Experts have long been reluctant to even talk of trying to eradicate the mosquito-borne disease that kills more than a million people a year.
The last time a drive was launched to eradicate malaria, the year was 1955 and the call came from the governments of the world through the United Nations.
Now, two people from Seattle are challenging the world to take up the cause again.
Because their names are Bill and Melinda Gates, the world is paying attention.
The fact that the push is coming from philanthropists rather than governments is a testament to the clout the Bill & Melinda Gates Foundation now wields in the arena of global health.
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“The world has shifted,” said malaria consultant Melinda Moree, one of 300 experts at a forum sponsored by the foundation with an endowment bigger than some national budgets.
Eradication is an extraordinarily ambitious undertaking. Only one other major human disease — smallpox — has ever been wiped out, and many health experts have been reluctant to even broach the possibility with malaria.
The director general of the World Health Organization — the U.N. body charged with guarding the health of all the world’s people — was in the audience Wednesday for the Gateses’ presentation.
Margaret Chan enthusiastically endorsed the goal. She thanked the couple for being the ones to put the “elephant” on the table by bringing up a subject gun-shy malaria experts refer to as “the E-word.”
“What is happening on the ground while we’re talking here?” Chan asked. “Children are dying. … Let’s be brave.”
The $60 billion Gates Foundation’s annual spending on global health now rivals that of Chan’s organization.
WHO led the charge on the earlier, failed attempt to stamp out malaria, a mosquito-borne disease. After post-World War II successes in the United States and temperate parts of Europe, experts predicted similar victories in tropical climes where mosquitoes flourish year-round. The use of bed nets, DDT and cheap, effective anti-malaria drugs slashed the number of cases in countries like Sri Lanka. But funding dried up, the malaria parasite developed drug resistance, and the disease roared back.
Today, about half the world’s population lives in areas where malaria is endemic, and more than a million people — mostly African children — die of the disease every year.
“We know that the word ‘eradication’ is troubling to many people with a deep knowledge of malaria,” Melinda Gates told the group. “It’s an audacious goal.”
It’s not as incongruous as it may seem for a private foundation to be issuing the challenge, she said in an interview.
The Gates foundation has committed about $1 billion to the quest for new malaria drugs, a vaccine, new insecticides and programs to expand the use of existing tools, she pointed out. Many of those efforts are starting to bear fruit, fueling optimism in a field where progress was stalled for decades.
“We believe in this,” she said. “I think it’s natural for us to be the ones to call the question at this point. … If anybody else could do it, great. We just didn’t see anybody else who did it … and we felt the time was right.”
Her husband cautioned that malaria won’t go quietly or quickly — though he wouldn’t estimate how long it might take.
“That’s the dangerous question to answer,” Bill Gates said. “It’s certainly a decades kind of thing.”
Building on more than a century of research, it took health experts nearly 15 years to stamp out smallpox — a much simpler disease than malaria, with no insect host. Experts also hope soon to tackle remaining pockets of polio.
The Gateses said they studied the smallpox story, and concluded that the same thing could be done with malaria, though it will take longer.
There’s isn’t yet any single tool, like a highly effective vaccine, powerful enough to wipe out the disease. But a combination of existing measures, like bed nets, insecticides and drugs, can drive down the number of cases and shrink malaria’s range across Africa and Asia, Melinda Gates said. Then, as new drugs, vaccines and bug killers are developed, they could provide the knockout blow.
Though the malaria group gave the Gateses a standing ovation, some were cautious about the prospects for eradication.
Janet Hemingway, of the Gates-funded Innovative Vector Control Consortium, pointed out that African health systems are already stretched nearly to the point of collapse, with severe shortages of personnel that will make it hard to distribute new drugs or vaccines and care for malaria patients. In an earlier session, Stephen O’Brien, the British member of Parliament who chairs the Malaria Consortium, said it’s important to have credible goals when asking the citizens of a nation where there is no malaria to support government funding of control programs.
But Melinda Gates said eradication is a cost-effective goal. If the disease is only held in check, it requires a constant investment in drugs, bed nets and spraying programs. But if it’s eradicated, the world could be free of the burden.
Sandi Doughton: 206-464-2491 or firstname.lastname@example.org