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 In exclusive interviews with Reuters in Davos, Gates and Chambers
both voiced concern about leadership changes in the U.S. and in
United Nations bodies and what these might mean for funding and
commitment to global health.
"The imponderable is what happens with President Trump," said
Chambers, the United Nations special envoy for malaria.
"We're just not sure."
Falls in deaths and infections due to the mosquito-borne parasite in
the past 15 years are "one of the greatest success stories in the
history of public health", Chambers said.
And Gates, whose Gates Foundation commits vast funds to global
health projects, said the world has never been closer to ending
malaria "once and for all".
But with the disease still killing a child in Africa every few
minutes, those eager to finish the job are worried that the
presidency of the United States - a crucial funding source for
international malaria control efforts - is now passing to a man
whose commitment to global health projects is uncertain.
And with looming leadership changes at organizations key to global
health and development aid - the heads of the United Nations, the
World Health Organization, the Global Fund to Fight AIDS,
Tuberculosis and Malaria, and the World Bank - malaria champions say
the risk of setbacks is unnerving.
"With malaria there's no standing still," Gates said. "Malaria is
very complicated."
WELL ON THE WAY
It is almost a decade since Gates first dared to revive what in
global health circles is known as the "e-word" in relation to this
ancient disease.
"We will not stop working until malaria is eradicated," Gates
declared in 2007.
Now, half the world's nations are malaria-free, and since 2000,
global malaria deaths have dropped by 60 percent. In Africa, where
the vast majority of malaria deaths occur, the malaria death rate
has come down by more than 70 percent.
But there's still much to do. Despite a steep rise in malaria
spending from 2000 to 2010, it has now plateaued.
Funding in 2015 was less than in 2013, with combined international
and domestic sources totaling $2.9 billion. Even this is only 45
percent of what malaria experts say is needed annually to reach a
target of a 40 percent reduction in malaria incidence and mortality
by 2020.
The U.S. is by far largest international malaria donor, accounting
for about 35 percent of total funds in 2015, followed by Britain, at
16 percent.
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The U.S. government-funded President's Malaria Initiative has been a
powerful force in the past decade, and monies for that rose above
£600 million in 2016 from $30 million in 2006.
TRANSITION, RISK AND OPPORTUNITY
Gates said he hoped the new Trump administration would continue
crucial malaria commitments, which he noted were ratcheted up by the
previous Republican President, George W Bush, and maintained at
those levels by President Barack Obama.
In a recent meeting with Trump, Gates said, they talked about
malaria, among other things, and had "good discussions".
"I wouldn't say we see a huge risk of those funds going away, but
(this is) a time when we're trying to raise the ambition," Gates
said. "Whenever there's transition it's an opportunity. We want to
step in and work with the new people."
Faced with uncertainty, Gates and Chambers have convened a new
global group of influential philanthropists, business people,
bankers and political leaders to plug commitment gaps.
The End Malaria Council includes African leaders such as the
President of Chad, Idriss Déby and former Tanzanian President Jakaya
Kikwete; Nigerian billionaire Aliko Dangote; and Luis Alberto
Moreno, head of the Inter-American Development Bank.
It will work on new ways to help affected countries and regions
fight their own malaria battles, with the hope that this will
encourage major donors to stay on board.
"There's a real desire coming out of the United States government,
the UK government and others to see endemic domestic countries
contribute more of their own capital towards fighting these
diseases," said Chambers. "We need innovative, unique and creative
ways of financing this."
(Editing by Alexander Smith)
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