The Prevention Paradox

Bed nets save lives and can help eliminate malaria. I had the opportunity to see this first hand at the Global Fund to Fight AIDS, TB and Malaria board meeting in Sri Lanka in June. The Government of Sri Lanka, with support from the Global Fund, has shown tremendous success controlling malaria with bed nets, along with indoor spraying, diagnosis and treatment, and disease tracking. There has been a 99.9% decline in malaria cases since 1999 when there were 264,000 cases of malaria. By 2012, there were only 23 cases in Sri Lanka, a country of almost 21 million people. There has not been a single death since 2007!

We should celebrate this success, but not let it sway our commitment to completely eliminating all malaria cases. Sri Lanka has been here before; in 1963 there were only 17 cases. With so few cases, attention shifted away from malaria, but success in malaria control is fragile. Plenty of mosquitos and some infected humans remained, and it only took a few years for malaria to come back, with 1.5 million infections between 1967 and 1968. Control efforts were reintroduced, but it was too late and the problem was already too big to tackle quickly. Millions of people needlessly fell ill with malaria over the next three decades. This is a paradox of prevention: when there are very few cases of malaria because of successful prevention efforts, commitment often wanes as people no longer see malaria as a problem. This results in a resurgence of the disease.

Unfortunately, Sri Lanka is only one example of what happens when interest in malaria control declines. In Africa, where Nothing But Nets works, Zanzibar, Mauritius, Madagascar and Swaziland (among others) all went down this same devastating path at one point or another.  Fortunately, with the aid of bed nets, all of these countries have dramatically reduced malaria again. This time we must work hard to sustain the gains we have accomplished and learn from our past. Now is a pivotal time in the fight against malaria. 

This year, your elected officials are deciding how much funding the U.S. Government will commit to the Global Fund.  You can ensure that we sustain the gains against malaria and send even more nets to save more lives by using your voice and telling Congress to support these life-saving interventions.  Send them a message here!