The billion dollar effort against malaria

My goal for the blog is to achieve one post every day. Clearly, I’ve missed that mark, blogging while traveling is a trick which might take me some time to master. Until then, my apologies for any lapses in news and comments.

Last week Nature carried a commentary from Mark Grabowsky, malaria manager at the Global Fund (previously mentioned here), as part of a special on malaria. The premise of the special is – now that we (the malaria control community) have money, what do we do? Dr. Grabowsky mentions a few ideas: integrating prevention, rapid treatment, and the need for monitoring systems. The last point should have been bolded in the article. If a priority list were to be made for what we should do next, I would rank it first. Good surveillance doesn’t require a lot of money – what it needs is a fundamental committment to data driven decisions. Quality surveillance is the first and most basic requirement for a successful control effort without which, in Dr. Grabowsky’s words, we are indeed flying blind.

Another key take-home from the article is Dr. Grabowsky considers providing access to prompt treatment a greater challenge than delivering bed-nets. There are numbers to back that assertion and the conclusion is not surprising as the lack of functional health infrastructure (consisting of physical centers, trained staff, and adequate supplies) is a greater impediment to providing treatment than to distributing bed-nets which can often be piggy-backed with other campaigns. Health infrastructure is vital for antimalarial treatment, for preventing overdiagnosis and drug resistance, and is an overall health multiplier. Health development efforts have traditionally shied away from directly investing in this area but the picture is changing – the Global Fund now allows such spending as a portion of a country’s grant. For all the challenges we still face, we are learning lessons and applying them.

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