Jessica Uno is winner of the World Briefing: Telling the Malaria Contest co-sponsored by Novartis Pharmaceutical Corporation and Malaria No More. Her winning essay earned her a trip to cover the MIM Pan-African Malaria Conference in Kenya and report back on the latest in the global effort to end malaria.

On the ride home from Mwea Mission Hospital, we stopped at a market center to buy locally-grown rice. When I stepped out of the car, I was immediately saddened by several vacant-eyed children begging for food. Our car driver told us that even when children have enough to eat, they often get the same variety of food year-round, which leads to malnutrition. This scene reminded me that even if a child does not suffer from malaria, his or her health is constantly threatened by other destructive forces. One source of hope are people like the dedicated staff at Mwea– if folks like these continue to reduce malaria, more resources and attention will be freed up to focus on other important issues plaguing communities across Africa.

Later in the trip, I met Dr. Nathan Mulure, Manager of Africa Operations, Malaria Initiatives at Novartis. Dr. Mulure told me that during medical school in Nairobi, he was taught that malaria was a common fact of life, not a disease that could be eradicated. Since, Dr. Mulure has been working to change this fatalistic attitude. In his role at Novartis, he helps to lead National Malaria Control Program (NMCP) “best practice” meetings attended by healthcare workers across Africa. These meetings encourage attendees to share effective techniques used in their local communities and discuss ways to expand access to prevention and treatment tools like antimalarials.

Dr. Mulure is a fine example of someone who has successfully wedded his interests in medicine and policy.  I was impressed with Dr. Mulure’s holistic approach to fighting malaria, which combines science and medicine with anthropology and sociology, policy, and economics for a multilateral attack on the parasite’s reign. From our conversation, I realized that it IS possible to take on responsibilities in both areas and develop a multidisciplinary expertise with tangible accomplishments.

At college campuses across the US, including Stanford, students are often advocating and recruiting their peers to champion different causes. Statistics comparing one issue to another are frequently used to highlight the relative urgency of each cause. I dislike this practice because I don’t think cancer is any less significant than human trafficking or world hunger any less important than heart disease.  When I asked Dr. Mulure about how he would present the topic of malaria to college audiences in a way that communicated its urgency without detracting from the other major diseases or causes, he noted that most illnesses and symptoms of poverty are interconnected.

Dr. Mulure reminded me that malaria is not only a leading killer of children in Africa, but also a leading cause of poverty. In relation to AIDS, malaria is a short-term illness that kills more quickly than AIDS – and people with AIDS are also victims to malaria. By alleviating malaria, not only can we eliminate a major threat to people living with AIDS, we will free up the $12 billion annually that Africa loses each year due to malaria. Ending malaria would also enable healthcare professionals to focus on other epidemics in Africa like AIDS and hunger. Reducing malaria is one step towards ending poverty.

Jessica’s trip to Kenya was supported by Novartis Pharmaceutical Corporation and Malaria No More.

Jessica Uno is winner of the World Briefing: Telling the Malaria Contest co-sponsored by Novartis Pharmaceutical Corporation and Malaria No More. Her winning essay earned her a trip to cover the MIM Pan-African Malaria Conference in Kenya and report back on the latest in the global effort to end malaria.

I spoke with Silvio Gabriel, Executive Vice President and Head of the Malaria Initiatives at Novartis, about the company’s key role in the malaria fight and the numerous challenges of sustaining non-profit efforts at a for-profit company.

As Mr. Gabriel sees it, anybody can fund malaria control efforts. However, companies like Novartis –with deep medical experience, expertise in training and education programs and knowledge of effectively distributing treatments– have a responsibility to provide patients with the prevention and treatment tools they need to fight malaria. This can help affect the most change.

Reducing the malaria burden is not simply a matter of big money, but of big IMPACT, especially sustainable impact. By raising awareness of Novartis’ Malaria Initiatives program, for example, the company is influencing others to follow their strong example of a public-private model. Such a model encourages other companies to make philanthropic, compassionate work a routine part of corporate activities. Corporate social responsibility programs also pave the way for powerful partnerships, such as that between Novartis and Malaria No More, which further reinforce the positive feedback loop of sustainable impact.

