The Malaria Misstep: Let African Scientists Solve Our Own Problems
In many ways, I am lucky to be alive. Growing up in Nigeria, I suffered several bouts of malaria when I was young, with intense headaches and fever. The latest World Health Organization statistics show that more than 400,000 people died from malaria in 2016 and pregnant women and children (like I was) are the most susceptible. My best friend was not as lucky as me, and when we were 9 years old, she died from cerebral malaria because the treatment she was given was ineffective.
A long-term outcome of my own experience with malaria and that of my friend is that I have dedicated my professional career to finding innovative ways to stop the spread of malaria infection in Africa. One of the biggest obstacles I see is that despite Africans suffering from malaria infection the most, 92 percent of malaria deaths in 2015 occurred on the African continent, the majority of the research against malaria takes place outside the African continent. This makes no sense. Instead, if we want to control malaria we need donors to invest more of their money in training African scientists who will oversee future malaria control innovations.
There is an urgency for this to happen now. Current research shows that the drug used to treat malaria, artemisinins, is failing in Southeast Asia due to drug resistance. Now there are fears that this resistance will spread to Africa, increasing the number of malaria deaths even more. Unfortunately, these fears seem to be justified as a recent study has shown that three patients, who presented with malaria at a hospital in Britain, had already received prior malaria treatment which didn’t clear their parasite infection. These patients were travelers who became infected in Angola, Liberia and Uganda and when they relapsed, the doctors realized that the artemisinin-based drugs had failed and the patients were subsequently treated with different drugs. But this means that the typical drug of choice has started losing its efficacy on the African continent.
If this is going to be the African reality in the near future, it means Africans need to be in a position to control the spread of resistance. Fighting malaria requires specialized and skilled scientists, yet the majority of African countries lack them. It is devastating that as a young malaria researcher, I do not see a good representation of Africa scientists carrying out malaria research at international conferences like the American Society for Tropical Medicine. This is simply because Africans do not have the same research opportunities as their counterparts. I personally had to go through my training outside the continent due to the lack of an enabling environment for science research and development.
Right now, most of the malaria funding comes from donor organisations and countries and a lot of the research is done in institutions outside of Africa, even though Africa is where the burden is. Various donor organisations have threatened to drastically reduce and, in some instances, stop funding for malaria research to recipient countries because of poor management of donor funds. Recipient African countries simply cannot maintain gains against malaria with the current country contributions and so it is important that international funding does not cease.
We need direct investments that improve scientific capacity to be made by both international organisations/donors and governments of African countries. That funding can help ensure that the right scientific skills needed to reduce malaria in Africa are home grown. These skills can be fostered by encouraging Africans’ entry into STEM subjects and through direct investments in science, technology and innovation. It is absolutely important to create innovative ways to maintain transparency in donor fund spending, to prevent incidences of mismanagement if funds are to be directed where they are needed.
Then, Africans can find solutions to their own problems and malaria elimination strategies will be planned from within individual African countries as opposed to an office in New York. They will have complete ownership and direction of projects and/interventions. This is especially important as no one African country is the same as the other and a tailored research and implementation approach is necessary. Simply replicating a program in Nigeria, for example, because the same programme worked in the Gambia is not realistic, especially as both countries have different profiles and even political systems which have an effect on the feasibility of malaria control programmes/strategies.
Ultimately, although there have been major gains in malaria reduction with the majority of effort from international organisations, to get to the point of malaria elimination, African countries have to be the major drivers of malaria control strategies. Thus, on World Malaria Day, this is a direct call to both international organisations and leaders in African countries to invest directly in research as a means of sustainably controlling and eradication the spread of this scourge.
Ify Aniebo recently received her PhD from Oxford University, and is working on a malaria project with the London School of Hygiene and Tropical Medicine. She is a 2016 Aspen Institute New Voices fellow.