Professor Sir Richard Feachem, University of California San Francisco
Commitment was the most important factor in eradicating malaria, and would make “all the ducks line up”, Professor Sir Richard Feachem from the University of California told the World Malaria Congress in Melbourne today.
Professor Feachem was speaking at a session on meeting the challenges of malaria eradication, which touched on Sri Lanka’s success, the great challenges facing Papua New Guinea (PNG), India and Malaysia, what the last battle ground of malaria would be, the threat of resurgent Anopheles mosquito populations, and the need for affected countries to invest more of their own money into the problem, instead of relying on foreign investment.
He said Sri Lanka’s achievement in eradicating malaria, largely during years when the country was at war, had been “spectacular” and the global community should offer all the assistance and funding needed to keep Sri Lanka malaria-free in the future.
Whenever asked what was the greatest threat to continuing malaria eradication, he said he always answered resurgence in Sri Lanka.
“It would set the political commitment back massively and would be evidence the sceptics would grab to say that this is overambitious,” he warned.
In Malaysia, monkey malaria, or plasmodium knowlesi, was now the source of most human malaria, providing a new challenge that could derail the nation’s goal to eradicate malaria by 2020, he said.
Professor Feachem advised PNG was a country firmly not on track to eradicate malaria, but moving “rather strongly” in the wrong direction.
“Melanesia will not be able to overcome these problems on their own. They need friends, friends with money, and friends with technical expertise, and I very much hope partners in the region will really come together in stronger support … particularly for PNG.”
India was also behind, with a dearth of available data on how serious its malaria problem was and related deaths estimated at anywhere from 400-48,000. India’s other challenge was its private, “anarchic, out-of-control” drug market for antimalarials.
He said a major challenge not being discussed enough was the “alarming” resurgent spread of malaria-spreading Anopheles mosquitoes.
Regarding the cost of malaria eradication, he said domestic governments of affected countries needed to spend more than they were currently doing, with an estimated USD$2.7 billion in 2017 spent on the problem by foreign agencies compared to USD$1billion by domestic governments.
That said, he said history had shown countries did not need to be rich to eradicate, with examples such as Tafea province in Vanuatu and Singapore. Timor-Leste is on track to eliminate malaria by 2020.
He invited the audience to look forward in time to the “last battleground” of malaria, which would be in Africa. In all countries as elimination approached, malaria became a disease affecting predominantly male adults, caused by plasmodium vivax.
A vaccine would help, but was not essential to achieve eradication, he said. More crucial than drugs, vaccines or insecticides was commitment, which would inspire solutions and answers.
“Commitment really, really matters.”
Dr Rima Shretta, from the Asia Pacific Leaders Malaria Alliance, said it would cost USD$29 billion over 14 years to eliminate malaria in the Asia Pacific region.
But the benefits would be close to USD$90 billion, saved on lower worker absenteeism, lower national mortality, greater school attendance, better health security and ease of burden on the health system. Close to 400,000 lives would be saved.