When I asked Mr. Gabriel about his motivations to push the Malaria Initiatives program forward, even in the most challenging situations, he offered encouraging advice: be realistic yet optimistic. He stated that he’s most inspired by the patients and their needs.  It’s the classic theory of “focusing on the solution rather than the problem,” he said. And Mr. Gabriel has proven that this mindset can help reduce suffering related to malaria. “Think of how many lives we can save, not how many people are dying,” concluded Mr. Gabriel. “That’s the way to make a sustainable impact in fighting malaria.”

Jessica’s trip to Kenya was supported by Novartis Pharmaceutical Corporation and Malaria No More.

Jessica Uno is winner of the World Briefing: Telling the Malaria Contest co-sponsored by Novartis Pharmaceutical Corporation and Malaria No More. Her winning essay earned her a trip to cover the MIM Pan-African Malaria Conference in Kenya and report back on the latest in the global effort to end malaria.

The MIM conference is such an international scene! I love being able to hear presentations from representatives of  multiple African and European countries in a single session and observing the fierce commitment they all share to the same cause. The desire to confront malaria transcends language, homeland, and occupation. All backgrounds are welcome here, even me — an American college student who has never personally suffered from malaria. Another exciting aspect of the conference is that it evidences the endless  possibilities for changing the world. As a college student, my peers are constantly making plans to save the world. Here, I am given affirmation that those dreams don’t fade once we enter the working world. At MIM, I’m hearing from dozens of successful scientists, health care professionals, entrepreneurs, policy makers, journalists, NGOs, and others who have built impressive careers dedicated towards ending malaria. Wanting to make the world a better place is not wholly an elusive idealism. It is a viable and thriving operation that calls for people from all walks of life. The only requirement: determination.

Jessica’s trip to Kenya was supported by Novartis Pharmaceutical Corporation and Malaria No More.

Jessica Uno is winner of the World Briefing: Telling the Malaria Contest co-sponsored by Novartis Pharmaceutical Corporation and Malaria No More. Her winning essay earned her a trip to cover the MIM Pan-African Malaria Conference in Kenya and report back on the latest in the global effort to end malaria.

I am fortunate to be at this conference attending fascinating presentations and meeting so many incredible players on the malaria scene. The opportunity to  learn about their experiences and motivations has taught me so much about malaria in just a few days.

One of the first admirable individuals I interviewed was Caterina Capaccioli, head of Strategic Planning & Execution, Malaria Initiatives at Novartis. Caterina introduced me to the role that collaboration among different organizations—corporations, non profits, African miniseries of health and others—have played in successfully reducing the malaria burden. For example, Novartis has worked closely with the Chinese government to develop effective innovations.  Another example  is the partnership between organizations like Malaria No More who help distribute mosquito nets and those who produce and distribute antimalarial treatments, pairing prevention and treatment. One major advantage to such collaborations is the greater number of skills and resources available to unite against malaria.

Combining unique specialties among partners is necessary when facing the constantly evolving malaria threat. A united front is much stronger and efficient than many  individual effort!

Jessica’s trip to Kenya was supported by Novartis Pharmaceutical Corporation and Malaria No More.

By the end of the morning I was in high spirits after seeing such inspiring anti-malarial efforts by the locals. Jane and the staff at Mwea reduced malaria in their communities with minimal foreign aid. While they obtained ACTs, bed nets, and program funding from nonprofits, they took on the larger challenge of properly applying those resources in communities used to viewing malaria as a permanent feature. They trained their own lab technicians, promoted their educational materials, and brought together entire villages in protecting themselves from malaria. Many of the Novartis officials I have interviewed have told me that one of the greatest challenges in ending malaria is improving coverage across Africa. As Ambassador Mark Green told me, while wealthier nations should do everything they can to support African players in the malaria battle, the “Great West” sweeping in and imposing their solutions cannot solve malaria. It must be a joint effort, with ultimately every level of the community participating, both local and international. Knowing that communities like Mwea are upholding their responsibilities to take care of themselves strengthens my belief that we will break the death grip of malaria in this lifetime.

