World Malaria Day 2015 is an opportune moment to take stock of the global fight against malaria. It also provides an opportunity to look forward at how we can work together finally beat the disease. For malaria, as much as for any other disease of poverty, finding new and ever-more effective treatments for people living with the disease, as well as ultimately developing a vaccine to protect people, will be fundamental to future global efforts to eradicate the disease in this generation.
It happens that this month myself and a group of staffers at the European parliament were lucky enough to be part of a fact-finding mission to Uganda to see on the ground level exactly what can be achieved through investment in global health research and development. On World Malaria Day 2015, then, what did we see and learn that gives us hope that a transformative breakthrough could be just around the corner?
Despite progress in recent years, malaria is still present in 97 countries. An estimated 3.3 billion people worldwide are at risk of malaria, resulting in 198 million cases of malaria in 2013 alone. By itself, malaria is responsible for over 580,000 deaths, 90 per cent of which take place in Africa. Despite these grim numbers, the world is on target to meet the malaria-related goals set out in the Millennium Development Goal (MDG 6 target C: to have halted by 2015 and begun to reverse the incidence of malaria).
What is more, deaths caused by malaria decreased by an estimated 47% worldwide between 2000-2013, and infections rates have also sharply decreased. This has led to a significant reduction in deaths of children (under five) due to malaria in the same period: 53% globally, and 58% in Africa. We can welcome this progress and the improvement that it brings to people’s health, while also acknowledging that the figures for infection and mortality remain unacceptably high. How then can we accelerate this progress so we can say we have defeated malaria by 2035?
World Malaria Day 2015 – the role of R&D
The roll-out of bed nets and other malaria treatments, alongside improving vector control, has been a major factor in the declining mortality rates due to malaria. Global health research and development has also been vital to these efforts by contributing to new testing and treatment technologies. However, there is as yet no vaccine against malaria and there are emerging concerns around growing resistance to anti-malarial treatments. New diagnostics are also needed to help distinguishing between severe and uncomplicated infections, and to differentiate between malaria and other illnesses. These innovations, coupled with a vaccine, would have transformative effects on the fight against malaria – but they need investment in order to happen.
And, right now, not enough investment in global health research is taking place and malaria research in particular is suffering. This is one reason why DSW has been calling on leading European politicians to step up and support increased investment in global health research and development – a highly cost effective way to make meaningful progress on the global health challenges facing us today. My recent visit to Uganda only served to reinforce for me the tremendous impact this kind of funding can have on just one country’s fight against diseases of poverty.
World Malaria Day 2015 – innovation in Uganda
The majority of Uganda’s high disease burden is caused by HIV & AIDS, tuberculosis and malaria. Of the three diseases, most of the researchers and politicians that we met in the course of our visit agreed that the progress made in the fight against malaria was the least satisfactory. Over three days in Kampala and Masaka, we met with researchers, members of the Parliament of Uganda and local community workers and what we were shown ably demonstrated the impact that investment has had on HIV & AIDS research, and could have for malaria.
Investment by programmes such as the European and Developing Countries Clinical Trials Partnership (EDCTP), and from donors such as the UK aid agency and the UK Medical Research Council (MRC) has markedly improved research efforts in Uganda in a number of ways. It has supported the creation of world-class and internationally accredited laboratory facilities. This means that money is saved on shipping samples for testing to Europe, which was done in the past, and supporting the education and training in situ of local researchers.
These new facilities and local knowledge has also enabled trials to take place in the countries affected at an earlier stage of a drugs development – meaning they can more readily take into account local factors. Investment by external donors and the Ugandan government has incubated a new generation of researchers who can undertake their graduate work in Uganda, rather than having to study abroad.
Now, this research capacity is being harnessed for the fight to end the Ebola outbreak in West Africa. At a research station in Masaka run by the MRC and Uganda Virus Research Institute (UVRI), researchers there told us they were waiting to receive the first batch of a trail Ebola vaccine for a trial in which they are participating. Local involvement in the fight against Ebola – vital to speed up the process of finding a vaccine – could not have happened without the investment by international donors in global health R&D in the country. As we were repeatedly reminded, should this funding reduce or disappear, the excellence that has been build up would gradually decline.
World Malaria Day 2015 – where do we go next?
The messages that we were told to bring back to Europe were applicable to the wider global health community. Investment in global health R&D at its most basic level often boils down to local researchers being given the resources and tools they need to advance towards new medicines and treatments that are needed in their country. This support is translating into new or improved diagnostics, drugs, and potential vaccines against malaria – there are already products nearly ready to emerge from the development pipeline, in late-stage clinical trials or already accessible on the market.
If we continue to push our political leaders to support investment in global health R&D in the coming years, the impact on malaria and other global health challenges we face could be exponential. If we can manage this, I look forward to going back to Kampala in 10 years and seeing what they have achieved!
For more information on DSW’s activities on global health, and how we are working with partners to improve funding and support for global health R&D, visit our website.