Malaria Control - Staying Focused on Local Communities

As I consider what impact the upcoming Malaria 2012: Saving lives in the Asia-Pacific will have on communities within our region, I am in the process of organizing a month’s worth of anti-malarial drugs for an upcoming trip, one of the few luxuries afforded to me that I would not consider going without. 

Malaria is one of the world’s oldest diseases yet continues to be a major global disease burden with enormous impact on the health and development of almost half the world’s population. Though in general, cases result in uncomplicated disease with a low case fatality rate, it can lead to severe complications, particularly for pregnant women and children. Demonstratively, across the Asia-Pacific there are 36 million cases of malaria every year, with 42,000 fatalities. Despite this significant impact on morbidity and mortality, the real tragedy of malaria is the burden placed on families and the economic growth of developing countries through losses in productivity, education, and the associated health care costs. 

RESULTS' Aldo King (left) and Maree Nutt (right) with the "African Princess" and Roll Back Malaria Ambassador Yvonne Chaka Chaka in Parliament House, Canberra to meet with MPs and Senators on Malaria and other issues.

This is a disease of poverty, mostly affecting countries with limited infrastructure and resources available for malaria control. In endemic countries malaria is a part of everyday life, you do not have to look far to discover the constant impact it has on communities. Some families can spend over a quarter of their income on malaria prevention and treatment. Therefore, aside from the modest goal of saving lives, a real benefit of controlling and eliminating malaria will be a significant improvement to the livelihoods of hundreds of millions of people. 

The good news is that malaria could be controlled for less than one-tenth of the economic losses suffered as a result of death and illness. Malaria control, costing between US $2-24 per disability adjusted life year (DALY) saved, is one of the most cost-effective health interventions. It is also considered one of the most effective strategies for reducing poverty and childhood mortality. So… if malaria is easily treatable and preventable, why does it continue to be a leading cause of morbidity and mortality across the majority world?
Infectious diseases do not respect borders, therefore, a regional approach must be a collaborative long term commitment. Developing countries have by far the largest global disease burden, but also both the lowest incomes and global health expenditure, tackling malaria has to be a responsibility for the entire international community. In the past a combination of political factors and shifting global priorities has meant we have failed to deliver a sustained and collaborative commitment.  Unless we see programs through to the end with necessary scope and coverage, the disease will resurge and all our efforts thus far will be waisted or worse, deadly, demonstrated by the emergence of increasing drug resistance. 

What we often neglect in the struggle to identify global priorities is what malaria control means at the local community level. The reality is that for many communities living in poverty, malaria prevention might not be the highest priority when faced with daily struggles to survive. Reflecting upon my own experiences in malaria endemic regions, and the fact that often effective and readily available interventions such as bed nets can be underutilized, we need to ensure that our efforts within the region combine resources and support with adequate education and awareness activities. 

Malaria 2012 therefore, brings me cautious hope. The increasing priority placed on malaria control globally is very exciting, and for our neighbours in the Asia-Pacific this could mean great things for both their health and economic development. It is pleasing to see Australia take leadership and place importance on this significant disease. At the same time, we need to ensure that recent and ongoing efforts to tackle malaria are sustained and comprehensive, staying focused on the very communities we hope to impact. The goal of saving lives by controlling and eliminating malaria will ultimately benefit us all. 

by Sandra Opoku, RESULTS Melbourne Group

The global TB situation

The newest Global Tuberculosis Report, which was released on 17 October 2012 and is the seventeenth report on tuberculosis (TB), reveals both bright and dark sides of the global TB situation. It is clearly great that we are on track and likely to reach the Millennium Development Goal (MDG) of reducing by half the TB epidemic by 2015. 

Yet the numbers of people infected by TB are still high. Last year 8.7 million people worldwide became ill with TB, and 1.4 million people died because of the disease. The highest numbers of TB cases are found in the South East Asia and Western Pacific regions, where about 60 % of the world's TB cases are located. Additionally, although the numbers globally are going down, seen regionally Africa and Europe are not on track to reach the MDG before its set date of 2015.

AIDS, TB and malaria are the three most deadly infectious diseases in the world today. However, funding for TB is lacking behind compared to the other two diseases. Consequently, the epidemic is becoming increasingly resistant to the few medicines available to fight the disease. 

This critical lack of sufficient funding for TB care and control, is one reason for the high numbers of TB cases, when there are not enough medicines or vaccines provided to the people in need. Also, research and development are held back because of insufficient funding, although there has been progress in developing new medicines and vaccines. 

