In a malaria-free world, "life becomes better," said Jackeline Chishimba (center). She and other mothers spoke with volunteer health workers about Zambia's effort to eliminate malaria. Photo: PATH/Gabe Bienczycki.
How do you eliminate malaria? With breakthrough strategies developed hand in hand with affected countries
In the courtyard of a health clinic in southern Zambia, nine women try to remember the last time their children had malaria. Precious says her 13-year-old daughter had four days of fever and missed school. Fanny’s six-month-old was sick in March.
But Jackeline shakes her heads. She can’t remember the last time anyone in her family suffered from the disease. In fact, most of the women can’t. And there have been no malaria deaths in the past two years, they say.
If people have symptoms, Precious says, “they get tested now, and they get well.”
We want to eliminate malaria
It’s a remarkable change from a decade ago. In 2004, almost 50 percent of people in the area suffered from malaria over the course of the year and many died, according to Tolbert Shaba, a medical officer for Kazangula District. The next year, the district embarked on a robust malaria control effort with the support of PATH’s Malaria Control and Elimination Partnership in Africa (MACEPA). By rapidly expanding the delivery and use of tools like bednets, diagnostics, and effective treatment, they were able to bring down malaria cases and deaths.
“When we started the intervention, we didn’t know it could work,” Tolbert admits. “But we found it was making an impact.”
Encouraged, the district decided to try out additional strategies. With PATH’s support, they trained community health volunteers to do rapid diagnostic tests and trace people who had contact with infected individuals. By 2014, malaria incidence dropped to just 5 cases out of 1,000 people.
“Now we feel we can do even better,” Tolbert says. “We want to eliminate malaria.”
An ambitious and necessary goal
Between 2000 and 2015, PATH-pioneered approaches contributed to a 62 percent decrease in malaria deaths worldwide. While these gains are impressive, progress against malaria can be fragile. The cost of maintaining interventions to control malaria forever is unsustainable, and malaria resurgence remains a persistent threat.
World leaders have committed to the ambitious goal of making malaria history, but eliminating the disease requires the right strategies as well as the right tools. PATH is developing the science behind how to eliminate malaria in sub-Saharan Africa (where it has never been done before) by piloting groundbreaking approaches in Ethiopia, Senegal, and Zambia. Our goal is to develop a package of approaches that are adoptable and adaptable across the region.
The beginning of the end of malaria
In Zambia, PATH and the Zambia National Malaria Control Centre are leading an effort to eliminate the malaria parasite from large regions of the country. We trained nearly 1,000 community health workers and data collectors who go house to house, treating hundreds of thousands of people. The plan is to track down and treat every infection, even in people who don’t know they have it, to end the cycle of transmission from human to mosquito and back again.
We also expanded rapid reporting systems using mobile phone technology to gather real-time information and better manage any resurgences of the disease. Careful, continual surveillance will ensure that potential new outbreaks are stopped in their tracks and enable PATH and our partners to assess what’s working and what’s not. We will apply effective strategies from Zambia to other countries, continents, and ultimately the world.
PATH’s Center for Malaria Control and Elimination
Other disease eradication campaigns, like the fight against polio, have shown that a targeted, collective strategy will be crucial in the end-game. PATH’s Center for Malaria Control and Elimination coordinates our cutting‐edge research and development of malaria drugs, diagnostics, and vaccines with the continued development of evidence and approaches needed to scale up critically important malaria programs.
No other organization combines PATH’s comprehensive approach with the capacity to integrate the necessary tools and strategies; develop new, game-changing tactics; and determine the right mix of tools for each situation. We have a proven track record of partnering with national governments of malaria-endemic countries and strong relationships with organizations crucial to the success of this enormous effort. Through our own work and relationships with key stakeholders, PATH is well positioned to inform the dialogue and decision-making about malaria elimination.
“Life becomes better.”
Eradicating malaria from the globe—and forever ending the risk of resurgence—is our long-term goal. A malaria-free world not only means lives saved, but is key to prosperity for many communities and countries.
Jackeline knows this well. Now that her family is free of the disease, she’s quick to describe a world without malaria: “People will be healthier and more productive. Children won’t miss out on school. Adults won’t miss out on work. Life becomes better.”