Jessica Uno is winner of the World Briefing: Telling the Malaria Contest co-sponsored by Novartis Pharmaceutical Corporation and Malaria No More. Her winning essay earned her a trip to cover the MIM Pan-African Malaria Conference in Kenya and report back on the latest in the global effort to end malaria.

Once we arrived at Mwea, we met Dr. John, director of the Vector Control Center at Mwea Mission Hospital. The outdoor hospital is four hours away from the next hospital and served a large patient body. The large rice paddies in that region force hospitals to be far apart. Dr. John and Jane told us about how they had reduced malaria occurrences to almost 0% in the area surrounding the hospital, through a combination of prevention and treatment measures. They pushed large campaigns to encourage the community to consistently sleep under pesticide-treated bed nets and made sure powerful ACTs were readily available for those with malaria. A large problem in applying our existing tools for fighting malaria is patient compliance. You can give a bed net to family, but if left alone, families will often misuse them or use them inconsistently. The same goes true with ACTs – often patients feel better after a day or two of treatment and stop taking their medicines. Creative strategies are necessary to motivate consistent net usage and compliance with malaria treatments. One of Mwea’s strategies includes portraying nets as “fashionable,” by having respected community leaders show friends and families that the frequently using nets are critical to avoiding mosquitoes. Malaria is preventable and not a fact of life, using the slogan “mosquito out, we are in the net together!” Rather than imposing the nets on the community, Mwea Mission Hospital was successful in encouraging net use in culturally sensitive, sustainable ways that actively involved community members.

After this discussion, we were given a tour of the laboratory. Two of the technicians demonstrated how they test patients for malaria parasites by examining their blood samples under the microscope. Sitting in the middle of a table in the room was a box containing dozens of tiny Anopheles mosquitoes that the laboratory used to study Plasmodium and to train community members in identifying and diagnosing malaria parasites in blood samples. I had never seen an infected Anopheles mosquito, and I was simultaneously repulsed and awed. Then, to my shock, one of the technicians actually mouth-pipetted a few mosquitoes into a tube for us to see. He showed us how to identify the male and female mosquitoes (the males are smaller and have little beards on their mouthparts). There was also a small tub of water where Anopheles larva wriggled and waited to turn into winged adults. Alongside the larva, I noticed a snail floating in the water. Turns out they also study the snail-borne parasite Schistosomiasis, another danger to workers in the rice paddies. I got really excited because the laboratory where I study malaria at UC San Francisco also focuses on Schistosomiasis. Except when they keep live specimens of the parasite, they are locked in a biohazard room and everyone always wears gloves before going anywhere near the infected snails. I was very impressed at the operations of this Mwea laboratory because they accomplished so much training, diagnosis, and research with a tiny fraction of the equipment I’m used to having in UC San Francisco’s laboratories.

We also talked to Jane about the health education projects she leads at local schools. She discussed some effective strategies for motivating both children and their parents to follow good anti-malarial habits and talked about how their programs encouraged children to take an active role in malaria prevention. This is part of a larger effort to inspire the next generation to take on malaria rather than accept the disease as unstoppable. Children produced beautiful art and poetry through various contests themed around malaria at the schools, some of which had grown into national contests bringing together children from different regions. Malaria education also gave children an opportunity to learn about future career options, like becoming lab technicians or doctors. Jane exemplified how communities are using malaria to create opportunities for growth, unity, and action independent of foreign aid.

Jessica’s trip to Kenya was supported by Novartis Pharmaceutical Corporation and Malaria No More.

Jessica Uno is winner of the World Briefing: Telling the Malaria Contest co-sponsored by Novartis Pharmaceutical Corporation and Malaria No More. Her winning essay earned her a trip to cover the MIM Pan-African Malaria Conference in Kenya and report back on the latest in the global effort to end malaria.

