Eric van Diessen meets inspiring people during his study trip to Zambia

Earlier this year, we posted an interview with Eric van Diessen, one of the winners of the 'World Briefing: Telling the Malaria Story' competition. Eric won the competition, which was organized by Novartis and Malaria No More, with his article on fighting malaria. The prize was a study trip to Zambia.
Now that he is back, we asked him about his experiences:

1. Who did you go on the study trip with?

I went on the trip with Peter Crauwels from Belgium and Jennel Cheng from the Philippines. We were accompanied by Caterina Cappacioli (Italy) from Novartis. It was clear when we met at London Heathrow that all three of us were really excited about going to Zambia!

2. Last time we spoke, you said that you had been to malaria-endemic areas in Africa several times. Was this the first time you were visiting Zambia? And if it was, can you tell us a bit about the malaria problems the country is facing?

In 2006, I travelled around southern Africa for a while, and spent some time in Zambia. People I know there arranged for me to visit a few hospitals, but I find it hard to compare the problems the country was facing a year ago with the ones it’s facing now. I heard that the morbidity and mortality figures have sharply dropped in recent years. During the trip, we spoke with a number of people working with malaria about the improvements in malaria care. Combining different measures is one of the things that has made the 'Malaria Control Program' so successful.

3. You hoped to gain more insight into the education programmes and new initiatives that have been set up to fight malaria in Zambia, and you also hoped to meet inspiring champions. Were your expectations met?

We were inundated with information. The success of the 'Malaria Control Program' is also the success of the harmonization of the different measures. The provision of effective antimalarial drugs such as the new ACTs (Artemisinin-based Combination Therapy) for a non-profit price by the Novartis Malaria Initiative, the large-scale distribution of insecticide-treated mosquito nets and indoor residual spraying are all effective measures to control malaria. The next step is the eradication of the malaria parasite. A number of new initiatives are in development in Zambia. For example, new malaria cases are well-documented and people who are in contact with a malaria patient are preventively screened. This is possible thanks to the availability of new rapid diagnostic tests (RDTs). By doing this, asymptomatic carriers – people who are carrying the malaria parasite and are not sick but can pass on the disease – can also be treated.

In order to develop and implement new preventive measures, you need people who are involved and motivated. We met some of these people on our trip. They were local doctors and clinical officers, and people who were working on improving therapy compliance and the logistics of supplying the drugs. Every person we met was inspiring.

4. What or who impressed you the most?

On the first day of the trip, a Zambian doctor showed us around the district hospital in Chongwe District, 50 km east of Lusaka. He told us about the various preventive measures they had implemented to fight malaria. The result was clearly visible in the patient list for the past months: there were no more than 10 malaria patients. This was in sharp contrast to the patient list of the Ugandan hospital where I had worked for a few months earlier this year. There, children were dying every day from the effects of a malaria infection. For me, this was absolute proof that malaria can be fought!

5. How did this study trip broaden or change your view on fighting malaria? Did it in any way affect your view on fighting malaria?

First, I realized that a good organization is essential to fighting malaria, and that access to the right knowledge is crucial. Differences in climate, geography and population mean that every region needs its own action plan. Long-term involvement is also necessary. Zanzibar is a good example: in the 1980s and 1990s, effective measures led to a sharp drop in the incidence of malaria. But when the measures were stopped, the incidence of malaria quickly rose to its old level. In my opinion, organizations and national governments have to be in it for the long term - both in terms of time and money - in order for any measure to have a lasting effect.

6. Thinking about your experiences in Zambia and the people you met, do you have any new ideas on how more awareness about malaria can be raised?

Good question. A lot of organizations are fighting malaria, and they are all helping solve the problem. But despite the recent successes in reducing the death rate and the disease rate in a few endemic countries, the problem is still huge. Malaria should be high on every political agenda. The international community must continue to help fight malaria, even in times of economic crisis. On the other hand, it is important to make more people aware of the size of the problem. New social media are good tools, but I think that new initiatives need to be continuously developed in order to keep people’s attention focused on malaria. Why not introduce a malaria tax for people travelling to malaria-endemic areas? The amount would be negligible compared to what people spend on malaria prophylaxis, for example, when travelling to Africa.

7. Will you continue to be involved in this initiative? If yes, how?

Yes, I would like to stay involved in this initiative, but I'm not sure how yet. I'd like to educate people about malaria, both in the West and in malaria-endemic areas. I also hope that I can use my position as a research physician and my area of expertise to fight malaria and improve clinical care in Africa. I'm working on it, and there will certainly be a sequel!

Eric and Margret from Malaria No More! Netherlands met at the end of February 2011 to talk about Eric’s involvement. They agreed that Eric would give guest lectures about malaria at primary schools. That is an excellent supplement to the malaria teaching package that can now be downloaded from the website.