Talking malaria with Ben Rolfe

Talking malaria with Ben Rolfe


In Asia, malaria is largely a disease of rural men, particularly in Southeast Asia. That means that we have some really novel problems in terms of dealing with forest malaria, in dealing with mobile and migrant populations, in dealing with populations that are moving across borders and therefore moving between health systems. That’s a particular challenge when we move to elimination. My personal view is that elimination by 2030 is absolutely possible. We have a whole range of challenges in the region and it’s certainly not a done deal. But I think there are many reasons for optimism and a number of challenges as well: We’ve seen the resurgence in Cambodia, a resurgence in Papua New Guinea, really showing that if you don’t keep your foot on the gas, you see the malaria come back to bite you. I think historically one of the biggest achievements in malaria has been the development of new therapies – artemisinin and combination therapies, that have had an enormous impact worldwide on how we treat the disease. The challenge we have now is the emergence of multidrug resistant malaria, in our region within the Greater Mekong Subregion, and that is affecting our ability to tackle malaria and to eliminate malaria and the experts all unanimously agree that the only solution to drug-resistant malaria is eliminating the disease for good and we now have a goal to eliminate malaria by 2030 across the whole of Asia Pacific. The fascinating thing about malaria elimination is it does require a strong health system to deliver. But to sustain zero malaria really requires an active presence of health professionals in communities. So that they can quickly identify and respond to outbreaks. And so, investments in malaria we have seen actually strengthen the broader health system. So, the message really is that you have to invest in the public health infrastructure, in prevention and primary health care, and if you do that well you drive down malaria as well, which has an ongoing benefit of course for everybody. The private sector is a massive contributing factor to the solution in malaria elimination. And as we move from control to elimination – it’s a complete change in mindset and it’s a complete change in intervention strategy and managing 2 billion people at risk of malaria and making sure that we’re responding to every case in a timely manner can’t be done without new technology. Mosquitoes don’t have passports. Countries have to move together to eliminate where they have shared borders and so having an understanding of what the bottlenecks are, what the shared challenges are, really helps countries as they coordinate with each other to eliminate malaria. The landscape for malaria elimination has changed beyond recognition in the last five years since I’ve been working in this space: the level of leadership, the level of financing, the level of commitment. So, I’m incredibly optimistic about the future. I think the success that we’ve seen in China, in Sri Lanka and that we will soon see in Malaysia, in Bhutan, is giving a huge sense of optimism to the malaria community. As long as we can sustain the current level of investment and leadership then I am really confident we can eliminate malaria by 2030.

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