This week I've been in Geneva for 28th Board Meeting of the Global Fund to Fight AIDS, Tuberculosis and Malaria and I've had the chance to talk with many colleagues who work on these diseases all around the world. It has been a great opportunity to catch up and a timely reminder of the incredible impact and progress that we have seen in the fight against these three diseases over recent years - and, of course, the challenges and opportunities that remain. Please check out an old friend and colleague Allan Ragi's Here I am video, which is a personal reflection on what the Fund can do when fighting the 3 diseases. And, as a final reflection from this week, I would like to share the story of Swaziland's fight to end malaria within its borders.
Nearly 30% of Swaziland's population is estimated to live places that are at risk for malaria, yet through strategic planning and stable financial support for essential malaria prevention, diagnosis, treatment and surveillance measures, the prevalence of malaria has been reduced to a mere 0.2%. Between July 2011 and June 2012 there were only 643 reported malaria cases--down from a peak of over 45,000 cases less than 20 years ago (1994-95) and as many as 6,500 cases merely 5 years ago. With support from the Global Fund and other partners, Swaziland has succeeded in slashing confirmed malaria cases by an impressive 74% between 2000 and 2012.
The Global Fund has provided significant support to Swaziland's efforts to defeat malaria. Thanks to this support together with strong partners and a committed government, Swaziland has been able to pursue an even more ambitious goal - to become malaria-free! This has been made possible thanks to the Global Funds' support of more than just the essential tools (such as mosquito nets, insecticides, tests and medicines) but also strong coordination and surveillance to ensure these tools are deployed where and when they are most needed.
To this end the Global Fund has supported the establishment of technical support teams to ensure effective prevention, diagnosis and treatment of malaria, along with a 13-person surveillance team that tracks every detected malaria case to their household residence. For elimination countries like Swaziland, strong surveillance systems are essential to enable a quick response to potential outbreaks, especially as malaria is able to rebound quickly if vigilance is not maintained. Without these crucial surveillance activities it will be near impossible for the country to achieve its goal of becoming malaria-free.
It is hard to over-emphasize the vital role of the Global Fund in the fight against malaria, not just in Swaziland, but around the world. The Fund represents half of all international funding to tackle the disease and it has helped stimulate significant global progress: with deaths from malaria in Africa reduced by a third since 2000. However, this preventable and treatable disease still kills a child every minute. The job is not yet done, not even in Swaziland. We cannot afford to lose momentum now. That is why I am supporting the Big Push initiative. We can roll back malaria, country by country, as the progress in Swaziland shows.
Swaziland, despite its small size, provides a crucial big-picture perspective on how the $22.9 billion invested around the world by the Global Fund since 2002 has successfully saved lives and driven one of the world's oldest and most lethal diseases closer to extinction. And perhaps most cogently, Swaziland provides compelling evidence for fully funding the Global Fund in 2013 and for the years to come.
Swaziland's Minister of Health, the Honorable Benedict Xaba, aptly described the crossroads at which the Global Fund and its partner countries currently find themselves in the recently launched Roll Back Malaria report documenting Swaziland's progress toward malaria elimination:
"We recognize that we will face several challenges on the road ahead, including the continued threat of case importation from neighbouring high endemic countries, and the task of sustaining the gains we have made in what is likely to be a less supportive donor environment. However, we believe we can achieve our goal through the strong partnerships we have developed, especially our cross-border collaborations with neighbouring countries, and increasing responsibility from our own government. We would not be where we are today without a shared commitment to realizing a malaria-free southern Africa."
In my mind, Swaziland is a powerful example of what a country can achieve when a critical blend of political will, funding, and evidence-based solutions are powerfully united. As the Global Fund prepares to implement a new funding model and assesses how to continue supporting successful malaria control efforts, it is essential to give voice to these stories, to show how historic progress in global health can be achieved with a focused combination of political will and resources. The Global Fund can and must remain at the forefront of this fight.
Lucy Chesire: TB-HIV advocate from Kenya, Alternate Board Member of the Global Fund Board Communities Delegation
About the Here I Am campaign: The Here I Am campaign is a global call on world leaders to save millions of lives by supporting a fully funded Global Fund to Fight AIDS, Tuberculosis and Malaria. Here I Am brings the voices of people that are directly affected by AIDS, TB and malaria into dialogue about decisions that affect their lives and the lives of millions of others in their countries. Through video testimonies from all over the world, campaign ambassador advocacy, online actions and on-the-ground mobilizations, the Here I Am campaign is building collective power to end three of the world's most deadly diseases. www.hereiamcampaign.org.