By Richard Tren, TES Contributor
Recently news broke about a potentially promising new tool to combat malaria and other mosquito-borne diseases. Researchers from the University of Maryland in the United States, in collaboration with a research institute in Burkina Faso, have discovered a new genetically modified fungus that kills mosquitoes when sprayed inside homes, protecting the inhabitants. While such new tools are much-needed, it is far more important for malarial countries to take the lead in the fight against the disease.
Malaria is an age-old disease that has resulted in millions of lost lives and subjected generation after generation to debilitating, bone-wracking fevers. Malaria was once widespread, robbing mothers of their children and stunting development across Africa, Asia, Europe, and the Americas. For centuries people believed the disease was caused by foul air emanating from swamps, hence the name: mal aria. Yet just over one hundred years ago, scientists discovered not only that the disease was caused by a parasite, but also that it was spread by the Anohpheles mosquito.
Armed with this new knowledge, public health officials began treating patients, eliminating the parasites, and controlling mosquitoes. The combination of safe and effective medicines and long-lasting insecticides led to the rapid decline of malaria cases and deaths wherever it has been deployed. In the 1950s malaria was eliminated from Europe and North America thanks to this twin strategy. It may surprise some to know that the potentially deadly Anopheles mosquito is still widespread in these formerly malarial areas, however without parasites, they are simply a nuisance rather than a threat to life.
Although the Anopheles mosquito could potentially spread the disease in developed countries, in all likelihood it will not for at least three reasons. First, increased wealth has meant that most people have decent housing, with windows and even air conditioning, that creates a physical barrier between people and disease-spreading insects. Second, communities in developed countries can afford effective mosquito abatement, reducing the number of adult mosquitoes and their larvae. Third, improved health systems means cases of malaria are likely to be detected early and treated, before the potential for any epidemic.
Poor, less developed countries that suffer from malaria can technically control the disease, and many do, mostly with assistance from international donors. Such aid saves lives, but donor agencies also require recipients to dance to their tune. In the past as donor agencies put pressure on malarial countries not to use insecticides sprayed indoors, in response to domestic environmental pressure. Donor agencies, and even the World Health Organization, also resisted calls to change malaria treatment regimens, even when they knew about widespread resistance to older, less effective drugs.
And so it was frustrating to read comments about malaria, on this website, made by the Minister of Health for Zanzibar. John Bridgeland, the Vice-Chairman of the non-profit Malaria No More, quotes the Minister as follows: “I have seen this movie four times before in my lifetime – the world mobilizes against malaria and the world forgets. This time, it is a blockbuster movie, but I worry the world will forget again and a generation of young people will have grown up with no immunity to malaria.”
The point of Bridgeland’s piece was to remind readers that malaria control and treatment saves lives and that wealthy countries can and should support efforts to do so. That is all well and good and something most people can support. However, by quoting the Zanzibari minister, Bridgeland undermines his cause.
As the saying goes, “God helps those who help themselves.” The same is true when it comes to public health and development in poor countries. The Zanzibari minister referred to the four times since the early 1950s that donor-led efforts to control malaria almost eradicated it from the island. The disease came roaring back, however, because of a failure to sustain the efforts. And the failure to sustain malaria control has much more to do with the choices Zanzibaris have made than with the rest of the world.
In 2001 the heads of state of African Union countries met in Abuja, Nigeria, and pledged at least 15 percent of their annual budget to improve the health sector. Eighteen years later, most countries are failing to meet their own targets. The United Republic of Tanzania, which incorporates Zanzibar, is faring particularly poorly. According to a recent UNICEF report, Tanzania devotes only seven percent of its national budget to the health sector, and this percentage has been declining in recent years. Tanzania also allocates less to healthcare than its neighbors, Kenya, Rwanda and Uganda.
Taxpayers in the United States and Europe, who fund most of the malaria control efforts in Tanzania and Zanzibar, may well ask why they should be expected to care more about the health and welfare of Zanzibaris than Tanzania’s own government? Zanzibar’s minister worries that the world will forget about malaria, a disease eradicated from wealthy countries three generations ago, while ignoring the fact that his own government has apparently forgotten its pledges made earlier this century.
Charities, such as Malaria No More, along with countless churches and civic associations have supported malaria control efforts in poor countries for many years. And western taxpayers have been extraordinarily generous – or rather elected officials have been generous with taxpayer money – in supporting malaria control. However, Zanzibar needs to prioritize its own health programs for several reasons.
Aside from the fact that it’s simply the right thing to do, Tanzania’s government should want the ability to direct its own programs so they are not subjected to the whims of donor agencies that have their own domestic political considerations.
Second, the minster seems to deny himself has his government agency in the fate of the health and welfare of his people. Aside from controlling malaria today, the solution for long-term development of the county lies within, not without. Any country can develop economically and become wealthy and healthy by adopting the right set of policies: principally private property rights, low taxes, the rule of law, and limited government.
In 2019 it is no longer a mystery why some countries grow and prosper and some flail in poverty and misery, constantly reliant on others. Tanzania and Zanzibar need to accept responsibility for their own health programs and while they’re at it, for their own economic policies.
Richard Tren is a Washington, DC based writer who formerly ran a health policy non-profit, Africa Fighting Malaria.