Defeating an ancient killer

FOR the 3,000 African mothers who bury children each day due to malaria, a new report by UNICEF offers a ray of hope.

Malaria has been all but forgotten in the U.S., yet it remains the leading cause of death for children under 5 in Africa, killing approximately 1 million people a year. Malaria causes poverty and poverty causes malaria. It is a vicious cycle.

The good news, UNICEF finds, is that over the past two years, new effective medicines and long-lasting bed nets treated with insecticide have been mass-produced to combat this disease. Together, they can cut deaths from malaria by as much as 90 percent.

We can now make sure children and their families sleep under a bed net. We can work with local groups to teach mothers to take anti-malarial drugs when they are pregnant and seek proper treatment for sick children. We can spray walls with safe insecticides so that disease-carrying mosquitoes do not infiltrate homes. We know that these methods, used together, are effective — amazingly so.

Tangible progress is already being made. According to UNICEF, insecticide-treated net coverage at least tripled between 2000-2005 in 16 of the 20 African countries where data was available. UNICEF's own procurement of nets jumped from 7 million to 25 million from 2004 to 2006.

Governments across Africa have overhauled drug policies to prioritize more effective Artemisinin-based medicines (ACTs) over chloroquine, which was causing drug resistance. Between 2004 and 2006, global procurement of ACTs grew from 4 million doses to an astonishing 100 million doses — each with the potential to save a human life.

Taken together, these results show that malaria control is turning a corner, setting the stage for big gains in the next few years. For the first time in history, multiple countries in sub-Saharan Africa are slashing deaths and illness from malaria, thanks to aggressive scale-up efforts made possible by organizations like the U.S. President's Malaria Initiative (PMI) and the biggest funder of malaria control, the Global Fund to Fight AIDS, TB and Malaria.

President Bush announced his malaria initiative in 2005 and pledged to increase funding by more than $1.2 billion through 2010 in 15 of the hardest-hit nations in Africa. By the end of the year, it expects to reach 30 million people with lifesaving prevention and treatment.

The Global Fund to Fight AIDS, Tuberculosis and Malaria was created by the world's wealthiest nations and has approved almost $3 billion for malaria programs since 2002, providing more than two-thirds of all international funding for malaria programs.

Next month, it anticipates approving the single biggest round of malaria funding to date: an additional $470 million over the next two years. The global fund works in close collaboration with PMI and together they are producing significant results.

These new resources, combined with major contributions from the World Bank Booster Program for Malaria Control and the Bill & Melinda Gates Foundation, will ensure that the world is able to ramp up comprehensive control efforts. For the first time, the elimination of one of Africa's leading killers of children is well within our reach.

Meanwhile, grass-roots campaigns like Malaria No More and Nothing But Nets have inspired tens of thousands of Americans to act by donating $10 bed nets to families in Africa. Where people see real hope for saving lives, we are witnessing an urgency and willingness to act.

Countries are putting these new tools and funding to good use, demonstrating that rapid scale-up can have immediate impact. Four years ago, Ethiopia lagged behind many of its neighbors with only 5 percent of households owning a single bed net. Today, having distributed 18 million bed nets since 2005, Ethiopia is approaching an unprecedented goal: two long-lasting insecticide-treated nets for every household in malaria-endemic areas.

Rwanda, Zambia and Kenya have registered similarly impressive results, complementing massive bed-net efforts with indoor residual spraying campaigns that use trace amounts of insecticide in people's homes to kill and repel mosquitoes. Anecdotal evidence from these countries suggests a 60 to 90 percent decline in malaria deaths from these interventions.

That is why global leaders from public health, business and government are meeting this week at the Bill & Melinda Gates Foundation in Seattle to share successes and challenges and plot out aggressive next steps in this global effort.

A recent World Health Organization study estimates that $1.7 billion to $2.2 billion per year is needed over 10 years to control malaria in Africa alone. Today, we are spending less than $1 billion a year worldwide. The plain fact is that this global threat can be brought under control if more funding is made available. It is as simple — and as difficult — as that.

We know how to defeat this ancient killer. We did it in the United States in 1951, and recent progress has demonstrated that we can do it in other nations ravaged by this terrible disease. Isn't that an investment worth making?