By: Jonas Gahr Støre is Minister, Foreign Affairs and Tore Godal, Special Adviser on global health issues at the Office of the Prime Minister
Economists consider malaria to be an important contributing factor to the low economic growth in sub-Saharan Africa. The fight against malaria is, of course, important in terms of improving people’s lives, but it is also an important means of bolstering economic and social development. Health crises are one cause of states weakening and collapsing. So helping to improve health in poor countries is in itself good foreign and security policy.
Malaria is caused by a group of parasites that live in humans and in particular species of mosquito. These mosquitoes transfer the parasite to humans. The disease is common in large parts of the world, including Europe, and is it believed that there have been incidences as far north as Hvaler in southeast Norway. Today it is primarily Africa that worst affected.
It is unlikely that malaria will be eradicated. But the target of removing it from the list of most common causes of death is within reach. Three factors are decisive for success: effective treatments, effective cooperation and effective financing.
In 1974, the World Health Organization (WHO), the World Bank and the United Nations Development Programme (UNDP) set up the Special Programme for Research and Training in Tropical Diseases. Norway provided the first funding for this programme. One of the medicines developed drew on Chinese folk medicine, using certain components found in the wormwood (artemisia) plant to treat malaria. This proved more effective than other drugs, and is now the preferred treatment. It must now be made available for everyone.
Major field studies were carried out in the 1990s under Norwegian leadership to assess the effect of distributing mosquito nets impregnated with insecticide. It was found that when children slept under mosquito netting, deaths were halved. This is not a high-tech solution. It is extremely low-tech.
Gro Harlem Brundtland made the fight against malaria a priority for WHO, and was behind the Roll Back Malaria partnership, which mobilises the private, public and voluntary sectors in a concerted effort to combat this disease.
Then there was the question of funding. In 2000, the G8 countries agreed to establish a fund for efforts to combat the main diseases affecting the poor. HIV/Aids was in focus. Thanks to the determined efforts of WHO, malaria and tuberculosis were also included. Today, Roll Back Malaria is the most important partnership in the fight against malaria, and the Global Fund to Fight AIDS, Tuberculosis and Malaria is the most important source of funding.
These efforts are producing results. In Eritrea and Rwanda, the use of mosquito nets is widespread, and increasing numbers of children are saved from malaria. The Lancet recently reported that deaths from malaria in Gambia fell by 90% from 2003 to 2007, and this is attributed to the introduction of insecticide-treated mosquito nets. The Red Cross has played a pioneering role in the distribution of mosquito netting in connection with vaccination campaigns. Women who take their children to be vaccinated are given mosquito nets to take home. Two objectives are achieved at the same time: protection against various childhood diseases and protection against malaria.
The new financing systems make it possible to save even more children’s lives through the introduction of new, subsidised malaria drugs on a large scale. Such a system is being launched in Oslo today. Once again, private–public sector cooperation, with the active involvement of the Government, is making it possible to purchase and distribute new effective medicines.
Norway has given priority to health as a key factor in the fight against poverty. The vaccine alliance GAVI and the Global Fund to Fight AIDS, Tuberculosis and Malaria have saved six million lives since 2000. Measles alone has been reduced by over 90% in sub-Saharan Africa.
We know it is possible to reduce child mortality from malaria by more than 90% by 2015. But to do so, more people must have access to mosquito nets and effective medicines. This will reduce the spread of the disease. At the same time, it will have a huge and far-reaching impact on public health, and will thus be an important factor in the fight against poverty
This article was first published in Aftenposten 17 April 2009, in Norwegian language