By Kent Campbell, Special to CNN
Editor’s note: Kent Campbell is the director of PATH’s Malaria Control Program, and was recently awarded the American Society of Tropical Medicine and Hygiene’s LePrince Medal. The views expressed are his own.
When I began working on malaria in the late 1970s, the disease was rampant. Working for the U.S. Centers for Disease Control and Prevention, I was stationed at a hospital in the Western Kenya district of Siaya. In the pediatric ward there were often two children to a bed, with more than half succumbing to malaria-related anemia.
Kenya didn’t have a strategy to protect children from malaria – at that time no African country did. In fact, bed nets, a cornerstone of today’s prevention efforts, were not being used. They hadn’t yet been proven to be an effective tool for fighting malaria. Instead, the focus was on providing treatment for the sick and trying to delay death that was often unavoidable.
Malaria was, without a doubt, the biggest problem Africa faced; but it was largely invisible. It was not considered a national or global priority and international funding was virtually nonexistent. We didn’t have the knowledge or tools to get it under control and make a lasting impact.
This all began to change, just over a decade ago. Data demonstrating the incredible power of bed nets began to mount and we realized the benefits of combining tools and strategies under national programs to control malaria. Until this point there wasn’t a roadmap to guide countries, showing how to do it and what to expect.
Beginning in 2005, we had the opportunity to do just that, show how you could design and implement a national malaria control program and make an impact. In partnership with the Zambian government, the Scale-up for Impact (SUFI) approach was implemented to rapidly deploy, at high coverage levels, malaria prevention tools to achieve maximum health impact. Zambia became the first country in Africa to successfully achieve high coverage with tools like bed nets, and the results were nothing short of dramatic. From 2006 to 2008, malaria cases, hospitalizations, and prevalence in children were reduced by more than 50 percent in Zambia – a major drop in a short period of time, never before seen in Africa.
The SUFI approach is now the global standard for malaria control, and has been implemented in more than 40 African countries. Thanks to these efforts and the work of national programs across Africa, partners like the World Bank and the U.S. president’s Malaria Initiative – and a surge in international funding through organizations like the Global Fund – the lives of more than one million African children have been saved in the last ten years.
Today, many of the countries that were early adopters of SUFI are now setting their sights on eliminating malaria, a once unfathomable goal. Kenya is one of these countries. The pressures and demands malaria put on the country’s health services have been relieved.
We know malaria can be controlled. We’ve seen the results. Lives saved. Health improved. But controlling malaria isn’t an acceptable goal, and especially not when we see a very real path toward elimination for the first time. It’s time to end one of the leading threats to Africa’s children by eliminating malaria. The evidence we’re seeing across Africa shows this is possible. What’s needed now is a new road map to guide countries on the path toward elimination. And our group at PATH, along with national program partners, is working on the development of the practical experience at the program level to build such a road map.
We’re working with partners across Africa, like Zambia, to show what works and what’s needed and to plot the path ahead. By maintaining the use of proven prevention tools while aggressively diagnosing and treating malaria, we can break the chain of transmission and end infections in Africa. We’ll create malaria-free zones one at a time, and grow them – to districts, states, and countries. The fight will be long, but it’s one that we can win.
But to say that malaria can be eliminated in Africa does not mean that it will be eliminated. Success requires political and financial support. It’s an effort that will require all of us – local and national governments, the global health and donor community, scientists and policymakers. We know there are challenges ahead, with countries and partners facing competing priorities and financial pressures, but we also know this is a fight that’s worth it. Together, we can make malaria history.