August 9, 2016 |

Will Brexit fallout derail Africa’s hope to end malaria?

Philippe Guinot, PATH’s country leader in Senegal, wonders what growing isolationism means for West Africa and malaria.
Philippe Guinot meets with a woman and a health care worker.
Senegal country leader Philippe Guinot visits a local health care clinic. Photo: PATH/Fatou Kande-Senghor.

My son, Alexandre, was a year old when we moved from France to Senegal, where I lead PATH’s country program. My family had never lived in a malaria-endemic country before, and I worried about the best way to protect Alexandre, as well as my two older children.

After lengthy discussions, we decided not to take prophylactic treatments, with their difficult side effects. Instead, we followed the recommendations of Senegal’s National Malaria Control Program: sleep under a mosquito net and get tested at the first sign of fever.

It’s hard to take such a risk when it’s your own child. Of the estimated 438,000 people killed by malaria last year, 70 percent were children under five.

But after five years in this beautiful country, not one of us has been infected.

We are not alone

Philippe Guinot talks with two women, one of whom is holding a child.
Philippe with families in Niakhar, Senegal. Photo: PATH/Fatou Kande-Senghor.

Today, the majority of Senegalese families are protected from the disease, and the northern part of the country is almost malaria-free. With sufficient resources, Senegal could become one of the first sub-Saharan African countries to eliminate the disease.

But seismic shifts in Europe have a dark history of causing profoundly negative impacts in Africa. Witnessing how the lives of people deep in Congo’s interior were upturned by World War II, the Belgian colonialist Vladimir Drachoussoff wrote, “Europe’s enfeeblement can only serve to elicit centrifugal forces.”

Following Brexit, I wonder what kind of centrifugal forces are being unleashed. Inspired by Britain’s vote to leave the European Union, other European countries, including my own, are moving toward more isolationism. How will the economic repercussions of this nationalist trend impact global health funding? And what about anti-foreign sentiment in the United States? Could these trends slow or even derail one of the greatest success stories unfolding in Africa—the elimination of one of the world’s oldest and deadliest diseases?

Remarkable progress at risk

Men unloading bednets from a truck.
Men unload bundles of bednets, which are one of the most effective interventions to avoid mosquito bites. Photo: PATH/Paul Libiszowski.

Over the last decade, Senegal has cut malaria deaths among children by more than half. This remarkable accomplishment is the result of strong national leadership, good donor support, and hard work on the frontlines by doctors, nurses, community health workers, and community advocates. I’ve had the opportunity to work closely with many of them, and I can attest to their amazing dedication, often working under harsh conditions.

Dr. Algaye Ngom, who leads the effort in the northern district of Richard-Toll, has proven what drive Senegalese-style can achieve. In the face of skepticism and even strikes by medical workers, he is gentle and persistent. His patience has paid off: Most families now sleep under mosquito nets and get tested if they have symptoms. And rapid response by health workers ensures that cases are contained and the disease doesn’t spread.

Last year Richard-Toll District saw only 317 malaria cases—down from more than 14,000 a decade ago—and zero deaths.

The approach Dr. Ngom and his team developed is now a model for other districts. And there’s no time to lose. Three-quarters of the malaria cases in Richard-Toll are now imported by seasonal workers from other parts of the country. Richard-Toll may be on its way to being a malaria-free zone, but to end the threat, Senegal needs to continue the march of malaria elimination to the southeastern part of the country.

In some districts, up to half of the population still suffers from the disease each year. So the National Malaria Control Program is distributing more than 8 million bednets to ensure that all Senegalese are protected while they sleep. It’s also rolling out a malaria surveillance system that gives health authorities the near real-time information needed to track and respond to the disease quickly.

Ending malaria takes support

Across Senegal, there’s a groundswell of support. The Zero Malaria: Count Me In campaign is mobilizing people with the help of soccer stars, members of parliament, and world-renowned musicians like Youssou N’Dour. Community champions educate neighbors about their right to free malaria diagnosis and treatment and how to prevent the disease.

Senegal is getting the word out on how to prevent malaria in many creative ways, such as music videos and TV programs like the one above (captions in English). Video: Zero Malaria.

Senegal is also increasing domestic funding by engaging the private sector in innovative partnerships and exploring new financing mechanisms. For example, Senegalese can now add a donation to fight malaria when they make a money transfer through a popular mobile payment application.

To end malaria, however, external financial support—for Senegal and beyond—must grow. History has shown that if we let up our efforts malaria will resurge, undoing progress that took years to achieve.

Europe is critical to this effort, and so is the United States.

In September, donors will gather in Canada to commit funding to the Global Fund to Fight AIDS, Tuberculosis and Malaria. I’m pleased my own country—France—announced that it will contribute €1.08 billion (US$1.19 billion). I can only hope that other leaders will demonstrate the same strategic commitment and clear-headed thinking, despite the uncertainties created by Brexit.

We can’t allow nationalist forces to dampen the very real prospect of a world without malaria. It may have plagued Africa for thousands of years, but today, I can watch my now six-year-old son Alexandre play with his Senegalese friends and know we have the tools to protect them—and all children in Africa—if the world stands with us.

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