Insofar as funding for malaria research and elimination is dependent upon the support and enthusiasm for it in Europe and North America, to what extent are the malaria professional communities in Europe /North America a little out of touch with what the general populations of Europe/North America actually know or think about the disease?
I am a retired UK lawyer. I had hardly any knowledge of or connection with malaria, and malaria for me would have been only an occasional news item. (I imagine the same applies to many others in the UK). Matters changed for me about 2 ½ years ago quite by chance, when I stumbled across some public health material including a small reference to the eradication of malaria in Israel, and how Palestine 100 years ago had been either very thinly populated or uninhabitable in many areas on account of malaria.
For the last five years, I have been assisting with a yearly event/exhibition to encourage 16-18 years old students to study the sciences at university. I gathered sufficient material about the effect and consequences of malaria in Palestine 100 years ago to display to these 16-18 year olds, because there was a likelihood that these students would go travelling in a ‘gap’ year before going on to university. As many of these students would have been travelling in areas where malaria was endemic, I thought they should see the effect and the dangers of malaria if they didn’t know it already, and the display of last year and earlier this year must have been seen by approximately 2,000-3,000 students.
It was fascinating and illuminating for me to talk to these students as, like me, they had had little or no previous contact with malaria. They suggested it was some exotic disease, that it occurred in far distant places, and that it did not impinge on their lives at all. There were scoffers who suggested it was overplayed, exaggerated, that it didn’t necessarily kill, and that anyway, most people recovered from it.
Incidentally, I have displayed this material and spoken a couple of times to educated adult audiences, and the ignorance about malaria of the adult audiences merely confirmed the ignorance of the students was not unusual.
Since February last, I have been reading MalariaWorld, and I wish to suggest that because many of you malaria professionals in Europe and North America have such an absorbing involvement with the disease, either in your laboratories or actually with malaria sufferers, you are unlikely to realise or notice to what extent the (non-malaria) others in the affluent western world are completely ignorant of the disease (other than them paying lip service as an item in an occasional news article).
The 2009 WHO malaria maps show that malaria has been eliminated from the whole of Europe and North America. In the early 1920s, the League of Nations established the Malaria Commission, a significant reason being to study/combat the malaria in broadly these areas, (although teams of experts did visit elsewhere). With malaria now no longer in Europe and North America, elimination now probably has a lower priority in these same Western areas than it had 90 years ago. The general population of those areas are now unlikely to know or recall much about the disease. Probably the European/North American governments previously were then enthusiastically providing funds to eliminate a disease within their own areas, but today, those same governments are less likely to be awarding the same level of funds for overseas aid when there are more pressing domestic needs at home. And the malaria of Europe/North America has long been forgotten. My experience in London has been that when talking to teenagers and adults about the consequences of malaria in eg Africa, there is a correct solemnity but not much else. I have tried using establishment material from MalariaNoMore or RollBackMalaria but little or no true interest has been generated. These adults and teenagers just do not seem to connect with malaria.
This lack of knowledge has a knock on effect for all you malaria professionals. The decision makers in these affluent malaria-free countries will usually react to the mood of their citizens when it comes to funding for malaria elimination. If a Western population considered malaria so important, that government or organisation is likely to provide greater funding. Less importance, lower funding. I have prepared a website/display www.malaria-aware.com which I intend to use with these students some time next year, and the primary intention is to explain the dangers from malaria if travelling. With this site, I merely wish to alert these students about the existence and dangers of malaria, and that if they still wish to travel, then my display suggests they should see a GP or travel clinic. But until these students understand and appreciate the danger of malaria, there is little or no point in telling them about precautions.
Donor fatigue will be apparent sooner than later if the donor does not share your sense of urgency. If the danger of malaria is not generally understood or appreciated by the donor population at large, that will trickle down to the decision-makers who may eventually withdraw from funding. Perhaps the time has come to concentrate on reminding and teaching Europe and North America what malaria was like, so that they will connect properly when you tell them about malaria elsewhere, and you go seeking funds to eliminate this wretched disease.
(I think a further matter that has surprised me is the fact that Palestine 100 years ago was ravaged by malaria which was eradicated in Israel 45 years ago, and yet despite this example, malaria still seems to extend itself around the world. Is this also donor fatigue, a loss of interest by Europe/North America? I have written in MalariaWorld about my historical findings on the eradication in Palestine/Israel at www.malariaworld.org/blogs/anton).