From donating $10 to purchasing insecticide-treated bed nets to contributing money for anti-malarial drugs, Americans have focused their generosity lately on trying to help eradicate malaria — a disease that has plagued humans for more than 50,000 years and is still killing people in sub-Saharan Africa at the rate of about 2 people per minute. It takes its greatest toll on infants and young children, before they build up resistance. Taking a permanent bite out the plague requires a long term commitment by the world and mobilizing societies, not just donors or governments, to take it on.
The last thing donors want to do is to crowd out local efforts to manage malaria or to make domestic malaria programs weaker than they already are. But this is exactly what can happen when external resources transform malaria programs into costly goliaths tied to donor country purchases of medicines and supplies that could not be financed through domestic sources. Great care must be taken as donor countries ramp up their efforts to create incentives for receiving governments to increase their efforts, not to sit back and relax while others do the job.
There is no question that additional funds and new technologies are needed to reduce and even in some areas eliminate malaria, but that means donors need to get into malaria control seriously for the long term. Supporting interventions that save lives today can make those same people more vulnerable to the disease later if malaria comes roaring back. Responsible donors will be careful to increase support in a way that can be sustained, to make a long term commitment for their own support (for decades, not years), and listen carefully to recipient country professionals to judge better what programs can work and be sustained in local conditions.
Equally important, pluralistic and redundant systems for malaria treatment and prevention are critical to ensure that these efforts do not fail. Knowledge about malaria, how to control it, and responsibility to control it, needs to permeate society. Global and local businesses — which are a core part of work, leisure, and communities everywhere — must be mobilized to strengthen the fabric of the effort against malaria. Businesses have a self-interest in safeguarding the health of their workers. Businesses have shown through their initiatives to fight and treat HIV/AIDS in the workplace that they can play a positive role to keep employees healthy by educating them about malaria, making sure community and environmental services are organized to reduce the danger of malaria, and supporting adoption of new technologies through workplace benefits.
Businesses can also go beyond their workers to contribute their core competencies on a pro bono basis — such as transportation or advertising, for example — to reach beyond the workplace and support enlightened and effective public policies. It is just a matter of getting them involved and ending the idea that donors or a paternalistic government can or should solve the problem alone.
On malaria as well as so many other developmental problems, there may be a silver bullet out there, like a vaccine that will end it once and for all. However, until that happens, success will depend on supporting individuals and communities to manage the problem and keep people healthy. The size of the bite that can be taken out of malaria depends on funding, for sure, but just as much on how predictable are the increased external funds, how well new efforts fit into the local environment, and to what degree all of society is mobilized to take on the challenge.
Brookings recently hosted a private sector forum with GBC to discuss the corporate response to malaria.