A stiff cocktail of regional cooperation to fight malaria

When the powerful antimicrobial medicine quinine came to Europe in the 1600s, it changed history. Religious leaders, royalty and the fortunate few who could obtain it often recovered from the mysterious bone-shaking chills and fever of the little-understood affliction called malaria.

The bitter powder gained popularity after it was credited with saving the life of England’s King Charles II and was later mixed with sweet water to form tonic and topped off with gin. The quinine-laced gin and tonic cocktail was seen by some as a miracle cure for malaria.

Though quinine has been used successfully for centuries, it has not been a miracle cure. The devastating parasites spread by persistent, elusive mosquitoes continue to bankrupt families, ruin villages, strain governments, and kill children.

More than 200 million people in nearly 100 countries contract malaria each year. An estimated 655,000 people are killed annually. A heartbreaking 86 percent of these deaths are children whose fragile immune systems cannot withstand the powerful parasite.

Though Africa is hit hardest by malaria, communities and families throughout Asia are also suffering. An estimated 36 million people in the region are infected each year, causing about 49,000 deaths. India, Indonesia, Pakistan, Myanmar and Papua New Guinea see the most infections.

The global economic impact of malaria has been estimated at more than $12 billion per year due to the cost of treatment, missed work and the lost economic opportunities for tourism and investment in affected areas.

Prosperous countries have defeated malaria. Aggressive monitoring, prevention and treatment have essentially run the once common disease out of North America and Europe ― clearly illustrating that malaria can be conquered.

Developing countries in Asia have made significant progress in combating malaria as well, but the poorest, most remote communities remain vulnerable. Too often, they are left to see their children die amid excruciating fever and shakes from a readily preventable ailment.

Increasingly, it is becoming clear that the same powerful forces that have brought unprecedented prosperity to Asia ― regional cooperation, trade and information sharing ― need to be harnessed to address communicable diseases such as malaria.

But the changes that have brought prosperity have also allowed communicable diseases such as malaria to move easily across borders and have hindered efforts by countries to isolate and eliminate the problem.

Amidst the factories that have given impoverished farmers good-paying jobs, there are also those which produce fake or adulterated malaria medicines that can move quickly through regional trade networks.

Among the most popular medicines to fake, or produce on the cheap at substandard quality, is artemisinin. This powerful and effective anti-malarial drug has played an important role in decreasing infections around the world. When it is adulterated, it can be sold at prices cheaper than the actual medicine.

Fake or substandard artemisinin, as well as incorrect usage of legitimate forms of the drug, has resulted in the emergence of drug-resistant strains of malaria. This disturbing trend has emerged in Cambodia, Myanmar, Thailand, and Vietnam.

Political leaders in Asia have recognized that in order to address these issues effectively, and eventually eliminate malaria, they must take the same concerted regional approach that has proven so successful in building prosperity in the region.

During the recent East Asia Summit in Brunei Darussalam, 18 leaders endorsed the creation of an Asia Pacific Leaders Malaria Alliance, which will partner with the Asian Development Bank and the World Health Organization, to bring political commitment, long-term financing, and a new approach to the fight.

The alliance, which aims to reduce malaria cases and deaths by 75 percent by 2015, will seek to contain the spread of drug resistant forms of the parasite by going beyond medical solutions and taking the fight into the areas of regional trade, transportation, migration, and industry.

The days of dreaming of a stiff gin and tonic as the cure for malaria are long gone, but leaders in the region have stepped forward to say that their countries are ready to join forces and do the hard work necessary to beat this disease.

By Woochong Um

Woochong Um is deputy director general of the Regional and Sustainable Development Department of the Asian Development Bank. ― Ed.