Today we got outside the city for a memorable road trip into rural Kenya. Our destination: Mwea Mission Hospital, 2 hours north of Nairobi, to learn about the role of African health clinics in fighting malaria. A colorful cast accompanied Rachel and I, including an Oxford scholar writing a book on the history of British malariologists, a well-known Belgian photographer, an Italian from Novartis, and Jane, our knowledgeable guide for the day who serves as the Malaria Coordinator for CFW Shops, a sustainable health care organization.

I thought I would fall asleep on the two hour ride, but as soon as we left the city limits, the skyscrapers gave way to tropical green hills, with fields of beans, coffee, maize, and rice paddies rolling by. The lush landscape was dotted by people walking or riding bikes on the dirt paths lining the freeways, some with heavy baskets on their backs. Road construction was a constant sight, with mounds of bright red dirt forming on either side of the existing road. Buildings got sparser and appeared increasingly run-down. Eventually we hit areas lined with crowded markets. Vendor stands selling items ranging from fresh mango to wood-carved bed frames, and shoes consisted of either blankets on the ground or small booths composed of tree branches and straw roofs. We began seeing more donkey-pulled carts and fewer cars. As the road became muddier, lined with rice paddies, we were grateful that we were in a four-wheel drive.

Jessica’s trip to Kenya was supported by Novartis Pharmaceutical Corporation and Malaria No More.

Jessica Uno is winner of the World Briefing: Telling the Malaria Contest co-sponsored by Novartis Pharmaceutical Corporation and Malaria No More. Her winning essay earned her a trip to cover the MIM Pan-African Malaria Conference in Kenya and report back on the latest in the global effort to end malaria.

So far my stay in Nairobi has been full of juxtapositions and conflicting images. It was hot and humid when we arrived at the Nairobi airport. The first thing I remember was my annoyance at my checked luggage, which for some reason was soaked through with (hopefully) water. The second thing I noticed were the rows of families lining the walls of the airport. It took me a moment to figure out why all these families were sitting on thin blankets against the airport walls. Then I realized they weren’t going anywhere, they were spending the night there. Men, women, and children of all ages were either praying or leaning against the sticky walls watching the sudden surge of obvious foreigners pulling their luggage through the hallway to find the fresh air outside the airport building, where dozens of shiny-faced cab drivers solicited customers. The air was thick and smoggy, and having spent the last 27 hours on an airplane or in an airport, I was eager to get to the hotel.

After we got in a taxi to the hotel, the scene immediately changed. As we drove into the city, neon signs flashed everywhere, and 5-story high billboards advertised cell phones, Coca-Cola, and television shows. All the signs were in English. I was surprised at how few of the signs actually featured African individuals. The television ads all featured Caucasian characters. The buildings got taller and taller as we approached our hotel. The city reminded me of Buenos Aires or New York, with people milling about everywhere under the gigantic lit billboards, despite the late hour. The roads were obviously dangerous for pedestrians; our driver never slowed when people walked in front of the car. Everyone somehow made it across the street in one piece though.

When I got to my 12th  story hotel room, I tried to photograph the view. I failed because my flash ruined the photo and without flash it just looked like a bunch of dots, but it was quite beautiful. In the daytime, the city from above looks a lot like Los Angeles, but with more trees. They stick scarecrows at the tops of some of the trees to scare away certain birds. The Hilton Hotel where I am staying is very comfortable and well-furnished inside, as are the conference center and the other hotels where we are interviewing different people.

I feel really guilty staying in such nice conditions when I am constantly hearing and talking about the millions of families suffering from malaria. I think it is one of the greatest ironies about these kinds of conferences. Not that I’m saying we should all stay in huts for the conference, but the discussion of malaria and its impoverished victims contrast so starkly with the air-conditioned, well-dressed environment of the conference. I personally struggle constantly with the thought of being so fortunate when so many others are barely making ends meet. Spending time in Nairobi, as well as Argentina and Mexico this past summer, have forced me to re-examine my lifestyle and the privileges I take for granted while living in the Bay Area. These thoughts however make me more amazed at the projects and efforts displayed at this conference. As I interview more leaders in the malaria field, I am more and more inspired by their compassion and motivations for eradicating malaria. I will share with you some of these motivations in later entries. In the meantime, I have to get some rest. Our days are ridiculously packed, and my sleep debt from Stanford midterms hasn’t quite worn off yet…

Jessica’s trip to Kenya was supported by Novartis Pharmaceutical Corporation and Malaria No More.

