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World Malaria Day 2021
April 25, 2021 marks my first World Malaria Day as CEOof the Asia Pacific Leaders Malaria Alliance (APLMA) and provides anopportunity for reflection. Fourteenyears ago, while living in the Eastern Highlands of Papua New Guinea, I held amostly listless four-year-old boy in our home. The boy was my eldest son. Thecause of his illness: unknown to us. At first we did not suspect malaria- therewas little, if any, where we lived in Highlands. But thinking it through further we recalledhe had been to Port Moresby in the recent past so perhaps that was theculprit? We rushed to our dearcolleagues in Goroka General Hospital but there were no rapid diagnosticsavailable. After searching widely in the public sector and health centersaround us, we found RDTs (Rapid Diagnostic Tests) in a private pharmacy. My spouse, a clinician,administered it at home; eventually we were able to diagnose a positive testfor p-vivax and sourced Artemisinin Combination Therapies (ACTs) from aprivate pharmacy (ACTs were also unavailable through the public sector). Ourson recovered in good time.
Countless families are not so fortunate.
PNG, among many other countries in the region where I havelived and worked, such as Myanmar, Cambodia, India, and Indonesia continuetheir fight. Despite the tools and evidence of how to test, track, and treat itpersists - claiming over 400,000 lives annually. In Asia Pacific we hadover 2 million reported cases in 2019, mostly among vulnerable, rural, andtribal populations. That malaria disproportionately affects these communities,where I have personally witnessed success in battling other infectious diseasessuch as TB and HIV, was core to my desire to join the fight towards malariaelimination in Asia Pacific. Suchinequity need not persist.
The malaria fight is one that can be won.
In the last 10 years alone, there have been 89% less deaths frommalaria in the Asia Pacific; cases have almost halved since 2010. Sri Lankaremains malaria-free since it was certified in September 2016 and China is soonto join. Malaysia and Timor Leste are on the precipice of becoming malaria freeand the Greater Mekong Subregion (GMS) has turned a tide.
Countries in the region continue to make impressive gains towardseliminating malaria by 2030. And remarkably, even during these unprecedentedtimes. From malaria cases dropping further between 2019-2020 in the GMS,despite the pandemic; to communityhealth workers stepping in to manage COVID-19 whilstcontinuing to manage malariaservices in pockets of the region. Where there's awill, there is indeed a way. From a neglected issue in 2012, collective actionaround a shared vision has delivered results. We cannot turn back.
Our region faces the biggest malaria burden (90%)in just five countries - India, Papua New Guinea, Indonesia, Pakistan and Afghanistan – the poor andvulnerable face the greatest risk exposure. From cases concentrated in the provinces and rural areas to hotspots along international borders, malaria is remarkablyresilient. As long as it exists, it will be an engineof inequality, burdening the poorest and most vulnerable communities, and willalways have the potential to resurge in times of crisis.
As of this writing, we are in yet anotherextraordinarily challenging phase of the pandemic. In our battle with COVID-19,we clearly see that links in systems we need - surveillance, community healthworkers, supply chain, data management - must extend to vulnerable communitiesand locales for us all to be safe.
This is true for our malaria fight as well. Tacklingthe last remaining areas of transmission through surveillance and data iscritical; tailored sub-national solutions that recognize the heterogeneity ofmalaria is foundational. Investments inbuilding capacity to manage effectively must accompany tools and innovation. We know what to do. Let’s apply it withincreasing precision, continued political will, and leadership that extendsfrom communities to capitals.
ASIA PACIFIC: Stay The Course to End Malaria
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