In honor of World Malaria Day, ASTMH asked some of our malaria expert members and colleagues what inspired them to specialize in malaria, what stands out in the fight against malaria and what will be the economic benefit of a malaria-free world. Other interviews in this series include: Past President Christopher V. Plowe, MD, MPH, FASTMH; Philip Rosenthal, MD, FASTMH, Editor-in-Chief of American Journal of Tropical Medicine and Hygiene; Councilors Nicole Achee, PhD, ASTMH, Laurence Slutsker, MD, MPH, FASTMH, David A. Fidock, PhD, Rick Fairhurst, MD, PhD, FASTMH; Stephanie Yanow, PhD, Assistant Scientific Program Chair; Capt. Judith E. Epstein, MD, of the Naval Medical Research Center; and Col. Robert M. Paris of the Walter Reed Army Institute of Research.
What situation or person inspired you to specialize in malaria?
I am the son of missionaries. I was privileged to grow up in the central highlands of Vietnam. I had malaria as a child, but I was fortunate to sleep under a net and had medicine to cure me. My parents ran a school, clinic and leprosarium. I witnessed service, passion and sacrifice driven by one’s faith and a commitment to provide physical and spiritual reconciliation.
Like everyone, I wanted to make a difference. I have had the pleasure and privilege to lead the President’s Malaria Initiative for a decade, and I can say without reservation that this work has provided me with challenges and rewards as great as those I experienced while on active duty with the U.S. Navy – except, perhaps, the thrill and excitement of taking off and landing aircraft from ships at sea!
I am thrilled to say that the incredible work of so many have led this program to being deemed one of U.S. Foreign Assistance’s greatest success stories. We collectively have reason to be proud – and much important work remains ahead.
Saving lives is what drives you, but what do you see as the economic benefit to eradicating malaria?
We have both moral and economic imperatives to end the disease. No child should have to die from a mosquito bite, yet malaria still kills a child every two minutes. Hundreds of thousands of children still die from malaria in Africa each year. It’s also a huge drain on economies, accounting for over $12 billion in lost economic productivity in Africa each year, due to the burden it places on health systems and the toll of work absenteeism and missed school days.
Malaria is both a disease of poverty and one of its root causes. Being poor makes individuals and communities more vulnerable, and malaria’s direct and indirect costs can also cripple economic vitality. Recently, public health economists identified the fight against malaria as one of the “best buys” in global development, estimating that a 50 percent reduction in global malaria incidence could produce $60 in economic benefits for every $1 invested in Africa. A new analysis also indicates that achieving malaria eradication by 2040 could deliver more than $2 trillion in economic benefits and save an estimated 11 million lives.
In thinking about malaria control and elimination efforts in the last five years, what stands out most for you?
The malaria fight is one of the most inspiring public health and development stories of our time. We have had great success improving lives and reducing sickness and death. The push to end malaria is also reducing the burden on healthcare systems, increasing attendance at school, improving worker productivity and boosting economies. We still have more work to do to assure that those hardest to reach are able to benefit from these efforts. Creative approaches will be needed to reach out to some of the hard-to-reach groups such as migrant workers and ethnic minorities. We are already piloting approaches, such as in Cambodia where we are working with plantation owners to provide ITNs (insecticide-treated nets) and diagnostic and treatment services to migrant workers. In some countries, where a large percentage of persons with fever and malaria seek care in the private sector, we are piloting approaches to improve the quality of the services provided. As we are increasingly successful in reaching stable populations, we will need to be increasingly creative in how we identify and reach out to those who have been missed.