Jessica Uno is winner of the World Briefing: Telling the Malaria Contest co-sponsored by Novartis Pharmaceutical Corporation and Malaria No More. Her winning essay earned her a trip to cover the MIM Pan-African Malaria Conference in Kenya and report back on the latest in the global effort to end malaria.

After dinner on my first full day in Nairobi, I received this message on my dessert plate. “…Energy and Persistence conquers all things…” It is a sign! I often feel overwhelmed when thinking about the staggering death toll of malaria on vulnerable peoples. However, in light of talking with Ambassador Green about “finishing the job” and hearing exciting presentations confirming the success rates of the Novartis malaria initiative program and other antimalarial efforts, this message was a very coincidental way to end my day.

Jessica’s trip to Kenya was supported by Novartis Pharmaceutical Corporation and Malaria No More.

Jessica Uno is winner of the World Briefing: Telling the Malaria Contest co-sponsored by Novartis Pharmaceutical Corporation and Malaria No More. Her winning essay earned her a trip to cover the MIM Pan-African Malaria Conference in Kenya and report back on the latest in the global effort to end malaria.

Ambassador Mark Green

Before I left for Nairobi, Emily from MNM set up a phone interview for me with Mark Green, executive director of Malaria No More’s Policy Center. Mr. Green recently finished serving as U.S. Ambassador to Tanzania and helped craft a number of policies and programs surrounding American foreign aid in women’s rights and health, AIDS, tuberculosis, and malaria. Ambassador Green’s impressive accomplishments and the fact that he was my first interview for this trip made me quite nervous about talking to him, but I was pleasantly surprised by his open and encouraging personality.

Ambassador Green has demonstrated his prowess in navigating policy related to Africa. His firsthand experiences living and working in Africa, personally suffering malaria, observing the child lives lost, families damaged, and economic productivity impaired by malaria have made him a skilled leader and policymaker. Ambassador Green described to me that until recently, malaria seemed an inevitable fact of life in Africa. However, we now know that malaria is highly treatable and preventable.

One point that stood out in our interview was the need to finish the job with malaria eradication. It is clear that we have the prevention and treatment tools that, when combined, are extremely effective in reducing malaria deaths. However, applying these tools to achieve our goal requires extended attention from the public, policymakers and leaders. According to Ambassador Green, some people would look at the statistic stating that malaria rates are less than 1% in Zanzibar and think “Oh, malaria’s not a problem anymore!” It is when this attitude takes hold however that malaria comes roaring back.

For those who aren’t familiar with malaria, it is a parasite that is transmitted by mosquitoes to humans. Once in a human, some of the parasites hide dormant in the body while others go out attacking, and so even if you clear a patient of the attacking parasites, the dormant ones are still there, capable of popping out unexpectedly and wreaking further havoc. Same in mosquitoes, not all of the parasites leave the mosquito when it bites a human. Thus, there are many ways the parasite persist in either human or mosquito hosts.

As Ambassador Green put it, “mosquitoes don’t respect national borders.” Until we completely stamp out the Plasmodium parasite, it will always be capable of returning with a vengeance, either through mosquitoes or humans. It’s an all or nothing battle. It requires commitment, but our progress so far has been extremely promising, and Ambassador Green believes that our efforts will be worthwhile during our lifetime. And the progress we make in fighting malaria and the surge of humanitarian energy such a victory would generate can be applied to thousands of causes elsewhere.

Jessica’s trip to Kenya was supported by Novartis Pharmaceutical Corporation and Malaria No More.