‘One of the worst things I’ve ever seen, years ago in Tanzania, was a child having seizures from cerebral malaria. I didn’t know if he would survive. I did know that, even if he did, his brain development would be impaired.’ Bill Gates (Co-founder, Bill & Melinda Gates Foundation)
Last week 53 Commonwealth Leaders met in London with a wide-ranging agenda to discuss how the Commonwealth can contribute to a future which is fairer, more sustainable, more secure and more prosperous. Attention focused on malaria, which still causes one out of ten child deaths in Africa, and costs economies billions every year. The number of deaths by malaria declined 50 per cent between 2000 and 2015. However, the declining trend in malaria cases and deaths has stalled and even reversed in some regions, where global investments have plateaued. Challenges today include increased resistance to the drugs and insecticides, which pose a serious risk to global health security.
“We knew malaria. We knew malaria intimately. So intimately that we recognized the specific contours of its affliction. My malaria always came with an unbearable rumbling, aching feeling that I can only describe as an anguish in my stomach. It left me light-headed, weak, nauseous, helpless.” Chimamanda Ngozi Adichie (Author & storyteller)
The Malaria Summit, London, on 18 April 2018, took place on the eve of the Commonwealth Heads of Government Meeting (CHOGM) and saw 12 Heads of State and Government, 2 Vice Presidents, The Prince of Wales, The Duke of York, Bill Gates, scientists, private sector and international organisations, including the World Health Organization, making significant commitments that will catalyse progress towards beating malaria.
The Summit, co-hosted by the Governments of Rwanda, Swaziland, and the United Kingdom, under the theme of ‘Ready To Beat Malaria’, garnered collective commitments worth over $4.1bn¹
Bill Gates set the scene for the meeting in a powerful speech that challenged the audience to bring new innovations and tools to the fight against malaria. ‘If there is one lesson we have learned,’ he said ‘it’s that we have to keep innovating to control malaria, because conditions evolve. The mosquito and the parasite develop resistance to the interventions we use to fight them. People move around and constantly change the patterns of transmission… Because conditions evolve, we must evolve too…What got us where we are today – blanket coverage with a small handful of tools – will not get where we want to go tomorrow.’
Gates shared the new innovations coming to market from surveillance tools; prevention using new generation insecticides and impregnated bed nets; to rapid diagnostic tests and new drug treatments. With a first generation vaccine (RTS,S) commencing trials; and, innovations which are showing real potential, like gene drive, a method of self-sustaining genetic change that causes mosquitoes to be infertile or prevents them from carrying the malaria parasite. If the resources can be devoted to rolling out these new innovations, the future without debilitating malaria looks feasible.
Prince Charles, The Prince of Wales, gave the second keynote speech of the day, focusing on why malaria is an issue which not only profoundly affects the Commonwealth, but that is also within the grasp of its members to tackle.
‘Happily much can be done when people are determined to work together. An example of this is Sri Lanka, when I first visited in 1998, the country recorded nearly a quarter of a million cases of malaria. Today, twenty years later, Sri Lanka has completely eliminated the disease and has been declared a Malaria-free zone.’ HRH Prince of Wales
Whilst the sums of money pledged were impressive, they will not meet the scale of needs. However, the commitment made by leaders in the CHOGM 2018 Communiqué holds real potential to make a shift change in political commitment to tackle this issue:
‘Heads welcomed global, regional and national efforts to combat malaria and other mosquito borne diseases, and committed to halve malaria across the Commonwealth by 2023. They also urged acceleration of efforts to reduce malaria globally by 90 per cent by 2030….. Heads agreed that progress on these commitments should be considered every two years at the Commonwealth Health Ministers’ Meeting and progress should be reported at CHOGM.’ Extract CHOGM 2018 Communiqué, paragraph 34.
The Commonwealth commitment demonstrates the importance of collective leadership and is a benchmark for renewed global attention and action against malaria. With Rwanda taking up the chair of CHOGM from 2020 there is a genuine opportunity for continued global leadership for the fight against malaria.
Oshun Executive Director, Sarah Beeching said ‘This is a disease that has no borders and our approach to ending malaria cannot either. It has been a huge privilege to work with partners at Malaria No More (UK), the RBM Partnership and the Bill & Melinda Gates Foundation to deliver the Malaria Summit. What marks this Summit as different, is not the financial commitments, impressive though they are, it is the political will generated, as evidenced in the Communiqué. If governments follow through on this commitment and devote the resources necessary, I truly believe can eradicate this terrible disease for good.’
¹Financing commitments included:
- $2bn domestic co-financing from malaria-affected countries to the Global Fund
- $1bn funding from Bill & Melinda Gates Foundation.
- $230million from the UK Government
- Private sector investment in R&D: GSK ($251m); Novartis ($100m), Sumitomo Chemical ($10m p.a.); Wellcome Trust ($142m)
- Nigerian Government ($318.7m): including World Bank, Islamic Development BankandAfrican Development Bank; President’s Fund ($18.7m); Global Fund ($37m)