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| Eric Swedberg holds a packet of antimalarial drugs, costing just a little more than $2.00 per treatment. |
Eric Swedberg, Child Survival Advisor, helps guide Save the Children’s global efforts to save the lives of children under age five in poor countries. For more than 15 years, he has been involved in the fight against malaria — a major childhood killer. The disease claims the lives of nearly 1 million children each year. On the eve of the first Malaria Awareness Day in the United States, on April 25, 2007, Eric shares his thoughts about promising new developments to prevent and treat the disease.
Q. How did you get interested in malaria as a life work?
I spent seven years of my childhood in Liberia, West Africa and saw first hand the devastating effects of diseases like malaria on children.
Q. Have you ever had it yourself? If so, how does it feel? If not, how did you avoid it?
Most of the time I was able to avoid malaria by taking a weekly Chloroquine pill, however, I have had malaria several times. In many ways it is similar to the flu but worse — high fevers, nausea, diarrhea, chills (when you feel like you are freezing despite layers of blankets) and terrible body aches, especially at night. During the day you may start to feel better, but then the aches, fever, and chills hit again!
Q. Do you think malaria's importance is recognized in most countries' global health efforts? In the U.S. efforts?
Malaria is only just starting to receive much-needed greater attention. Africa has the greatest problem because it has the most severe and life-threatening form of parasite, and the mosquitoes which transmit this parasite. Countries in Africa have lacked the resources and infrastructure to mount sustainable campaigns against malaria. There is now a growing commitment by African leaders for action on malaria and by donor countries such as the U.S.
Q. What has President Bush's malaria initiative accomplished? For children specifically?
The President’s malaria initiative, since its launch in June 2005, has reached an estimated 2 million people with lifesaving medicine, insecticide-treated bed nets and includes spraying households with insecticides. So far it is assisting seven countries in Africa and plans to add another eight countries in 2007. These activities especially help children because they are the most vulnerable.
Q. How does malaria affect children and pregnant women differently from adults?
Malaria is the leading killer of children under five in Africa. The disease claims more than 1 million young lives each year, with the majority of these deaths occurring in Africa. A newborn starts being vulnerable to malaria at four months of age when the maternal immunity to diseases diminishes. Children infected with the parasite will then start getting two to five malarial fevers every year. The tragedy is that the vast majority of these deaths are preventable.
Pregnant women are also particularly vulnerable because during pregnancy (the first pregnancy, mainly) women’s immune response is lowered and women are thus at higher risk for illness. And, when a pregnant woman gets malaria, it can lead to premature labor, putting her and her baby’s health at risk.
Q. What is Save the Children doing to help those children and mothers? For young people?
Save the Children is first providing treatment for pregnant women when they come for prenatal care services. This treatment of two or three doses of sulfadoxine-pyrimethamine (SP) protects women from malaria and Anemia, and also reduces low birth weight in infants, which leads to many newborn deaths.
Save the Children also provides bed nets treated with insecticide to pregnant women and children. They have proven highly effective in killing mosquitoes and preventing malaria transmission.
Save the Children is helping to introduce more effective drug therapies for treating malaria, because the older drugs are no longer effective — the bugs have developed resistance. We train health workers and community caregivers in the use of these new drugs, and help to set up management and logistics systems for their distribution.
Save the Children is also providing malaria treatment kits to schools in several countries where malaria is a major problem. Teachers are trained to diagnose the disease and give medicine to the children. Not only did this lead to reduced mortality but it has reduced absenteeism. Keeping kids in school is one of Save the Children’s major goals.
Q. What are the current challenges of fighting malaria? Is drug resistance the most serious?
A major challenge is getting bed nets to the people who need them the most. In villages all over Africa, people know about nets and want nets, but can’t afford them. To succeed in these poor rural communities, we need the resources for free, mass distribution of long-lasting insecticide-treated bed nets.
Drug resistance is one of the greatest challenges. Resistance to Chloroquine, the cheapest and most widely used anti-malarial drug, is now common throughout Africa. Many countries have changed their treatment policies and are starting to use drugs that are more effective; however, they are also much more expensive.
Q. What good news or developments do you see coming?
A number of African countries (including Eritrea, Tanzania, Togo, Malawi and Zambia) have conducted successful initiatives to increase the use of insecticide-treated bed nets.
A new promising approach under study is preventive treatment for children. A dose of anti-malarial drugs is given to children during three of their vaccination visits. So far, several studies have very encouraging results, but more research is required before this strategy is adopted on a larger scale.
Another new development is training community volunteers to treat children with malaria. Health facilities are often hard for families to reach, especially during the rainy season when malaria transmission in highest. Many countries are beginning to implement new strategies such as community case management, which will increase the number of children being treated.
Q. April 25th is Africa Malaria Day. And, for the first time in the U.S., President Bush has proclaimed Malaria Awareness Day on the same day. What do you hope will result?
I hope it will make the American public more aware of the problem and what can be done to prevent these needless young deaths due to malaria. I also hope it will lead people from all walks of life — corporate, government, and citizens — to join efforts to help. There are simple life-saving solutions, but we need to get them to children and families in need.
