Deputy coordinator of malaria control center in Zambia shares her personal story, perspective

Chilandu Mukuka, MD, DrPH, is deputy coordinator of the National Malaria Control Center of Zambia. She spoke at PATH’s annual Breakfast for Global Health, held in May 2007 at PATH’s Seattle headquarters. This is a transcript of her speech.

I am so glad to be here with all of you today. I relish the chance to help my friends at PATH because they have been such a tremendous help to me, and to all of Zambia.

[PATH president and CEO] Dr. Chris Elias has told you the devastating toll that malaria takes around the world. It’s no different in my country.

Right now, it’s already evening in Zambia, and today, children died from malaria. This breaks my heart. These are very young children—not even school age yet—and today they died, leaving their parents, sisters, brothers, and communities with an unspeakable absence.

Even though yesterday, some of them might have felt and looked perfectly healthy, these children woke up this morning feeling sick. And over the course of the day, they developed chills and a high fever, had difficulty breathing, may have had convulsions, and then they died. All of us, especially those of us with children of our own, can only imagine this nightmare.

Malaria is a part of life in Zambia, but it should not be. Malaria is endemic in our country so there is no family that has been spared, including mine. My mother died in 1991, within hours of first showing symptoms. She was only 56 years old. She was a nurse.

Then, in 1999, my 30-year-old sister died of severe malaria, leaving three children. I have taken on raising the youngest, my niece, to this day.

These are vivid memories for me, and particularly painful because this disease is preventable. These two should both be here today to witness the progress Zambia has made. They should not have died.

Besides the terrible personal toll, malaria also places a serious financial burden on families. An adult sick with malaria cannot earn a living, and on top of that, families spend about a quarter of their income on medicine or hospitalization for malaria.

Malaria can also devastate whole economies. Nationally, the Zambian government figures that some 40 percent of its health budget goes to treating malaria. Even so, just three years ago, we had few bednets in peoples’ houses, very little spraying to protect people in their homes, and nothing in the way of a national campaign to prevent this disease, only a silent acceptance of the illness, waiting and treating patients when—or if—they made it to hospitals.

In addition to the economic burden, Zambia’s health care system is heavily challenged: the country has just 700 doctors for a population of 12 million. That’s as if you here in the Seattle area had fewer than 60 doctors for everyone living here!

You can see that people in my country had little chance to protect themselves from malaria. And so continued the cycle of sickness and poverty in families and communities all over the country.

Then, in 2005, with PATH and many other partners, we launched an ambitious six-year plan to tackle the disease. The Malaria Control and Evaluation Partnership in Africa, or MACEPA, has been instrumental in developing our strategy for providing bednets, spraying homes, getting medicine to pregnant women, and providing drugs to treat those who are already suffering.

Here’s what I want to tell you: by the end of next year, at least 80 percent of Zambians will have access to these crucial interventions. That means that three years from now, we will reduce malaria deaths by half. By half!

How will we do this? Among other things, here is one example of what we will do. Where just a couple of years ago, we only had about 14,000 bednets in peoples’ hands, this year, more than 3 million bednets will be distributed.

We are saving lives now. Our fight against malaria is making strides but we have far to go. The government of Zambia has made a commitment to rapid and nationwide malaria control and prevention. We know the world is watching this bold effort and we welcome the spotlight.

We are confident of success with your ongoing support. What is happening in Zambia—“leadership and partnership for results” as it was called on Africa Malaria Day last month—is something for all of us to be proud of.

PATH’s support is central to our success. PATH has been working shoulder-to-shoulder with the Ministry of Health’s national malaria control program and all our other partners to ensure that our collective goals are sound, that progress is accurately measured, and that results are achieved.

We are determined that accepting malaria as a way of life—and death—in Zambia must change. And it is within our power to make that change. Together we can make a difference—and bring health within reach of everyone, no matter where they happen to live.

Photo: Kerry Dahlen.