In August Gabrielle Fitzgerald of the Bill and Melinda Gates Foundation chronicled an extraordinary five-day journey through Tanzania and Uganda on the ONE Blog. Joining her were Dr. Margaret Chan, Director-General of the World Health Organization, Mr. Ray Chambers, the United Nations Secretary-General’s Special Envoy for Malaria, and Dr. Tachi Yamada, President of the Global Health Program at the Bill & Melinda Gates Foundation. Gabrielle reflects on their visit, and the progress being made in the fight against malaria in Tanzania and Uganda:

Last month, we had the pleasure of travelling together to Tanzania and Uganda to review progress toward achieving the 2010 malaria goals. Our five-day visit took us to Dar es Salaam, Zanzibar and Kampala, with meetings in the capitals and site visits to villages in the surrounding area.

Along the way, we met impressive individuals at every stop who showcased the commitment that is required to fight an enemy as difficult as malaria. From Hassan Mshinda, a leader in science and technology in Tanzania, to Dr. Abdullah Ali, Zanzibar’s malaria director, to Kyagularyi Augustus, a subsistence farmer and community drug distributor who is a hero to his village of Bulimba, Uganda, we were continuously impressed by the dedicated professionals and volunteers who are contributing to the fight against malaria.

We also saw numerous examples of “African solutions to African problems.” We met with executives of local companies such as A to Z Ltd, which manufactures nets from a locally-owned factory in Arusha, Tanzania, and Quality Chemicals, which produces anti-malarial medicines in Kampala. We toured the research facility of the Bagamoyo Research and Training Center of the Ifakara Health Institute, which is leading the clinical trials of a new malaria vaccine candidate. And we joined a press conference with representatives from MTN and the Uganda Football Association, who are joining together with other partners to raise awareness about malaria through the United Against Malaria campaign.

The highlight of the trip was a visit to an empty pediatric ward at the Mnazi Mmoja Hospital in Zanzibar, which just three years earlier had been over-capacity with children sick from malaria. Seeing that ward was an affirmation that progress in malaria is possible, and is in fact happening. This outcome was due to both Zanzibar’s commitment to fighting malaria, paired with a highly-functioning health system.

The level of political engagement in both countries was very energizing, as evidenced in meetings with H.E. President Jakaya Kikwete of Tanzania and H.E. Vice President Gilbert Bukenya of Uganda. Both countries are fully committed to reaching the 2010 malaria targets. However, there are challenges that need to be managed to meet those targets. There are bottlenecks with funding, procurement and delivery of essential commodities. The good news is that those challenges are being addressed, particularly as this trip enabled meaningful and impactful discussions around issues pertaining to the disbursement of critical Global Fund resources.

One of the most rewarding aspects of the trip was seeing the impact of donor funds at work. Everywhere we went, we heard stories of what’s been able to be done with funding from the Global Fund for AIDS, Tuberculosis and Malaria and the U.S. President’s Malaria Initiative.

In the coming months, we plan to share what we learned on the progress and challenges toward reaching the 2010 malaria goals, through media interviews and speeches. We want to ensure that there is a greater understanding that development aid is working, as evidenced by the progress in malaria.

We hope that others will be as inspired as we were by the tremendous progress being made. The collective efforts of so many people are beginning to pay off, to ensure that malaria is no longer needlessly causing the suffering it has for too long in too many places.

Gabrielle Fitzgerald, Bill and Melinda Gates Foundation

Gabrielle Fitzgerald of the Bill and Melinda Gates Foundation is on the ground in Uganda with Dr. Margaret Chan, Mr. Ray Chambers, and Dr. Tachi Yamada. She reports back on their fifth day:

Our last event of the trip was the kick-off of Uganda’s United Against Malaria campaign – a coalition of local business, football and non-governmental organizations who have come together to raise awareness about malaria.

Dr. Tachi Yamada of the Bill & Melinda Gates Foundation joined Minister of Health Stephen Mallinga and representatives from MTN and Uganda’s football community in launching the campaign.

Edgar Watson said, “Football is a game that is so dear to my heart. It therefore gives me so much joy to see that the United Against Malaria campaign is using the football platform to fight malaria. I pledge to hold the football torch, as we, the coaches and footballers in Uganda all rally behind United Against Malaria. I do this for the children and for the future.”

Uganda is United Against Malaria!

