Fighting Malaria in Africa

July 22nd, 2013

One Death Every 60 Seconds

In one sense, the statistics are encouraging. Just a few short years ago, children in Africa were dying from malaria at a rate of one every 30 seconds. Thanks to malaria eradication efforts such as the United Methodist-supported Imagine No Malaria program, the World Health Organization (WHO) now estimates that the rate has been halved.

What this means, however, is that a child still dies every minute from this preventable disease. The cost to African development from malaria, according to the NetsforLife program in Africa, is an estimated $12 billion annually in lost productivity. In 2003, the World Bank estimated that the gross domestic product (GDP) in sub-Saharan Africa is 32 percent lower than it would have been if malaria had been eradicated in 1960.

Why does a disease that has largely disappeared from the developed world continue to exact such a heavy toll on Africa? What sort of progress has been made in fighting the disease, and what remains to be done? What can Christians in North America do to support these efforts?

Taking Up Her Mother’s Work

The Reverend Adlene Kufarimai, now a provisional elder in the North Alabama Conference, has seen the impact of malaria firsthand. Growing up as one of eight children in the African nation of Zimbabwe, Kufarimai saw her mother, a health worker with the World Health Organization, educating African communities about malaria. “My mother spent most of her time going from village to village, inspecting areas around homes that could be breeding areas for mosquitoes,” Kufarimai writes in an article on the Imagine No Malaria website. “She also educated villagers on preventative measures such as covering stagnant water, protecting water wells and taking the full course of malaria medication.”

Kufarimai credits her mother with saving many lives; and today Kufarimai is continuing her work as a field coordinator with the Imagine No Malaria program, a United Methodist initiative to expand the denomination’s work in the area of malaria eradication. Recently, her sister in Malawi almost died from cerebral malaria, an experience that brought home the importance of her work. “I believe God has put me in this position for a reason,” she says. “The death rate due to malaria calls me to participate with enthusiasm and passion to the call of saving lives because mine has been saved, and I am thankful.”

A Small Insect With a Big Bite

Mosquitoes, despite their size, are the biggest players in the story of malaria. Malaria is spread between humans when a female Anopheles mosquito (prevalent in Africa) that has bitten an infected person then goes on to bite someone who is not infected. Therefore, most of the prevention methods related to this disease focus on the insect.

Malaria kills about 655,000 people a year, 90 percent of them in sub-Saharan Africa. But even with this high death toll, most cases of malaria don’t end in death. It is the high frequency with which people contract the disease and the vulnerability of certain populations (the poor, children under five, and pregnant women) that put them at risk. Healthy adults might be bitten twice a day by malarial mosquitoes during certain seasons and not be hospitalized, but other populations are affected more severely. Brian Greenwood, a malaria expert at the University of London School of Hygiene and Tropical Medicine, told National Geographic News that “malaria is the commonest cause of admission into pediatric wards.”

A Sportswriter Spurs a Net Campaign

One of the most effective ways to combat the Anopheles mosquito is with nets. Simple bed netting, treated with a long-lasting insecticide, can keep sleepers free of bites and reduces the mosquito population. The Nothing But Nets campaign reports that these nets, each of which can cover up to four people, can reduce malaria transmissions by 90 percent in areas where they are widely used. Spraying the interior walls of a home with insecticide can produce similar effects.

The Nothing But Nets campaign began in 2006, spurred by a Sports Illustrated column written by sportswriter Rick Reilly. Reilly challenged sports fans and sports leagues, especially net-using leagues like the National Basketball Association (NBA), to contribute to a United Nations Foundation effort to get $10 nets to Africa. “I tried to think how many times I have said or written the word ‘net’ in 28 years of sports writing, and I came up with, conservatively, 20,000. So I’ve already started us off with a $20,000 donation,” Reilly wrote back then. “That’s a whole lot of lives. Together, we could come up with $1 million, net. How many lives would that save? More than 50 times the population of Nett Lake, Minn.”

The Nothing But Nets campaign that sprung up in the wake of this challenge quickly gained major supporters such as the NBA, Major League Soccer, the Bill & Melinda Gates Foundation, and The United Methodist Church. The campaign supports the work of the United Nations Foundation by raising funds for the nets and working with UN agencies to get them to people in Africa. The net distributions generally come as part of broader public health efforts in the receiving countries.

One Step Further

“Reading scripture calls us to action. James tells us to be doers of the word. The world is calling out for help.” With those words, Bishop Thomas Bickerton of the Western Pennsylvania Conference urged the 2013 meeting of the Missouri Annual Conference to support the ongoing efforts of the Imagine No Malaria (INM) campaign. INM is a United Methodist campaign that builds on the work of Nothing But Nets. Part of the denomination’s Global Health Initiative, INM began with a commitment of $75 million to help Africans achieve sustainable victory over malaria. Four years later, the initiative just reached a benchmark goal of $40 million ahead of schedule.

INM goes beyond Nothing But Nets in focusing on more than preventing the spread of malaria. Prevention remains a key component of this comprehensive approach; and through this campaign, 1.2 million nets have been distributed, according to the initiative’s website. But the initiative also focuses on education, communication, and treatment.

INM representatives have trained more than 5,400 community health workers, recognizing that “local people are the most credible and trusted source for information about malaria.” The initiative’s use of these local workers reflects learnings from previous efforts in which net distribution was seen as simply a matter of getting products to the location. Nets were sometimes misused or resold without getting them to the people who needed them. Now the community health workers will open the bags in which the nets are sent (inhibiting resale) and will demonstrate to families how they are to be used, even helping them hang the nets and monitoring their use.

Beyond this training and education effort, INM also focuses on communicating information on the use and care of nets through word of mouth and even radio broadcasts on a United Methodist-run radio station in Cote d’Ivoire (Ivory Coast). The initiative wants to improve treatment for malaria through the 300 hospitals, clinics, and health outposts that United Methodists support throughout Africa. The initiative says these facilities “are a vital and trusted part of the healthcare delivery system on the continent. We are in many hard-to-reach places, beyond the reach of many aid organizations, sometimes even governments.”

A Million and One

Ellen Johnson Sirleaf, president of Liberia and a United Methodist, said in a WHO update, “During the past eight years, scaled-up malaria control helped us avert over a million deaths.” This is progress we can celebrate, but there are signs the progress is slowing. The 2012 WHO report on malaria noted that funding remains far below what is needed; the expansion of indoor residual spraying programs has leveled off; and net distributions have fallen to less than half of what they were at their peak in 2010, when 145 million nets were distributed in sub-Saharan Africa.

“We must maintain this momentum and do our utmost to prevent resurgences [of malaria],” says Sirleaf, who also serves as chair of the African Leaders Malaria Alliance. Without this, the WHO says the current slowdown in progress “could threaten to reverse the remarkable recent gains in the fight against one of the world’s leading infectious killers.”


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