George Osborne and Bill Gates have announced a major joint investment to address the challenge of malaria. This shows the reaffirmation of British commitment to play a significant role in global public health.
George Osborne strongly defended the decision to invest a lot of money in practical efforts to address global problems. The recent Ebola outbreak and the ongoing crisis with refugees from Syria, he argued, illustrate the degree to which the UK is part of an interconnected world. It is, therefore, in the UK national interest for its government to invest in finding solutions to major global problems. He pointed out that the UK has a lot of capacity to undertake research on global health. This, combined with the threat that infectious diseases pose to the well-being of people living in low income countries and to the global community, constitute a strong argument for prioritising this area.
Global investment in global health
This announcement is a major addition to the Ross Fund, which will support efforts to address resistance to antibiotics, strengthen global efforts to prevent and respond rapidly to outbreaks of new infectious diseases and address the continuing problem of neglected tropical diseases. Together, they represent a major investment in global health.
Bill Gates emphasised the progress made over the past few years in reducing mortality from malaria. He called for a concerted effort aimed at eliminating malaria by 2040, beginning with Southeast Asia and Southern Africa and eventually extending to tropical Africa. He said that the strategies could be modified based on the experiences of these two regions. He said that the achievement of this would have a dramatic impact on economic growth and the wellbeing of millions of families. He emphasised the contribution that research on new insecticides and anti-malarial drugs and on mass strategies for reducing transmission of the malaria parasite could make to this initiative.
It is not possible to predict whether the effort to eliminate malaria in under 25 years will succeed. Bill Gates acknowledged that this is controversial.
Eliminating malaria is not just about more investment
The recent experiences that George Osborne cited in West Africa and the Middle East, illustrate that investment in scientific discoveries and new technologies, on its own, is unlikely to be enough.
Many factors influence the degree to which technological breakthroughs lead to sustained improvements in the health of poor and marginalised populations:
- Governments need to implement basic public health measures to reduce the exposure of their population to malaria and other infections. This played a central role in the improvements in health during the nineteenth and early twentieth centuries.
- Governments also need to build their capacity to provide basic health services and deliver the new drugs or vaccines, or to regulate non-government providers, who do so.
- Individuals and local community organisations need to play a role in building a healthier environment and using the appropriate medicines and insecticides effectively.
The recent rise in the proportion of malaria parasites in the border regions of Southeast Asia that are resistant to artemisinin illustrates the danger that newly developed drugs can rapidly lose their efficacy if they are used where health systems are poorly organised. The response to the Ebola outbreak in West Africa exposed how low levels of trust between citizens and their local and national governments can jeopardise an effective response when an emergency arises.
It is certainly important that the large amounts of public funds the UK government is investing in development are used to devise and implement effective strategies for tackling major problems. These strategies will include measures to accelerate the development of scientific knowledge and of new technologies.However, they also should include research and social experimentation on the most effective way to ensure that residents of low-income countries benefit in a sustainable way from new knowledge and new technologies.
This is a worthy challenge for the UK research community and one of the reasons the Institute of Development Studies has made participation in these efforts to improve global public health a priority. We need to ensure that we are capable of living up to it by building collaboration across disciplines to address these complex but, potentially resolvable, problems.