Malaria remains one of the most pressing health challenges of our time, with sub-Saharan Africa shouldering the greatest burden. In the face of huge therapeutic and preventative scientific advancements over the past 30-odd years, malaria still kills and continues its devastating impact on people’s lives, undermining communities and stifling economic development. But the light at the end of the tunnel is now very much in sight. Collaboration is key partnerships with national governments and local communities, non-governmental organizations (NGOs), and private sector partners are proving to be hugely transformative. This article provides insights into some examples of how these partnership approaches are making an impact. Malaria remains a major burden on people’s lives and is a significant hindrance to social and economic development in sub-Saharan Africa.
The Malaria Challenge
Malaria is a serious disease caused by parasites that must enter the human body through the bite of an infected mosquito species. After the mosquito bites, a person experiences fever, chills, and flu-like illness. If untreated, they can experience severe complications and die. In 2020, the World Health Organization estimated that there were 241 million cases of malaria in the world. Most of these occurred in Africa.
The battle against malaria is an amalgam of safe mosquito nets (insecticide-treated nets, or ITNs), indoor residual spraying (IRS), rapid diagnostic tests (RDTs), and effectual treatment (with artemisinin-based combination therapies, or ACTs). Delivering the tools is as hard as the tools themselves.
The Role of Partnerships
Government and NGO Collaborations
Governments are vital to malaria control but they set policy and raise funding; they might not have the infrastructure to coordinate an effective response, especially when economies are failing or health systems are struggling. NGOs can help those governments, whether it is through funding provided by wealthy individuals such as the Bill and Melinda Gates Foundation or MSF (Médecins Sans Frontières/Doctors Without Borders). The Global Fund finances combinations of governmental and NGO programs worldwide.
Case Study: The Global Fund’s Partnership with National Governments
The Global Fund is the largest source of grants available to these national malaria control programs, and acts as a vehicle for accomplished countries, such as Nigeria and Mozambique, to scale up the use of ITNs and ACTs. The partnership between local governments and the Global Fund helps ensure that funding goes to the right places and programs are tailored to local needs.
Case Study: Médecins Sans Frontières (MSF) in the Democratic Republic of Congo
For example, MSF has also worked in the Democratic Republic of Congo – where, despite high mortality rates, health infrastructure is inadequate and access to care can be limited, making the organization’s presence in one of the world’s most conflict-ridden countries all the more vital. In regions of the DRC that are inaccessible due to conflict and poor infrastructure, MSF – which works with local health workers and community leaders to provide emergency malaria treatment in combination with prevention – can play an important role in reducing infections and saving lives.
Private Sector Engagement
The private sector also has important roles. Pharmaceutical firms, for example, manufacture and distribute antimalarial medicines, and many, notably GlaxoSmithKline and Novartis, work with public health bodies to ensure the supply of affordable malaria medicines.
Case Study: The Private Sector and the Roll-Back Malaria Partnership
The Roll Back Malaria (RBM) Partnership a collaboration of governments, NGOs, and the private sector in the fight against malaria has also enlisted the support of pharmaceutical companies in the development and distribution of new, effective malaria treatments. In this way, the private sector often gives logistical support and funds for the delivery of malaria interventions.
Local Community Involvement
Enlisting local communities is vital for the success of malaria control programs; community health workers, in particular, who are often locally recruited and trained, are the ones who go door to door providing interventions and informing people about malaria prevention and treatments.
Case Study: Community Health Worker Programs in Ethiopia
One notable example is community health worker programs in Ethiopia that have supported their efforts in controlling malaria by training local health workers to screen, treat, and educate their communities about the disease. Grassroots programs provide excellent public health services to remote communities, and the involvement of citizens close to the problem facilitates success by overcoming many of the cultural and logistical barriers to treatment uptake and adherence that can prove fatal in some cases.
