Since 2000, the world has seen “remarkable progress” in the fight against malaria, according to the World Health Organisation, with 20 million fewer cases in 2017 than in 2010 globally.
But progress has definitely levelled off, and the toll of malaria is still unacceptably high. Even now, a child dies every two minutes as a result of the preventable and treatable disease.
Meanwhile, every year, more than 200 million new cases of the disease are reported.
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Urgent action is needed to get the global response to malaria back on track — and individual activists and campaigners are absolutely essential to making sure that malaria is kept high up on the political agenda.
Activists like Dr. Elvis Eze, 27, who now works for the NHS at Southend General Hospital, and knows only too well how devastating malaria can be.
“I was born and I grew up in Nigeria,” he tells Global Citizen, when we meet at a Pret a Manger at London's Trafalgar Square. “I have four siblings, three before me and one after me. But after I was born there was some unrest in northern Nigeria, and Kaduna to be precise, [and] my family had to move from Kaduna to Lagos.”
Despite growing up in a middle-class family, and not being as worried about health indices then as he is now, it’s only retrospectively that Eze realises his family “was actually only a health bill or a hospital bill away from poverty.”
“But that’s the story of the average middle-class family in Nigeria, so it’s nothing special,” he adds.
It was in Lagos that Eze trained as a doctor, studying medicine at the University of Lagos and working as a doctor in the main hospital for close to two years.
Here, in the hospital in Lagos, Eze first really came to terms with the impact of malaria and “seeing children die of different diseases, but malaria was one that stuck with me because it’s so common.”
Then, in 2015, Eze moved to the UK for the Commonwealth Young Professional Programme, and continued to work for the Commonwealth Secretariat for two years as an assistant health officer and carrying out policy research.
“It was a great experience being at the Commonwealth at that point, because it gave me the access that I needed and I took a step back and understood more what that space looks like and how to give my voice,” Eze added.
As well as his experiences in the Lagos hospital, Eze has also experienced the effects of malaria for himself.
“I had it a lot, like everyone in Nigeria,” he said. “This is why I feel like it’s an important story, but it’s not a special story. Just speak to anyone, and they’ve had malaria … But it’s important — it’s important that we know that it’s happening.
“The last time I had malaria was last year. Because it recurs and I go back often,” he continued. “So I was back last year for my brother’s wedding and, again, I got malaria. Because yes, we have precautions, we have the bed nets, we take all of those precautions, but can you imagine having to take a pill every day that you weren’t taking previously … sometimes you miss it, and when you miss it, you get malaria.”
“And I always joke that since I started doing more malaria campaigning, the mosquitos are kind of aware and tend to give me more malaria,” he added. “Every time I go back I almost always get it, no matter how many precautions I take.”
But what is the real impact of having malaria, and why is it an issue that everyone that everyone should be talking about?
“For the average person who hasn’t had severe malaria, malaria is one of those things that makes you lose maybe a couple of days of work, maybe a week,” says Eze. “So if you calculate how rampant malaria is in Nigeria, you’ve lost a lot of productivity from people not going to work.
“But this is just for the average person who is able to get treatment easily,” he points out. “But we have to remember that for loads and loads of people, [it’s difficult] to get treatment because, again, Nigeria has a large population living under the poverty line [$1.90 a day].”
“But then a malaria tablet costs more than $1, the full cost,” he adds. “So when people of that class get it, it’s almost like pushing them into poverty…there’s really nothing they can do.”
For Eze, working in a hospital, he came face-to-face with the most severe cases of malaria.
“It’s worse in children and pregnant women, and that’s another thing,” he says. “A kid can easily get cerebral malaria…which means fitting, having a seizure, all because of a disease that could have been prevented or cured easily.”
According to the World Health Organisation, Africa has the largest burden of malaria deaths, with 200 million cases in 2017 — 92% of the world’s malaria cases. That’s followed by the South East Asia region, with 5%, and the Eastern Mediterranean region, with 2%.
Nigeria alone has about 25% of the world’s total malaria cases, followed by the Democratic Republic of Congo (11%) and Mozambique (5%).
For Eze, it’s his personal connection with malaria that inspires him to keep going with his campaigning against malaria.
“I think a personal story is powerful and that power behind it should be used when you have it,” he says. “But if you don't have a personal story, you can still do much, much more.”
This is really key for Eze, that every single voice counts in the fight against malaria and even if, like him, you’re a marathon-running, 12-hour shift working NHS doctor, there is always more time in the day with which to do it.
For anyone aspiring to become a campaigner — about any issue, not just malaria — Eze believes that the central things to think about are: action, access, and accountability.
“Access would be maybe someone who’s a leader of a youth group,” he gives as an example. “Action might just mean the little thing you do in your little space, whether it’s just using your social media account or talking to a local school, doing something to raise awareness.”
“Those little things, they actually count,” he emphasises. “And then accountability is, when we do get into spaces where we’ve been given responsibility, how are we accountable for our current work and the next generation? And that’s the question we always need to be asking ourselves.”
But Eze is also quick to point out that activism and campaigning is not an area he ever saw himself in, until he suddenly found himself in it over the last couple of years.
He’s now one of the foremost advocates for a group called Malaria No More. During the Commonwealth Heads of Government Meeting 2018 Malaria Summit, Eze presented the Youth Declaration calling on heads of government to make clear commitments, with earmarked domestic financing, to join young people in eliminating malaria by 2030.
The Malaria Summit, co-hosted by governments from the UK, Rwanda, and Swaziland, called on governments across the Commonwealth to commit to halving malaria in the next five years. The UK government also reaffirmed a commitment of £500 million a year towards tackling malaria until 2020-21, including £100 million for the Global Fund to be match funded by the private sector.
As well as awareness-raising, more funding is absolutely key for the global fight against malaria — and it’s dwindling funding that Eze blames for the slowing down of progress.
The coming year will be critical for global health funding, particularly in the fight against malaria, with a replenishment coming up in October for the Global Fund to Fight AIDS, Tuberculosis, and Malaria — hosted by French President Macron in Lyon.
The replenishment seeks to raise at least $14 billion to help save 16 million lives, avert 234 million infections, and help the world get back on track to end these diseases.
But if you don’t have a spare $1 billion lying around, there are still things each of us can do to help support the effort, according to Eze.
“If you feel like you can add a voice to it, do more,” he says. “Being a campaigner doesn’t take special things, but it’s something special to do. It’s just about speaking up really.”
“In a global world, you can’t be isolationist,” he says. “And because you can’t be isolationist, a problem in one place is a problem everywhere. Whether it’s health, or climate change, if a country decides not to follow on our shared goals… then everyone’s going to lose.”
In that sense, he says, whatever you do in your little space affects the world in general.
“Day to day, it’s the opportunities you get, whether you’re on social media, or having a conversation around coffee… It’s just going at it over and over again,” he says. “It’s really that collective movement rather than individuals doing it on their own. It’s more lending your voice, and when you get a chance to be at the front, you shout about it.”