Tackling Malaria: Making Headway Against a Killer

News about global health is often sobering. I'd like to highlight something the international community is increasingly getting right: tackling malaria.

We've been fighting mosquito-borne disease since 800 B.C. though - officially - the "global fight" started in 1955, when the World Health Organization (WHO) launched the first Global Malaria Eradication Program.

Unfortunately, that program quickly fell apart. The "one size fits all" strategy of 1955 ignored differences among cultures, governments and the various malaria epidemics themselves. In most countries, any positive results were negligible. We learned a lot from those mistakes. And a half century later, there's cause for some hope in the long battle against the disease.

At the frontlines stands the nation of Rwanda, a country that has known more than its share of troubles since independence. Yet the government of Rwanda is now proving to be one of the boldest and most important global leaders in malaria control efforts. As recently as 2004, the disease was responsible for more than half of all hospital cases in Rwanda, with most deaths occurring in children under five.

But in 2006, the government took the matter into its own hands; it called on its global health partners (like PSI) to support it in a new national strategy, more aggressive, comprehensive and country-specific than any ever seen. Under the Rwandan government's leadership, we threw every possible malaria intervention at the disease -- nets, drugs, household spraying and local capacity-building -- and we did it faster than ever before.

In 2006, the Rwandan government in partnership with PSI delivered 1.3 million nets in one month, ensuring that nine out of every 10 children under five slept under a free net. In 2007, another 1.7 million nets were delivered to pregnant women and newborn children. Seven out of every 10 households were now covered.

At the same time, we increased access to malaria treatments, making them available in 100% of public clinics and interested local pharmacies, and providing community health workers with the knowledge and drugs administer in rural areas, where malaria was most common.

The results of these measures and others are astounding: Rwanda has cut the number of deaths due to malaria by 60% in just 18 months. And hospital beds that used to hold multiple patients now hold only one or are empty.

So what have we learned? First, success is achievable -- we have the tools to prevent and treat this disease. Second, partnerships are vital -- without organizations like the WHO, UNICEF, and (immodestly) ours, or funding agencies such as USAID and the Global Fund, Rwanda's success would not have been possible.

And finally, and most critically, we learned that national governments and national leadership are key -- while the international community was ready with the resources, the Rwandan government ensured those resources would not go to waste.

All the groups involved in the fight against malaria have now agreed to a plan of action, known as the Global Malaria Action Plan ( That plan is building on Rwanda's success, coordinating efforts between countries, donors, NGOs and other partners to ensure the best return on resources.

Rwanda is a welcome reminder that, learning from past experiences and working in partnerships, the world can make headway against a killer that has defied us through the ages.