Overcoming Hurdles Through Collaboration
Logistical Challenges
Logistical constraints to delivering malaria interventions can be substantial, especially in regions that are remote or are prone to conflicts. Such zones often lack stable infrastructure for supporting transportation mechanisms, secure storage facilities, or skilled personnel. Private sector logistics companies, working with collaborative partnerships between international organizations, local governments, or even private investors, are increasingly finding ways to address these challenges.
Case Study: The Logistics of Malaria Distribution in Uganda
Uganda’s national partnerships with NGOs and private logistics firms have taken malaria interventions into rural communities, where they’ve developed new methods to reach isolated areas via mobile health clinics and drone delivery. Malaria control has grown in scale and impact through such civil partnerships, leveraging and coordinating resources and capabilities.
Financial Constraints
Perhaps the most important barrier to progress is funding. Treatment and prevention are expensive, and many countries struggle to find the money. Schemes that use joint funding mechanisms, such as the Global Fund and other international donors, make a big difference.
Case Study: The Role of the Global Fund in Financing Malaria Programs
Addressing Resistance
And now ‘the real threat to prevention efforts is the spread of resistance to the drugs and insecticides’, as the outcome of the project states. New lines of funding are necessary and possible for collaborative R and D.
Case Study: The Fight Against Malaria Resistance
This also involves developing new insecticides and antimalarial drugs, a process driven by collaborations between researchers, pharmaceutical companies, and health organizations. Notable achievements include the discovery of new artemisinin derivatives and alternative treatment regimens. Only by continuing these collaborative research programs will the responses to resistance succeed in maintaining the effectiveness of the tools of malaria control.
Success Stories from the Field
The Case of Rwanda
Rwanda has made great strides in malaria control via a comprehensive malaria control program including international organizations, community involvement, and innovations – lowering the incidence of malaria drastically in the last decade. The Government, NGOs, and local communities together fought against malaria, achieving remarkable results.
Innovations and Partnerships
These included the more widespread distribution of ITNs, the application of successful IRS programs, smartphones, and human-backed systems for monitoring and tracking malaria. Partnerships were key with the Global Fund, the US President’s Malaria Initiative (PMI), and others – for funding and expertise that allowed Rwandans to make the most of these strategies.
The Success of the Malaria Consortium
The international NGO Malaria Consortium has implemented numerous malaria control schemes that appear to have an enormous impact in Africa, including community-based programs for early diagnosis and treatment in Zambia.
Community Engagement and Impact
The charity Malaria Consortium, which operates in Zambia, trained health workers at the village level to provide basic malaria services. Village volunteers, also trained by these health workers, educated their communities about malaria. Despite these efforts, disparities in income, power, and land ownership still exist, so it’s important not to overstate the progress that has been made. However, the extensive community-based work undertaken in Zambia and elsewhere has resulted in greater access to malaria services and improved health outcomes. This experience highlights the need to engage more with local people if we are to establish Sustainable Malaria Control.
The Future of Collaborative Malaria Control
A lot of work remains to win the war against malaria. However, if we apply the lessons from the parasite’s history to guide our future partnerships, we could soon achieve victory.
Strengthening Partnerships
We need to enhance coordination between governments, NGOs, the private sector, and local communities to ensure that malaria control efforts continue and expand. Collaborative efforts need to address both new challenges such as drug resistance and funding shortfalls, as well as the need to develop new strategies to reach those most at risk.
Innovations and Research
However, investments in research and innovation are needed to continue these advances in malaria control. Shared research and development, with close links to both scientists and pharmaceutical companies and public health organizations, is the next step.
Ending malaria is a complex task that can’t be resolved with a single, panacea-like intervention, but the scope and scale of the problem weigh on us all. Collective action through partnerships is the most promising approach to addressing the delivery problems of malaria interventions and finally turning the tide on its transmission in many countries across all corners of the world. The stories you’ve read in this article show the transformative power of partnerships. These lessons hold for all countries working on malaria elimination.
