Civil society: a force for change to move forward against malaria | future planet

Some 627,000 people died from malaria and another 241 million were infected in 2020, according to the annual report of the World Health Organization (WHO). Olivia Ngou (Yaoundé, Cameroon, 37) knows this well, having survived him several times. Ngou is the founder and CEO of Africa Health Impact (ISA), a women-led Cameroonian NGO that focuses on the promotion of parasitic diseases through community engagement. “I believe that building resilient community systems, mobilizing local leaders and empowering communities are key to winning and sustaining the war on malaria. By working with the stronger and smarter global and local community, leaving no one behind, we can win.” For this reason, from ISA, he co-founded and established the first Global Civil Society Network for Malaria Elimination (CS4ME)for its acronym in English), which now coordinates with more than 450 members from 43 countries.

After years of steady decline, malaria cases and associated deaths are on the rise. According to Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund), funding has stagnated and resistance to drugs and insecticides is on the rise. This accelerates the risk of a resurgence of this disease, caused by parasites which are transmitted to humans by the bite of a female mosquito of the genus Anopheles. The parasite multiplies in the liver and enters the bloodstream; if another stilt bites that person, the insect becomes infected and the cycle of propagation continues. Although the annual number of deaths has almost halved over the past two decades, the year 2020 ended with 69,000 deaths and 14 million additional reported infections. compared to 2019. About two-thirds of those additional deaths were related to COVID-19 disruptions.

Thus, malaria remains a serious public health problem in many regions, particularly in Africa. In 2020, the continent accounts for 95% of malaria cases and 96% of deaths from this disease. Of all the deaths due to malaria recorded in the territory, 80% correspond to children under the age of five. “Growing up it was an ever-present threat, with friends, family and even myself suffering from the tiny but deadly mosquito,” said Ngou, who has survived its attack multiple times. “In addition to the physical symptoms (fever, joint pain and headaches, vomiting), it prevents children from going to school and families from earning a living, which reduces the chances of communities thriving,” says he. “As long as malaria continues to increase in Africa, the continent will not be able to reach its true potential”, he denounces.

As long as malaria continues to increase in Africa, the continent will not be able to reach its true potential

So when it comes to eliminating malaria, Ngou points out, civil society organizations and communities really matter. “It is the people on the ground, those who suffer from it on a daily basis, who have the power to change the fight. We have seen time and time again that malaria programs and initiatives are most effective when they work with local communities upwards,” he says. “How do you do that?” asks Ngou. “Joining national and local health committees, multiplying communications on prevention methods, advocating for more national funding…”, he replies.

To give an example, he refers to CS4ME. “Through the network, civil society organizations joined forces to develop charters and declarations for leaders and organized campaigns and meetings with high-level officials across Africa to demand accountability,” he said. Also, give another example: Zero malaria starts with mean awareness campaign launched in 2014 by the Senegalese organization Let’s talk Africa. “Since then, he has become a force across the continent. Taking advantage of Senegal’s success, the Heads of State and Government of the African Union endorsed it,” he explains.

Civil society, but also political commitments and funding

Although the ISA has learned that “top-down government investment is not enough,” Ngou argues, “political commitments and leadership accountability for increased funding are critical to continuing the mission.” Because many resources are still needed, and because they must reach everyone. “We need new tools, new more effective vaccines, new treatments, and we need to reach the most vulnerable and isolated populations.”

Over the past 20 years, the Global Fund partnership has invested more than US$53 billion (€51.906 million) to help save 44 million lives and reduce the combined death rate from HIV, tuberculosis and malaria in more than half. Now, the campaign for the seventh replenishment is already underway and, for the period 2023-2025, the Global Fund intends to raise at least 18,000 million US dollars (17,628 million euros). “This is the minimum number needed to end the three epidemics, build resilient and sustainable health systems, and strengthen pandemic preparedness and response in order to achieve a fairer and more secure world in the face of future threats,” they point out from the organization. This capital would save 20 million lives and reduce the death rate from these diseases by 64%.

For the period 2023-2025, the Global Fund aims to raise at least 18,000 million US dollars (17,628 million euros)

The Global Fund is not the only funder. Other philanthropic organizations, governments, international organizations are also contributing money… However, the amount invested in 2020 did not reach the 6,700 million euros estimated to be necessary, a gap which has widened drastically in recent years. last years. During the period 2010-2020, international sources provided 69% of total funding for malaria control and elimination, led by the United States, United Kingdom and France. Governments of countries where malaria is endemic provided almost a third of the total funds, with investments close to €1.1 billion.

And the vaccine?

According to Ngou, the malaria vaccine, recommended for large-scale use by WHO last year, is only “a new weapon, an additional tool which is added to the preventive and repellent treatments already present in the antimalarial arsenal”. For the moment, only Ghana, Kenya and Malawi inject it, within the framework of the Pilot implementation programwhich has reached more than a million children since 2019. Cameroon, not yet.

Given the partial effectiveness of RTS,S (Mosquirix) immunization, of 40%, this inoculation is not intended as a single remedy, but rather as a complementary tool to existing ones that will help reduce infant mortality . In this sense, Ngou lists other means of prevention, such as mosquito nets, indoor spraying of insecticides, larvicides, water and sanitation, or even chemoprophylaxis for children under five, in endemic areas, for pregnant women, and for people who are not safe to travel to affected areas.

For Ngou, the most frustrating thing is that malaria is “preventable and curable”. However, it continues to kill thousands of people, mostly children. To eradicate it, he says, “people have to believe it’s possible.”

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