Fighting Malaria: Will U.S. Cuts Hurt Global Effort?

On this World Malaria Day, African countries celebrate major gains in fighting malaria. During the past 10 years, 11 African countries have seen new malaria cases and deaths drop by more than 50 percent — due in large part to funding by international donors. But will budget cuts in the U.S. and other donor countries mean setbacks to the worldwide effort against malaria? Host Michel Martin discusses the future of fighting malaria with Dr. Joia Mukherjee, chief medical officer for Partners in Health.

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MICHEL MARTIN, host:

I'm Michel Martin and this is TELL ME MORE from NPR News.

Coming up, paparazzi may be a common site in New York or L.A., but Washington, D.C.? In our weekly look inside the pages of The Washington Post Magazine, we'll find out why the paparazzi are coming to the nation's capital. In fact, they're already here.

But, first, we want to tell you why today on World Malaria Day leaders of a hospital in Rwanda, among others around the world, are celebrating. World Malaria Day was started by the World Health Organization to recognize progress made in controlling the disease around the world, and progress has been made.

International donors poured an estimated $1.8 billion just last year into fighting malaria and similar amounts in recent years. The investment is paying off. In the past 10 years, 11 countries in Africa have seen the number of new malaria cases and deaths drop by more than 50 percent; that, according to the World Health Organization.

But now as the U.S. and other donors struggle with their own budgetary concerns, health experts worry that the headway made in controlling malaria might be threatened. For more on this, we've called on Dr. Joia Mukherjee. She is the chief medical officer of Partners in Health. That's an international health organization with projects in Rwanda, Haiti, Peru, Mexico and eight other countries. She's a doctor who specializes in infectious disease. And she's also an associate professor of global health at Harvard Medical School. And we reached her on the line from Boston.

Dr. Mukherjee, thanks so much for joining us.

Dr. JOIA MUKHERJEE (Global Health, Harvard Medical School): Thanks for having me.

MARTIN: Well, Happy World Malaria Day to you.

Dr. MUKHERJEE: Thank you very much. We're happy to have some progress on this day.

MARTIN: You know, we wanted to get a sense of the efforts to control malaria in one place, so we spoke earlier with Dr. Peter Drobac. He's the director of Partner in Health's Project(ph) in Rwanda. He's a friend of yours. He's a friend of yours. He directs 37 health centers and three rural hospitals around the country and this is what he had to say.

Dr. PETER DROBAC (Director, Partners in Health Project in Rwanda): The Rwanda Ministry of Health just did a fairly rigorous analysis of the progress so far in malaria control. And the findings thus far show a 70 percent reduction in the overall number of malaria cases over the last several years, and a 61 percent reduction in malaria deaths.

MARTIN: So I wanted to ask if this success is typical and what do you think are the major factors contributing to it?

Dr. MUKHERJEE: Yeah. I think the success in Rwanda is never typical because Rwanda has an enormous amount of political will and the ability to really have policy change at the national level be translated down at the health center level throughout the country. And we're happy to be partners with the government of Rwanda. But even in places we are not partners with them, they have profound effect. So Rwanda is less typical.

However, we are seeing drops throughout the world, as you mentioned in the introduction. And I think it's very encouraging. The thing is, we've long known what to do to prevent and treat malaria. And we have had a lack of finances globally to bring to bear on the problem. And so left to the devices of the market, the people who are most vulnerable to malaria, poor children are really ill-equipped to just pay for bed nets or medicines on, you know, on - if the burden is placed on poor families.

MARTIN: Well, one of the things that activists have long told us, which is that some of the - one of the key prevention efforts, bed nets, are actually quite inexpensive. But what about the treatments?

Dr. MUKHERJEE: So, bed nets are very inexpensive, and yet any - before I go to treatment, I would say that what we found, and some interesting work was done at the Poverty Action Lab here in Boston, showing that any fee for a net for a poor family results in not - no net being used. So regardless of how cheap they are, we have to make them free and we have to help people to install them in their homes.

The treatments, the prices have come down and some of this has been due to generics coming on the market. Some of them have been due to philanthropic efforts of companies like Novartis to make drugs such artemisinin-based compounds much much cheaper for poor governments to afford. So we see a lot of forces, more money to the problem, some corporate responsibility, some generic competition and political will on the parts of governments to really bring these treatments to the people who need them most.

MARTIN: Now, I want to ask you, though, that it's no secret that this country is facing, you know, budgetary issues, certainly around the deficit there's been some very heated discussion around how the U.S. spends its money and what its priorities should be. So - and foreign aid is one of those areas that often does not have a very vocal constituency.

So I'd like to ask you: What would you say to someone who asks why malaria should be a funding priority at this point when the U.S., certainly among other donor nations, is struggling with its own issues?

Dr. MUKHERJEE: Well, first of all, obviously I'm a very big supporter of U.S. foreign assistance as a way of promoting peace and stability throughout -around the world. And I think as we look at our military spending, and some have just recently - even from the military itself, we see that this kind of force that we're using is not really winning hearts and minds around the world.

The treatment of malaria, on the other hand, is highly effective, prevention is highly effective and relatively inexpensive. And malaria remains one of the biggest killers of children under five around the world. So this is a way that the American people in concert with governments can do something very positive that will have a profound effect even in the short term, in less than a year, one malaria season, and can really generate life-saving therapy as well as really, you know, a way to express our solidarity and concern for children all over the world.

So I think this is a really great investment in the lives of poor children, and not only in the lives, but the intellectual and social achievement of these children.

We know that profound anemia, which is caused by multiple bouts of malaria, is one of the main things that prevents children from reaching their social potential. And so you can stop that by treating malaria.

MARTIN: All right, Dr. Mukherjee, we just have one minute left. So I wanted to ask you: International leaders, including the U.N. Special Envoy for malaria and President Obama, have expressed the goal to stop all bets for malaria by 2015. Is that realistic?

Dr. MUKHERJEE: Yes, absolutely. I love ambitious goals and we should do it.

MARTIN: Do you think we will?

Dr. MUKHERJEE: Sure. Absolutely. If we have the will and we have the money -and the will is there by the countries that want to stop this problem to see -stop seeing children die needlessly. So we need the money. We have plans. It's not a difficult thing to do. We can do it.

MARTIN: Dr. Joia Mukherjee is chief medical officer of Partners in Health. That's an international health organization with projects in Rwanda, which we've been hearing about, Haiti, Peru, Malawi and eight other countries. She has worked in international health for more than 20 years and she was kind enough to join us on the line from Boston.

Dr. Mukherjee, thank you so much for joining us.

Dr. MUKHERJEE: Thank you. And thanks for having this program.

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