My reflections on malaria are informed by different views at different phases of growing up: First as a child in rural Africa more scared of hyenas, leopards and my dad than the tiny mosquitoes that buzzed everywhere; then as a young African physician having to make heart-breaking choices when four or five children with severe malaria turned up in a government hospital ward in the dead of night and I only had one dose of quinine left.
Finally as a businessman trying to maximise access to the medicines I sell to keep patients doing more, feeling better and living longer, while at the same time meeting shareholders’ expectations.
Still, it is a horrifying but harsh reality that, in this day and age of medical and technological innovation, people are still needlessly dying of malaria, a disease that is both preventable and treatable.
Although malaria is endemic in almost 100 countries across the world, African countries — in particular in sub-Saharan Africa — are by far the most affected.
According to the World Health Organisation, 306,000 children aged five or below died of malaria last year alone; 95 per cent of them came from Africa. In 2015, 90 per cent of all malaria deaths occurred in Africa.
Apart from the trauma of losing a loved one, and the personal economic cost for families forced to forgo work and income to care for sick children, the disease takes a significant toll on our economies. Since 2000, the average cost of managing malaria in sub-Saharan Africa has rocketed to $300 million a year, amounting to 1.3 per cent of the region’s GDP.
More people are at risk even when prevention and cure are just a tablet away. Studies show that more than half of Kenya’s population is at risk of being infected with malaria, a situation that is not helped by lack of information about the dire consequences of malaria infection. The picture is similar or even worse in most East African countries.
Plenty of research has gone into tackling this modern-day plague, and I am proud that my company is taking a leading role in finding a lasting solution to the epidemic. Since 2003, GSK has committed over $6.9 million to community initiatives fighting malaria and has partnered with organisations on the ground to promote use of existing interventions such as bed nets, indoor residual spraying and other preventative methods.
Key to our contribution has been the forging of robust partnerships that over the past 30 years have seen the world progress towards the first vaccine against malaria and indeed the first vaccine against any parasite! With an investment of over $700 million, this would not have been possible without different institutions coming together. Frankly, as a doctor growing up in Africa, I didn’t dare dream of such progress in my lifetime.
Overall, the partnership interventions are paying off. In Kenya, for instance, we are working with Save the Children to reduce the number of maternal and newborn deaths from malaria and other common illnesses by increasing use of health services specifically designed for mothers and newborn babies.
This project has seen the partnership recruit and train community health workers who in turn educated women of reproductive age on key healthcare issues during household visits. This is how we quietly push back malaria inch by inch in resource-challenged rural areas.
In Tanzania, we have partnered with Amref Health Africa to implement a three-year programme to reduce maternal, newborn and child deaths due to malaria and other common illnesses in Tandahimba district. We work with the local authorities to improve services by training community health workers, engaging traditional healers and cultural representatives and installing murals and billboards to raise awareness of malaria prevention and treatment.
Access to healthcare
In July 2015, RTS,S – developed in partnership with the PATH Malaria Vaccine Initiative - became the first candidate vaccine for the prevention of malaria in young children to receive a positive scientific opinion by the European Medicine Agency.
It is our firmly held conviction that all patients across the globe should have access to healthcare regardless of their ability to pay. In this regard, and if all regulatory approvals come through, RTS,S will be offered at a not-for-profit price as part of our commitment to alleviating the significant health and economic burden of malaria in affected countries.
There is a direct correlation between improved health and economic growth. Better health increases productivity, reduces days lost to illness and can even decrease medical spending, freeing up capital for investment in other social needs such as education which will in turn give our children a better future.
Fortunately, the battle lines against malaria have been drawn. Over the past 15 years, in the Millennium Development Goals era, we reduced deaths from malaria globally by nearly 50 per cent, reason to believe we can win.
In January this year, the UN’s Sustainable Development Goals came into effect, setting new and ambitious targets for tackling malaria and other epidemics. More needs to be done if malaria is to be completely eliminated by 2030 in line with the SDG target.
Each time a child dies, so does their potential. We lose the doctors, farmers, lawyers, support workers and politicians of tomorrow. We all have a responsibility to do what we can to protect our children today and the generations of tomorrow.
This is a concerted effort. We cannot do it in isolation. In fact, no one business, government, charity or local community can tackle malaria alone.
Eradicating the disease requires partnership; it requires everyone to unite behind a common goal. We need to work together to raise awareness and build understanding of the causes of the disease, increase access and advance prevention and treatment strategies.
We need novel partnerships to strengthen healthcare systems and train frontline healthcare workers to reach patients across Africa including those in rural communities who often live huge distances from healthcare facilities.
By combining resources, funds, expertise and influence we can eliminate malaria. We can free future generations of this preventable burden. We can be the change. Together.
Dr Allan Pamba is the general manager (East Africa) and vice presidentfor government affairs (Africa) at GlaxoSmithKline (GSK) Pharmaceutical