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Wiping out malaria

By Tim Ziemer, John Bridgeland and Mark Grabowsky
November 12, 2007

Last week, scientists on three continents confirmed what we had hoped — that there has been a dramatic reduction in malaria deaths and infections on the islands of Zanzibar on the east coast of Sub-Saharan Africa. That same week, we participated in the national launch of an anti-malaria campaign on another island in Africa: Madagascar. The world is mobilizing to attack the single leading cause of death among children in Africa — a preventable and treatable disease called malaria — and good progress is being made.

Every year, malaria kills more than 1 million people worldwide, and 30,000 in Madagascar. Most are pregnant women and children under five. Clinic after clinic we visited in Madagascar had thousands of patients admitted for various causes, but the predominant cause was malaria. This disease of sad contradiction is one the world can stop.

The good news is that Madagascar welcomed to its island shores international and domestic organizations that are working collaboratively to support the country's audacious goal of eliminating malaria by 2012. Among them were both the American and Canadian Red Cross; the Global Fund to Fight AIDS, TB and Malaria; the President's Malaria Initiative, led by the U.S. Agency for International Development; Malaria No More; the Roll Back Malaria Partnership; the Canadian International Development Agency; UNICEF; and the United Nations Foundation. Most observers who participated in the Mother and Child Health Week believe the goal of elimination can be achieved with a smart combination of indoor residual spraying of homes to kill the mosquitoes that transmit malaria, the distribution of bed nets under which families sleep at night and drugs called ACTs that fully treat malaria.

After the national launch in the public square of Fianarantsoa, the home of the charismatic and strongly committed president of Madagascar, Marc Ravalomanana, leaders in the campaign spanned out across the country to participate in village distributions of Vitamin A supplements, de-worming tablets, measles vaccinations and insecticide-treated bed nets to protect families from contracting malaria. Two of the authors, together with the RBM and UN Goodwill Ambassador Yvonne Chaka-Chaka, visited the Ankazomiriotra village. What we saw was a sea of hope.

More than 800 mothers and their children waited patiently in lines to protect their children from the ravages of disease. We distributed bed nets to families whose smiles showed their gratitude. Many mothers we interviewed had walked more than 10 miles that morning with their children in tow; health clinics and village leaders had spread the word rapidly throughout their districts; and posters advertising the campaign blanketed every region of the country.

In a private conservation with President Marc Ravalomanana, he expressed his gratitude for President Bush's Malaria Initiative, the Global Fund, Malaria No More, American Red Cross, UNICEF and others, but his biggest interest was "ensuring the reality on the ground took full advantage of these new resources."

Leaders of the ground campaign in Madagascar, principally led by UNICEF, brought together leading institutions in prenatal care, nutrition, primary and secondary education and more to launch a coordinated attack that would not only conquer disease but would give children the tools they need to grow and develop.

Something unexpected happened to us in Madagascar. As we sat in a village holding children and distributing bed nets to their parents, we found ourselves not only helping to prevent disease but also creating a new reality of hope.

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