Agriculture & Public Health; #ReadytoBeatMalaria, Together

Op-Ed by Sarah de Souza, member of the Environmental Science business unit within Bayer’s Crop Science Division

I was only 8 years old when the Roll Back Malaria Partnership (RBM) was created but I had already suffered from malaria several times by then.  I was born and grew up in France but my family comes from West Africa.  When I was a child, our family would visit relatives in Benin during the holidays.

Despite taking malaria prophylaxis, sleeping under bed nets, using mosquito repellents and wearing appropriate clothing, I caught malaria on several occasions and spent time in hospital fighting for my life. I remember the sickness caused by malaria being worse than anything I have ever experienced.

Coming from an affluent background and staying in the country’s economic capital of Cotonou, meant that I was diagnosed quickly and had easy access to medicine; my recovery was therefore relatively quick and without major consequence. Thankfully, I did not form one of the statistics of a child under 5 which still commonly dies from this preventable disease.

Those trips to Africa as a child opened my eyes and inspired me towards my studies in science as a means to find solutions to some of the most pressing social challenges; namely health and nutrition. Malaria has a clear link with the former but a less well-recognised one to the latter of those.

With 216 million cases and half a million deaths reported annually, malaria in Africa is first and foremost a health issue, however, there are also significant consequences that go far beyond the intolerable sickness and suffering it causes.

Malaria is a predominantly rural disease and the mosquitoes that transmit the disease generally need the same three elements required for productive agriculture – heat, water and people. The 500 million smallholder farmers, responsible for 80 percent of the food consumed in developing countries, are therefore some of the most affected by this disease and the consequences in terms of nutrition are profound.

Farmers, who rely on growing crops for their livelihood, cannot tend to their fields, provide food for their family or use the surplus to create an income if they are suffering from malaria.  Women, who play a leading role in farming in rural Africa, are especially vulnerable to malaria.

When sick they are no longer able to take care of the family crops but they also carry the additional burden of caring for sick family members at home. This leads to the family being short of food and income – further reducing their ability to afford medical treatment. It is a vicious circle in which disease flourishes – an example of the poverty trap in all its might!

But the need to eradicate malaria in order to ensure sustainable food supply goes even further than the needs of the individual farming families and their local communities.  It is of global importance. By end of the century, it is estimated that there will be an additional 4 billion people on Earth – and 3 billion of these will be born in Africa.

The continent must therefore quadruple its agricultural productivity to feed itself and to ensure economic and social stability – not only within the continent but also on an international level. Eliminating malaria could strongly contribute to that – according to a recent study, there are a potential 3.8 billion agricultural working days that could be saved if malaria was eradicated by the year 2040.

While sub-Saharan Africa is rich in natural resources and is home to nearly half the world’s uncultivated land, I believe innovation in agriculture will be the key to increasing productivity.  However, innovation in public health will also have an important role to play.

I have worked with Bayer for the last 2 years in Ivory Coast, West Africa where 65 percent of the land is agricultural and two-thirds of people’s income comes from the production of what is called “Brown Gold”- cocoa and where malaria transmission rates are some of the highest in the world.

My work involves bringing sustainable malaria prevention to the smallholder farmer communities in the form of insecticide-based vector control solutions which are currently the most efficient and cost effective means to prevent the disease today. Indeed, nearly 4 in every 5 of the 663 million clinical cases averted since 2000 have been thanks to insecticide-based vector control interventions, such as treated bed nets or Indoor Residual Spraying of houses.

Bed-nets are a highly effective and well-known vector control tool but face challenges related to human behaviour – for example, in times of hot weather in the Ivory Coast many people tend not sleep under nets because they complain that they are too hot. Indoor Residual Spraying is challenging to implement at scale but is widely recognised as being effective when well implemented.

Together with the support of the Institute of Public Hygiene, a branch of the Ministry of Health in the Ivory Coast, we are working together with the cocoa cooperatives on a pilot initiative to train those responsible for applying crop protection products so that they are also qualified in Indoor Residual Spraying against malaria vectors.

The ultimate objective is empowerment, enabling local communities to effectively and sustainably protect themselves against malaria, allowing them in turn to potentially increase their yields and so their economic wellbeing.

The pilot has been running for 4 months and involves implementing Indoor Residual Spraying in the temporary camps where cocoa workers live. In these camps, farm workers are not likely to take their own mosquito nets from home but spraying of the structures is a workable solution.

The cooperatives are already reporting that they are experiencing a drop in the number of mosquitoes but we now need to establish a system of reporting to measure the impact of the initiative on the number of malaria cases amongst the farm workers – something that is easier said than done in some of the remotest areas of the world.

Today, more than ever before, the agriculture and public health sectors are understanding that sustainable malaria prevention and a reliable food supply go hand in hand.

At the World Malaria Summit in April this year 5 of the leading agricultural companies, including Bayer, came together under the banner of “Zero by 40” signing a declaration to continue investment into the research, development and supply of vector control solutions with the aim of eradicating malaria by 2040, in less than a generation.

 This joint commitment has been made in the very same spirit of collaboration and rallying behind a common goal that was the inspiration behind the establishment of the Roll Back Malaria Partnership 20 years ago.

Since then over 7 million lives have been saved thanks to increased international investment and coordinated action driven by the RBM Partnership.  We need now to apply and build upon the learnings of the last 2 decades to ensure that the RBM anniversary in 20 years to come is not only the celebration of a date in time but also the celebration of malaria eradication across Africa.