Malaria’s Greatest Fears

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Let’s get hypothetical. If you were to make a list of malaria’s greatest fears, what would you include?

Topping my list would be Rwanda, which in the last three years decreased the reported incidence of malaria by 60% — and there’s nothing hypothetical about that.

Thursday, I had the opportunity to attend the Global Health Council’s congressional briefing on Rwanda’s fight against malaria. Through an incredible integration of prevention, treatment, mosquito control, and health system strengthening, Rwanda decreased cases of malaria reported in public clinics from 1.7 million in 2005 to 700,000 in 2008! How did Rwanda do it?

To begin, Rwanda implemented the common system of community health workers in a unique and effective way. Instead of having the community health workers act as an extension of individual NGOs or other charitable organizations, they are an official piece of Rwanda’s health system. Rwanda’s community health workers are elected by their community, hired by the government, and are therefore accountable to both. They are the backbone of Rwanda’s progress in eradicating malaria, and the numbers back this up.

In 2005, only 1 in 10 high-risk households had a bed net. In 2008, after the distribution and usage follow-ups by the community health workers, this number rose to 6 in 10. In addition, 9 out of 10 fevers are treated within the first 24 hours and 9 out of 10 high-risk households are sprayed with pesticide. Both the treatment and spraying are done by the community health workers. Couple the work in the field with a government that is extremely results-oriented and tough on corruption, it is no surprise that Rwanda is winning the fight against this preventable disease.

Though there are definitely factors still to be confronted, the largest being tackling malaria not just in Rwanda but the region as a whole, the foundation is laid and the enthusiasm is there. In a region where it is easy to focus on the challenges, it is refreshing to hear a positive story.

-Ian McGroarty, ONE’s US Field Team Intern

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