorded since 1930 and nearly all are linked to decreases in resources and the scaling back of malaria programs, according to an assessment published in the Malaria Journal. In addition, a recent report titled Cost of Inaction calculated that, if global funding for malaria were to decrease, the disease could kill up to 196,000 more people and sicken an additional 430 million each year – illnesses and deaths that otherwise could have been prevented. The evidence is clear: A well-funded Global Fund is imperative to be able to finish the work on malaria that we’ve started, and to support countries like Senegal as they chart new strategies to end the disease.
The alternative – trying to maintain high levels of malaria control and prevention measures with no end in sight – is like attempting to put out a wildfire by only extinguishing part of the flames. Experience shows us that if we pull back in our efforts even a little, we can see a resurgence in malaria cases in just a few months. Challenges like the parasite’s growing resistance to our best treatments and the mosquito’s increasing resistance to insecticides make elimination an even more urgent goal. Thus, we are at a pivotal moment in time: If the world was to decrease its commitments to fighting malaria now, it would put at risk everything we have invested -- and the progress we have made -- over the last decade.
So what is life like in Richard Toll, now that the region is nearly free from malaria? Fewer children are getting sick or missing school, there is increased productivity at work, money is being saved or reallocated that would otherwise have been spent on malaria-related costs, health systems are freed up to focus on other concerns, and the overall standard of living is on the rise. It’s wonderful progress, but we aren’t done yet.
The Global Fund launched its Fourth Replenishment in December 2013, the beginning of a rolling, three-year resource mobilization effort. The United States is matching pledges from other donors worldwide - $1 for every $2 donated by other countries, until September 2014. With every dollar absolutely critical to the fight, we must not leave any money on the table.
In the years ahead, the Global Fund will deepen its work with governments and encourage increased private sector investments and domestic co-financing. On this World Malaria Day, will you join us in mobilizing the resources needed to seize the opportunity to defeat malaria once and for all -- and give all communities the chance to be malaria-free like Richard Toll?
Awa Marie Coll-Seck is Senegal’s Minister of Health, and former Executive Director of the Roll Back Malaria Partnership, a global partnership founded by WHO, UNDP, UNICEF and the World Bank.
Dr. Mark Dybul is the Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, the world’s largest public health financier.