Malaria déjà vu, Gates, and the politics of eradication

When Melinda Gates ushered the eradication word at a meeting last October, she certainly took the malaria community by surprise. The New York Times examines the reaction to the Gates Foundation’s goal in which responses to eradication have ranged from “audacious” to “foolhardy”. Given the history of malaria eradication, many are skeptical. The previous attempt at eradication from 1955-69, which while having many successes, failed in its ultimate goals. The long-term consequences of the Global Malaria Eradication Program included a lack of malariologists and the dismantling of malaria control infrastructure leading to terrible resurgences in many countries. The WHO malaria chief Dr. Arata Kochi, who has other complaints against the foundation (previously posted here), also dismisses eradication as counterproductive. Supporters, like Sir Richard Feachem who was the first director of the Global Fund, counter we are in a different era with the public exposure, political support, funding, and control tools to make eradication a reality.

With polio not yet eradicated, though tantalizingly close, I wonder if this pronouncement was premature? Regardless, of one’s position on malaria eradication, we should broadly consider how many eradication programs are simultaneously possible or desirable? The eradication debate will continue though one concern of many scientists is the loss of Gates Foundation support to those who do not preach the gospel of eradication. It will be interesting to see how the cards play out.

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