Awa Marie Coll-Seck, RBM
Professor Coll-Seck has been Executive Director of the Roll Back Malaria (RBM) Partnership since 2004. She is a professor of infectious diseases and an expert in public health and tropical medicine. From 2001 to 2003 she was health minister for Senegal. Professor Coll-Seck has also been president of the Assembly of the Ministries of Health of the West African Health Organization and director of the policy, strategy and research department at the joint UN programme on HIV/AIDS (UNAIDS), where she led the programme's largest department.
Professor Coll-Seck
1. To mark RBM’s 10th anniversary you are launching ‘A Decade of Partnership and Results’. What key messages does this report contain for the malaria community?
The report has three main messages.
One, a decade of partnership has led to record progress against malaria. Major changes have occurred in every aspect of malaria control since 2000. The creation of the Roll Back Malaria Partnership in 1998 and robust country partnerships have led to vastly improved policies, strategies, financing, and interventions. As a result, 43 countries have decreased malaria cases by 50% or more over the past decade. An estimated 1.1 million lives of children under five saved in sub-Saharan Africa alone, with an estimated 38% reduction in malaria deaths globally.
Two, results are impressive, but progress will rapidly be reversed if we relax our efforts. It is essential to keep the momentum against this tenacious disease, by securing an adequate and sustainable source of funding, containing drug and insecticide resistance, and investing in the development of new tools. Indeed, malaria has many times demonstrated its ability to evade the grasp of control efforts-- by bouncing back as soon as commodity supply slows, or by developing resistance to control measures.
Three, with continued ambition and investment we will achieve even greater progress against malaria. We can have an enormous impact by increasing coverage with the tools that we have already: 3 million additional lives can be saved and hundreds of millions malaria cases can be prevented by 2015. Armed with a decade of knowledge, experience, and well-informed optimism, the international community is now gearing up to achieve the goal of near-zero malaria deaths by 2015.
2. What do you believe are the main challenges facing the malaria community in the next decade?
We have a lot of work to do, quickly, if we are to achieve our goal of near-zero malaria deaths by 2015. Many high-burden countries still have a long way to go to reach universal coverage, and the progress must be maintained. This means that all we must also fill the funding gap now, and secure an adequate and sustainable source of funding over the long term. It also requires the involvement of a wide range of partners.
Furthermore, resistance is a very real public threat, and the World Health Organization's strategies to contain artemisinin and insecticide resistance must be implemented urgently in order to preserve the efficacy of the tools we have today. At the same time, we must continue to invest in the research and development of new treatments, vaccines and insecticides so that alternative tools are immediately available in case today's tools fail, and so that malaria can be eliminated in high-transmission zones.
3. Do you think we will have eradicated malaria by 2021, or even earlier?
Most experts believe elimination is not possible in high transmission areas with today's tools. While the research and development community is working on identifying the gaps and developing the tools for global malaria eradication, particularly through the Malaria Eradication Research Agenda Initiative, no date has been set for achieving this target. It is very unlikely that malaria will be eradicated by 2021, but it is encouraging to remember that we can achieve even greater progress against malaria with the control tools we already have.
4. What would be the impact of artemisinin resistance spreading to Africa? What measures need to be taken now?
Because there are no other available medicines against malaria, artemisinin resistance spreading to Africa would have a terrible impact in Africa and globally. Malaria deaths would increase. Eventually artemisinin might become wholly ineffective against deadly malaria, as chloroquine is today.
We must act immediately to contain artemisinin resistance. Simply put, we need to implement WHO's Global Plan for Artemisinin resistance containment (GPARC). Banning monotherapy malaria treatments is crucial. The spread of resistant parasites must be stopped immediately with a combination of malaria control and elimination measures. Monitoring and surveillance must be increased at global, regional, national and local levels. We must improve access to diagnostics and rational treatment with ACTs, and invest in artemisinin-related research. All of this requires motivating action and mobilizing additional resources.
5. We are really pleased that you agreed to join the WWARN Board. What contribution do you see WWARN making to the fight to control malaria?
WWARN is already making an important contribution to the fight against malaria by gathering data and creating a platform for a comprehensive global surveillance. Indeed, the availability of timely, good-quality data is essential to assess the evolving threat of artemisinin resistance, track progress in managing it, and steer future containment activities.
6. How do you see RBM and WWARN working together over the coming years?
I see WWARN working with all of the other RBM Partnership stakeholders-- particularly the World Health Organization's Global Malaria Programme, endemic countries, the private sector and other academic and research institutions to help implement the GPARC. Together we will continue developing and expanding the global platform to share information on antimalarial resistance.