Stepping up fight against malaria in Asia to protect gains made everywhere

A mother from Myanmar and her child waiting to be seen at the Wang Pha clinic near Mae Sot, Thailand, near the Thai–Myanmar border. Her son has symptoms of malaria. Photo: Mark Tuschman 

This was originally published on Global Health TV on August. 31, 2018

The future of malaria in sub-Saharan Africa and everywhere else may depend on whether we can stop drug resistant malaria in five countries of the Greater Mekong subregion of Southeast Asia and whether new vaccines will work against it.

Great progress has been made against malaria on both continents. The incidence rate of malaria has decreased 18% globally between 2010 and 2016, according to the World Health Organization. The WHO South-East Region recorded the largest decline (48%) followed by the African Region (20%). Malaria cases worldwide have fallen from 237 million in 2010 to 216 million in 2016.

Two years ago, Sri Lanka became the first country in the region to eradicate malaria. Six more countries (Bhutan, China, Malaysia, Nepal, South Korea, and Timor-Leste) are on track to eradicate it by 2020 and the other 15 nations are targeting 2030. But a few of those 15 countries are struggling – malaria cases increased in six of them in 2016. India has the third largest burden of malaria in the world, accounting for 89% of malaria cases in the Southeast Asia Region.

“We’ve made extraordinary progress in the Asia-Pacific Region,” says Dr. Ben Rolfe, CEO of the Asia Pacific Leaders Malaria Alliance based in Singapore. “Malaria has been halved, and then halved again. Even Myanmar has made extraordinary progress in the most difficult of circumstances. The downside is that we have only bitten off the easy fruit. We are now getting down to dealing with remote communities with very little access to health services. It gets exponentially harder to reach those places.”

New book "Factfulness" asserts that world is much better than most believe

This was originally published on Global Health TV on August 6, 2018.

I first saw Hans Rosling deliver a presentation on facts and fiction on global health in New York in 2010. Like many of his fans, I was swept away by his stunning visual presentations of data, his charming Nordic folksiness and his ability to shed light on some glaring misconceptions of global health and development that he has been working to rectify the last two decades.

He was shocked to discover that people get basic facts on population, health and development wrong, and not just the general public but also highly educated people, even at the World Economic Forum in Davos and Nobel laureates. So this Swedish professor of global health set out to educate people, primarily through his TED talks, which have been viewed more than 35 million times (check out “Let my dataset change your mindset” and “How not be ignorant about the world”), to such an extent that he became a nerdy global health rock star.

In September 2015, Hans and his son Ola Rosling and daughter-in-law Anna Rosling Rönnlund decided to write a book to explain why people do not see the world as it really is, and why we get so many basic facts so wrong. Five months later, he received a diagnosis of incurable pancreatic cancer, and was told he had two or three months to live. He threw himself into finishing this book to such an extent that he was going over printed copies of the latest draft from his hospital bed in the days before he died in February 2017.

Tremendous progress against malaria seen but challenges remain

Twins Dorcas and Deborah Bendak, 7, under their mosquito net at their home in Musoma, Tanzania. Insecticide-treated bednets have become the cornerstone of malaria prevention efforts. Photo: Riccardo Gangale/VictorWorks, Courtesy of Photosphere

This was originally published on Global Health TV on April 25, 2017.

When I was a young development worker, I engaged in high risk behavior one night in a village in Mali: I slept without a mosquito net. A week or so later I contracted malaria.

Of all the diseases I have written about here, malaria is the only one with which I have personal and intimate experience. And it was not pleasant. It was so debilitating, so sapping of my energy, I remember not caring whether I lived or died.

Fortunately, I was an otherwise healthy young male and bounced back briskly after a week or so of misery. In fact, I have lived long enough to see the beginning of the end (or at least the decline) of this global killer: In December, the World Health Organization (WHO) released the World Malaria Report 2016 in which it estimated that 1.3 billion fewer malaria cases and 6.8 million fewer malaria deaths occurred between 2001 and 2015 than would have occurred had incidence and mortality remained the same. About 97% of those deaths averted were for children under five years (who are most vulnerable to the disease, along with pregnant women).

It's too soon to declare victory over Ebola

This was originally published at Global Health TV on Aug. 24, 2015.

There has been a welcome spate of good news coming out of West Africa in recent weeks on the apparent demise of Ebola, which has caused the region nothing but misery, illness (27,952 reported cases) and death (11,284 reported deaths) for over a year.

Ebola cases continue to fall. For the week ending Aug. 16, no new cases were reported in Liberia and Sierra Leone, for the first time, has gone one full week without any new cases. Guinea was the only country to report any new cases — but just three.

And The Lancet published “interim results” from research on the efficacy of an Ebola vaccine in Guinea showing a vaccine efficacy of 100%.

The news is undeniably good. In the last week, I read these headlines:

Associated Press: “UN official: Ebola epidemic could be defeated by end of 2015.”

Scientific American: “Does This Ebola Vaccine Herald the End of the Virus?”

National Public Radio: “Zero Ebola Cases Reported in Sierra Leone as Epidemic Peters Out”

This is all welcome news but if you go beyond the headlines you quickly realize that this epidemic is not yet over.

New campaign aims to reach Americans to give unvaccinated kids a Shot@Life

NEW YORK — Did you know that in developing countries a child dies every 20 seconds from diseases that are entirely preventable with vaccines? Did you know that the number of children dying every year from these preventable diseases is nearly equivalent to half the children entering kindergarten in the U.S.?

Those are a few of the points driven home yesterday at the official launch of Shot@Life, a new United Nations Foundation campaign directed at the U.S. public and Congress, at a luncheon here on the first day of the U.N. High-Level Meeting on Non-Communicable Diseases.  

 Some of these facts were new to me even though I have been working in global health for almost 20 years, and not all of it was bad. For example, I learned that 80% of the world’s children are vaccinated. That was wonderful to hear.

But the flip side is that, in 2011, one in five children does not have access to the immunizations they need, and that translates into 1.7 million children dying from diseases that have all but disappeared in the U.S. The UNICEF representative at the launch called this “The Last Quintile,” and it will undoubtedly be the toughest quintile.