The Global Fund is a major sponsor of fighting TB, malaria and AIDS, and 90 % of global funding for TB comes from this financing institution, which is one of RESULTS International's partner organisations. 

The annually Global Tuberculosis Report gives a comprehensive and up-to-date assessment of the TB epidemic, and analyses the progress in implementing and financing TB prevention, care and control at global, regional and national levels. This report is helpful for the future work on TB, and important in our struggle to reach the MDGs globally, regionally as well as nationally.

Important days for the future

The International Day for the Eradication of Poverty was marked on the 17th October.  This day is a part of the Anti-Poverty week 2012, running from 14th to 20th October. This is a day than the United Nations General Assembly has designated to promote awareness of the need to eradicate poverty and destitution in all countries. 

This year's Day for the Eradication of Poverty was the twentieth ever, and the focus of the day in the country was on Australia's aid program towards the important Millennium Development Goal (MDG) number one - eradicate extreme poverty and hunger. The aim is to cut by half the global number of the people living under such conditions. 

The theme for this year's day was 'Working together out of poverty', which highlights the need for a truly global anti-poverty alliance. There are different ways of lifting people out of extreme poverty. Some examples are to train farmers in more efficient agriculture, microfinance and financial services to secure poor families' income, provide health services to poor communities, and provide primary education to more children worldwide. 

For Anti-Poverty Week, and the International Day for the Eradication of Poverty our lovely RESULTS supporters at Elanora Heights Public School Ella, Sienna (pictured) and Edita celebrated by educating their school friends about poverty and getting all pupils in year six and many teachers performing a fabulous flashmob dance to a cheering school crowd. They also managed to raise over $700 for RESULTS' ongoing education and advocacy work. Fantastic effort girls, we are so proud of you!

The importance of education was also being emphasised on the International Day of the Girl Child, of which the very first was marked on Thursday 11 October 2012. This day, that is to be celebrated every year on 11 October, is a day to recognise the importance of girls globally, and focus on their rights. The focus of this day's first celebration was to end child marriage.

Child marriage is a fundamental human rights violation in itself. In addition, many more rights are ignored and violated when girls are forced to marry at a young age. Consequently, she is denied a childhood, and her education is most likely disrupted, which limits her opportunities in life, and prevents her in reaching her full potential.  Conversely, girls with little or no education are more likely to be married early.

Early and unwanted pregnancies also very often follow child marriage. This poses life-threatening risks for girls, especially considering that pregnancy-related complications are the leading cause of death for girls in developing countries aged 15-19. Child marriage is a major obstacle for reaching the MDGs, such as improved maternal health, universal education, promoted gender equality, as well as eradicate extreme poverty.

When looking at the age group 20-24, on a global basis today, every third girl was first married before her 18th birthday. The connection between child marriage and education is vital. In developing countries one in four girls does not attend school at all. Also, the drop-out rate of primary school is quite high. There are various reasons for this in addition to child marriage, for example that the family cannot afford to pay the tuition fees, or the family prioritises the boys over the girls. Some girls are taken out of school by their parents because the schools do not have separate toilets for boys and girls.

When a girl receives education of seven years (or more), she will marry four years later and have two less children, than in the case of no education or if she is dropping out during primary schooling. If she receives secondary schooling, she is up to six times less likely to be married before the age of 18.

As the problems of child marriage have so many solutions in education, as well as education has so many repercussions, it is important to continue to focus on primary education in the struggle to reach the MDGs. 

In addition to emphasising the importance of education, there are other focus areas that has proven effective to better and prolong the lives of girls and women. It is vital to continue and expand the work of immunisation of children worldwide. GAVI is doing remarkable work in this area, as the organisation is providing a great part of vaccines to children at risk in developing countries.

Microfinance has also proven to be an effective way of protecting girls and women. But also for this a certain level of schooling is necessary, to learn how to manage a business and money, and to secure work and income. When a mother's income increases, it will have impacts on the whole family. For example, her daughters (as well as boys) will most likely stay in school longer, develop their potential further, and be more responsible. This will also benefit the society, not only the people directly involved. 

It is important to remind the world and state leaders about the unfair inequalities and problems that exist in the world today. Occasions like the Day for the Eradication of poverty and the International Day of the Girl Child are great opportunities for this, and important in the fight of poverty and protection of girls' rights, which are closely related. 

Have a look these fantastic animations - great for kids and adults.

The Girl Effect                                 The Clock is Ticking