Gabrielle Fitzgerald, Bill and Melinda Gates Foundation

Gabrielle Fitzgerald of the Bill and Melinda Gates Foundation is on the ground in Uganda with Dr. Margaret Chan, Mr. Ray Chambers, and Dr. Tachi Yamada. She reports back on their fourth day:

Kyagularyi Augustus is a subsistence farmer who lives in Bulimba, a small rural village off a dusty, rutted, track about an hour northwest of Kampala.

Augustus is also a community drug distributor for his village. When asked why he is willing to take on this added responsibility, he beamed with pride as he told visitors how much he likes helping people in his community, and the respect he gets for helping others. Dr. Tachi Yamada of the Bill & Melinda Gates Foundation was so impressed by his commitment, he told Augustus he is a “hero to his community.”

After leaving the village, we headed to Balibaseka Secondary School, where Uganda’s Vice President, Gilbert Bukenya, hosted a ceremony to welcome the delegation, honor the volunteer drug distributors and educate the community about malaria.

After schoolchildren recited a poem reminding their listeners of the symptoms of malaria, Dr. Margaret Chan, Director General of the World Health Organization, asked all the young people in the audience to help in the fight against malaria. They all shouted back in unison, “Yes, we will help!”

Learn more about malaria in Uganda here.

Learn more about the Global Malaria Action Plan here.

Gabrielle Fitzgerald, Bill and Melinda Gates Foundation

Gabrielle Fitzgerald of the Bill and Melinda Gates Foundation is on the ground in Zanzibar with Dr. Margaret Chan, Mr. Ray Chambers, and Dr. Tachi Yamada. She reports back on their third day:

Maliza Malaria!

Walking through the empty pediatric ward of the Mnazi Mmoja Hospital, Zanzibar’s malaria director, Dr. Abdullah Ali described the scene three years ago: three children in each bed, with many more sleeping on the floor, “The whole situation has changed completely,” he said.

This visit capped a day where the delegation learned more about Zanzibar’s incredible progress in the fight against malaria. Over the past decade, Zanzibar’s malaria prevalence has dropped to less than 1 percent, virtually eliminating hospital admissions and death due to malaria. 
Despite the good news, Zanzibar’s history provides a cautionary tale in the fight against malaria. This is the third time in 40 years Zanzibar has come close to eliminating this disease. In the past, the government gave up the fight too soon, and malaria came surging back. This time will be different, vow officials at every level of the government.

“We can no longer afford another bout of malaria resurgence,” Dr Abdullah Ali told the delegation.

To prevent that from happening, Zanzibar is maintaining their insecticide spraying campaign and encouraging people to sleep under nets. Through the U.S. Government’s President’s Malaria Initiative, Zanzibar has piloted the Malaria Early Epidemic Detection System, a partnership with the local mobile phone company to provide data to Zanzibar’s malaria office on a weekly basis. By looking at trends, officials monitor any possible malaria resurgence, to determine what may be causing the malaria, and what they can do to stop it.
 Zanzibar is truly close to reaching their goal of Maliza Malaria!



-Gabrielle Fitzgerald, Bill and Melinda Gates Foundation

Gabrielle Fitzgerald of the Bill and Melinda Gates Foundation is on the ground in Tanzania with Dr. Margaret Chan, Mr. Ray Chambers, and Dr. Tachi Yamada. She reports back on their second day:

WHO Director-General Margaret Chan greets a mother and her child in the pediatric ward of the Bagamoyo District Clinic, where the Ifakara Health Institute is testing a promising new malaria vaccine.

A one-hour drive from Dar es Salaam, Bagamoyo, is home to stunning crystal-clear water and white sand beaches, and also much history. It was an ancient slave-trading center and the port of disembarkation for American journalist Henry Stanley as he set off to search for British explorer David Livingstone.

Today, Bagamayo is home to a cutting-edge facility, the Bagamoyo Research and Training Center of the Ifakara Health Institute. Salim Abdulla, the impressive doctor who founded the center, gave the delegation a tour of the campus, and described how their medical research is fully integrated in to the district health system – meaning local residents can participate in tests of new medications at their village hospital.
We visited the 16-bed pediatric ward, where we were surprised to see three empty beds. Dr. Abdulla told us that 57% of the homes in the area own nets, and they have seen a decrease in the numbers of children coming to the hospital with malaria.

One of the most exciting activities currently underway at Bagamoyo is a trial of a new malaria vaccine for young children through a partnership of the Malaria Vaccine Initiative, GlaxoSmithKline and the Ifakara Health Institute. Bagamoyo is one of 11 sites across Africa where the vaccine is being tested. The first child was immunized in May, and the trial will eventually enroll 800 children to test this promising new vaccine. Early data shows that it will protect at least 60% of the vaccinated children from malaria.

