Jakaya Kikwete, the former president of Tanzania, recalled arriving at his cousin's house to find the family arguing about taking their feverish teenage daughter to hospital.
"They were saying: 'No, no, no, it's not malaria',"
he said, describing how the family had sought advice from a traditional
medicine man who said a jinni, or spirit, had invaded her body.
Ignoring their protests, he took the girl to hospital but it was too late. She died from malaria.
Kikwete,
who also lost his brother to malaria as a child, is committed to
eradicating the disease, which killed an estimated 438,000 people
globally in 2015 - making the mosquito, which transmits it, the world's
deadliest creature.
He and his wife even appear in television adverts, urging Tanzanians to prepare their bednets before they sleep.
"We are looking at 2040 as the most probable date for a malaria-free Africa," Kikwete, who stepped down as president in November, told reporters at a recent dinner in Dar es Salaam.
"If we continue with the interventions that we have been doing here relentlessly, we should be able to get there."
THE "E-WORD"
Global
plans to eliminate malaria were abandoned in 1969 as the goal was seen
as prohibitively complicated and expensive, despite success in
eradicating the disease in the 1950s in parts of Europe, North America
and the Caribbean.
The "e-word" has been revived
in recent years, with support from the world's richest couple Bill and
Melinda Gates and U.S. President Barack Obama, who called malaria a "moral outrage".
Bill Gates, who Kikwete describes as a "good friend", aims to eradicate malaria by 2040 and has called for a doubling of funding by 2025.
His
goal of permanently ending transmission of the disease between humans
and mosquitoes is more ambitious than the Sustainable Development Goal
of ending epidemic levels of malaria by 2030.
Spending
on malaria, mostly by the United States, surged to $2.7 billion in 2015
from $130 million in 2000, while death rates in Africa have fallen by
66 per cent, according to the World Health Organization (WHO).
The
most important investment was the roll out of one billion free bednets.
Some 68 percent of malaria cases prevented since 2000 were stopped by
these bednets, according to a study by the University of Oxford.
Money
was also poured into improved diagnostic tests, better drugs, indoor
spraying with insecticide and educating the public to use these tools -
rather than blaming witchcraft or buying medication blindly over the
counter every time they got a fever.
EVERYTHING IS FREE
In
the Tanzanian town of Arusha, overlooked by the dormant volcano Mount
Meru, donor-funded bednets and free tests and medicines have made a
significant impact.
In a country with a powerful
faith in witchcraft and traditional medicine, health officials have
worked hard to persuade people to adopt proven methods of preventing and
treating the disease.
"There are very few cases of malaria nowadays," said Pius Dallos, the officer in charge of Kijenge Dispensary, where women sat on wooden benches, cradling their babies.
"Previously... if you didn't have money, you could die from malaria. But nowadays, everything is free."
But
donors' ability to maintain - and increase - funding is by no means
certain given sluggish global growth and uncertainties over U.S. funding
under a new administration.
"The political will to go that final mile may be hard to sustain because it will remain expensive until the end," Dyann Wirth, a tropical disease expert at Harvard T.H. Chan School of Public Health, told the Thomson Reuters Foundation.
"It's a question of priority."
It
is unlikely that Africa, which accounted for nine out of 10 of the 214
million cases of malaria in 2015, according to the WHO, could foot the
bill itself.
On the edge of Arusha, Africa's
largest bednet manufacturer, A to Z Textile Mills, has been the main
source of 50 million free bednets given to Tanzanians between 2009 to
2016.
Giant, noisy warehouses produce
insecticide-treated fibres which are woven into round and square blue
bednets. Women in green T-shirts work in fast-moving pairs, folding and
cutting panels ready for stitching.
Donor funding drives production of the much-needed nets, as many ordinary Tanzanians cannot afford them.
"Demand is not driven by the need (but) by the funding,"
said factory director Kalpesh Shah, sitting in front of framed
photographs of visits by celebrity campaigners like Bono and Will Smith
on the boardroom wall.
Commercial customers
account for less than one percent of sales, he said. The Gates-funded
Global Fund To Fight HIV, Tuberculosis and Malaria is their main buyer,
followed by the U.S. President's Malaria Initiative.
"The question of sustainability is on everyone's mind," said Daniel Moore, acting mission director for the U.S. Agency for International Development (USAID) in Tanzania.
"Right now, we are carrying the load."
RISK
The failure of the global eradication programme that began in the 1950s casts a shadow over the latest campaign.
As
mosquitoes and parasites developed resistance to insecticides and drugs
in the 1960s, malaria rebounded in countries like Sri Lanka where once
it had been virtually eliminated.
Resistance is
becoming a major problem again. But greater efforts are being made to
invest in new products that will keep humans one step ahead of
evolution.
New tools are also required to
eliminate the parasite from 'asymptomatic carriers' - people with a few
parasites in their blood who don't fall sick but can act as reservoir
and spread the disease when they get bitten again by mosquitoes.
As
the number of malaria cases falls, it will become harder to maintain
the momentum among donors, governments and ordinary people in endemic
regions.
"Without the long term investment of
funds and the political commitment to continue the fight, we risk
wasting the entire investment," said Wirth.
"We are going to go back to the s
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