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USAID: Malaria is a Marathon, Not a 50-Yard Dash

(USAIDEach year, World Malaria Day (April 25) commemorates the global fight toward zero malaria deaths and mobilizes action to combat malaria. This year’s theme is “Invest in the Future: Defeat Malaria.”

I used to call them “disease du jour” bills. As a staffer on the U.S. Senate committee with jurisdiction over public health issues, every time a Senator’s nephew or cousin or college roommate’s daughter got a terrible diagnosis, it was my job to explain why passing a one-time bill wasn’t the answer for every disease. Washington’s attention span tends to wane after the galas end, the celebrities leave town, and the surge of early funding and enthusiasm dries up. Without unglamorous vigilance, the disease remains after the politicians and paparazzi move on to the next disease du jour. Global health was no different. After working on malaria policy for several years, I noticed the buzz starting to shift to tuberculosis. Malaria control was just so… 2006.

Surely the private sector wouldn’t be so fickle, right? I joined MosquitoZone International, a U.S.-based firm that offers malaria prevention services to companies with operations in endemic areas. How exciting to work with clients who were absolutely committed to keeping their workers and communities safe from malaria! It turns out, of course, that companies can sometimes be a lot like governments. They invest in controlling malaria and they make so much progress that pressure builds to redirect scarce resources into one of the other health and safety threats facing their workers and their bottom line. But malaria doesn’t go quietly into the night.

One of our clients started off doing everything right. They committed to eliminating malaria at a sub-Saharan African project site. They hired us to run a comprehensive vector control program and we don’t play around. Our entomologists knew every mosquito on that jobsite by name and killed it. By 2011, our client had zero new cases among non-immune expatriate workers and zero complicated cases among semi-immune local workers. They bragged about their success on the company web site. Problem solved.

Inevitably, the urgency of the need for investment in sophisticated entomology was questioned. After all, there were plenty of other problems clamoring for their health and safety resources. Unfortunately, when you stop putting experienced entomological eyeballs on surveillance data, the bugs get the upper hand. After we left, the company failed to respond to entomological data suggesting a major spike in the mosquito population that should have prompted a five-alarm investigation. The company recognized the problem, recommitted to entomological excellence and their success continues with MosquitoZone’s entomologists driving their prevention program today.

Time and again, we see the same predictable cycle in public and private sector programs all over the world. Success turns the volume down on the alarm bells that drive the investments that produced that success in the first place, and when that happens, only failure raises the alarm again. But failure isn’t just a technical abstraction about budget line-items or resistance data. Failure means babies dying, workers downed, and human productivity and potential plummeting.

When it comes to the wily mosquito, every day has to be World Malaria Day.


This originally appeared on the Impact Blog.

Posted by  on Wednesday, April 24th 2013

Photo credit: USAID


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