Singers like me don't often go to scientific conferences. Science and singing seem as far removed from each other as malaria is from mbaqanga. But the scientific conference I am attending this week in Durban, South Africa, is no usual gathering of ivory tower academics. It is the malaria community's largest meeting in four years - the 6th MIM Conference (Multilateral Initiative on Malaria malaria).
At the MIM, the scientific community exchanges information on the latest developments in malaria research, so as to keep fresh ideas flowing and to sustain the spirit of sharing and innovation that moves the malaria fight forward. Leading researchers connect with decision-makers, policy-makers, health workers, and advocates. Dialogue is lively; experts from diverse organizations and sectors come together to talk openly and build bridges for future action. They know all too well that ending malaria is too big of a task for any single government, organization or business.
It was at a MIM conference in Yaoundé that I met the malaria community for the first time back in 2005 when I began my service as a Goodwill Ambassador of the Roll Back Malaria Partnership. This is where I came to appreciate for the first time the technical complexity of malaria control.
Anti-malaria tools - bed nets, diagnostics, drugs and insecticides are to be conceived, tested, approved, manufactured, purchased and delivered to endemic countries at the best cost and at the right time. They need to reach people through deficient supply chains. Suspected malaria fevers need to be correctly diagnosed and handled competently by trained health workers in clinics and health centers. In places where health systems are too weak to do the job, community workers need to be trained to deal with malaria cases. People living in malarious areas need information and education to be able to take responsibility for their own health and the health of their children.
Establishing malaria control programs takes first and foremost political will and resources. But making them work requires much more than that; it takes first-class scientific knowledge, technical know-how and robust organization. And while multiple partners in the malaria community work tirelessly to put all this in place, the parasite pursues a single goal: survival. The malaria parasite changes fast, learns new tricks and, sooner or later, succeeds in circumventing the best man-made defenses. Over the past several decades, it has developed resistance to one antimalarial after another. If today's emerging resistance is not successfully contained and artemisinin-based combination therapies (ACTs) and key insecticides are lost, malaria deaths and cases will likely skyrocket in no time, reversing one of the greatest public health achievement in the past decade.
This is why investing in continuous research is so vital. Staying one step ahead of the parasite is not optional. It is a critical success factor in the malaria fight. Without continuous research and a well-funded, vibrant research community we would not have come that far in malaria control and we stand no chance of going much further.
Fortunately, thanks to public and private funding, malaria research today is gaining speed. Newly founded product development partnerships have expanded the pipeline of innovative technologies to include new drugs, diagnostics, insecticides and vaccines. In addition to product development the malaria community needs continuous operational research to understand how to use currently existing tools at their best capacity in the specific context of each country.
Putting science to the service of humanity is not the job of scientists alone. Even the smartest scientific advances will do no good, if they don't reach the people in need or if they are not used well. This is where organizations like the Global Fund come into play. The Global Fund, malaria's main financier, pays the way life-saving commodities travel from manufacturers to poor people with no means to protect themselves from illness and death.
Thanks to malaria control scale-up strategies, coordinated through the Roll Back Malaria Partnership and funded primarily by the Global Fund, malaria-endemic countries across the globe have achieved stunning progress. Malaria deaths in Africa have decreased by one-third; worldwide -by a quarter, compared to year 2000. More than a million lives have been saved from malaria since the year 2000, most of them among children under 5 years of age. Many more can be saved over the next 2 years, if the Global Fund is fully replenished this December.
The Global Fund helps countries to not only access antimalarial interventions but also find out how to use them to achieve the best impact at a reasonable cost. As countries receive grants through Global Fund, they are encouraged to spend 5 to 10 per cent of their grant budget on monitoring and evaluation, which includes relevant operational research. This is a valuable opportunity that African countries are yet to fully benefit from. I believe that Africa needs to seize every chance to build solid home-grown research capacity and train qualified researchers. To be able to make sustainable progress in its malaria fight, Africa should lead in conducting research for a disease whose victims are primarily Africans.
I am a singer, not a scientist, but I feel at home at this scientific conference. I am here to add my voice to the chorus of activists who fight for keeping the malaria fight on the global agenda and giving it the means it needs to make malaria history.
References
1 A rhythmical music style with Zulu roots