Paul Ehrlich, the Stanford biologist and feted doomsayer, famously predicted, and continues to predict, widespread famines and an increase in diseases. Ehrlich is also famously wrong. Although global populations continue to increase, agricultural technologies ensure that fewer and fewer of us are hungry and greater access to safe and effective vaccines, medicines, and public health insecticides has reduced the burden of disease. Average life expectancies globally are increasing, with fewer new HIV infections and an evergrowing number of people receiving antiretroviral treatment. Malaria has been steadily declining too, thanks to increased donor-funded efforts to control the disease.
Such progress should not lead to complacency however. Malaria still claims an estimated 660 000 lives each year, mostly children in Africa. Children who survive often suffer cognitive impairment, blighting their futures and leaving them less able to be productive. Southern Africa has made the most dramatic progress, so that now four countries - South Africa, Swaziland, Botswana, and Namibia - have in sight the total elimination of malaria. The region has long supported malaria research, measuring progress, experimenting with different strategies, and understanding what works best. Ministers of health in the region took advice from scientists and implemented evidence-based strategies, such as indoor spraying with the insecticide DDT.
South Africa has long secured local funding for malaria control, which has meant that disease control experts could get on and do their jobs without having to worry about the vagaries and somewhat mercurial nature of donor agencies. Research into new and essential tools to fight infectious diseases in Africa must continue. Many of the obstacles to improving health outcomes, such as weak infrastructure, bureaucratic hurdles and the stark reality of millions of poor individuals who can barely sustain themselves, however, will continue to hamper the fight against infectious diseases.
Urbach is director of Africa Fighting Malaria. The congress is at the Cape Town International Convention Centre from tomorrow to Saturday. Khaya Dlanga is away.