Learn more about the RTS,S vaccine here.

Learn more about malaria in Tanzania here.

-Gabrielle Fitzgerald

Gabrielle Fitzgerald of the Bill and Melinda Gates Foundation is on the ground in Tanzania with Dr. Margaret Chan, Mr. Ray Chambers, and Dr. Tachi Yamada. She reports back on their first day:

Our first site visit this trip is to the Amana District Hospital, which provides care to the one million residents of the Ilala municipality. The hospital complex was large and well-maintained, and was filled with orderly rows of mothers and their children waiting to be seen.

Amana sees approximately 1400 people a day, and delivers 100 babies. New mothers are given a bed in the maternity ward for six hours to recover from the delivery of their baby, before being discharged to go back home.

But what has traditionally driven the high volume of patients at the hospital has changed in recent years. In 2006, malaria was the leading cause of admissions for both adults and children. Since then, Amana’s malaria cases have dropped by more than 50%.

The drop in malaria cases is due to increased use of insecticide-treated nets, new anti-malarial medicines and better diagnostic tests.

Tanzanian health officials credit support from the Global Fund for AIDS, Tuberculosis and Malaria and the U.S. President’s Malaria Initiative for this progress, and are confident that these numbers will continue to decrease as malaria programs reach a greater number of the Tanzanian population.

You can learn more about malaria, what it is, and how it’s prevented and treated, here.

You can learn more about bed nets and how they are distributed, here.

-Gabrielle Fitzgerald, Bill and Melinda Gates Foundation

Starting today, we will get on the ground reports from malaria sites in Tanzania and Uganda, as Gabrielle Fitzgerald of the Bill & Melinda Gates Foundation blogs for us. She will be traveling with Dr. Margaret Chan, Director-General of the World Health Organization, Mr. Ray Chambers, the United Nations Secretary-General’s Special Envoy for Malaria, and Dr. Tachi Yamada, President of the Global Health Program at the Bill & Melinda Gates Foundation as they visit programs that are making a difference in the fight against malaria. Join us!

Here’s some background and bios on the 3 travelers:

Special Envoy for Malaria Mr. Chambers is a philanthropist and humanitarian, and since February, 2008, has been serving as the United Nations Secretary-General’s first Special Envoy for Malaria. In this capacity, he is committed to achieving the Secretary-General’s goal of ensuring universal access to malaria prevention tools in all endemic countries by the end of 2010, with the ultimate goal of achieving near zero preventable malaria deaths by 2015.

Most of his other efforts have been directed towards children. He is the Founding Chairman of the Points of Light Foundation and co-founded, with Colin Powell, America’s Promise Alliance. Mr. Chambers is Co-Founder of the National Mentoring Partnership, and Founding Chairman of both The Millennium Promise Alliance and Malaria No More.

Mr. Chambers is also the Founding Chairman of the New Jersey Performing Arts Center and is a member of the President’s Council on Service and Civic Participation He is the former Chairman of Wesray Capital Corporation, which he co-founded with William E. Simon.

……

Dr. Tadataka (Tachi) Yamada, president of the Bill and Melinda Gates Foundation’s Global Health Program, leads the foundation’s efforts to help develop and deliver low-cost, life-saving health tools for the developing world. He oversees Global Health’s grantmaking, which focuses on four major activities: discovery, development, delivery, and advocacy.

Before joining the foundation, Yamada served as chairman of research and development and was a member of the board of directors at GlaxoSmithKline. Prior to that, he was chairman of the Department of Internal Medicine at the University of Michigan Medical School and physician-in-chief at the University of Michigan Medical Center. Yamada is a past president of the American Gastroenterological Association and the Association of American Physicians, a master of the American College of Physicians, and a member of the Institute of Medicine of the National Academy of Science in the United States and the Academy of Medical Sciences in the United Kingdom.

…..

Dr. Margaret Chan is the Director-General of WHO, appointed by the World Health Assembly on 9 November 2006.

Before being appointed Director-General, Dr. Chan was WHO Assistant Director-General for Communicable Diseases as well as Representative of the Director-General for Pandemic Influenza.

Prior to joining WHO, she was Director of Health in Hong Kong. During her nine-year tenure as director, Dr. Chan confronted the first human outbreak of H5N1 avian influenza in 1997. She successfully defeated the spate of severe acute respiratory syndrome (SARS) in Hong Kong in 2003. She also launched new services to prevent disease and promote better health.