It's tempting to view disease control as a series of steady strides forward. Sadly with malaria, that's not the case. Last week's Partnership Forum in Bangkok recalled the hundreds of millions of deaths averted in the 1950s thanks to the use of the drug, chloroquine. That was until a resistant strain of the disease emerged and malaria came roaring back.
Malaria control is now back on track and the annual death rate has halved since 2000. However, today's most powerful treatment, artemisinin, also faces resistance. As that resistant strain spreads across Myanmar and into India, partners from the Asia-Pacific region and the global health community are aware there is no plan B medication if resistance grows and spreads into Africa.
Their focus is therefore a malaria-free Asia Pacific. And to achieve that, civil society efforts need to be strengthened to reach marginalized populations such as refugees and migrant workers.
A side meeting on malaria hosted by Global Fund Advocates Network Asia-Pacific (GFAN AP) during the Partnership Forum was an opportunity to start a discussion on malaria advocacy in the region. Partners from the Asia-Pacific region are committed to tackling the emergence of malaria parasite resistance to artemisinin in the Greater Mekong Region and to achieve the goal of an Asia-Pacific free of malaria by 2030. But to succeed, the effort will require leveraging domestic resources, regional action and advocacy.
"Civil society knows exactly what is needed and can be an excellent partner with government. Civil society is great for sharing the experience of living with a disease and can improve the strategy for reaching people and ending epidemics," said Viengakhone Souriyo, from the Positive Health Association in Lao PDR.
Dr. Thet Aung, works on Global Fund-supported malaria projects for World Vision in Myanmar. "If it reaches into Africa, a lot of people will die of malaria, because compared to Asia the burden is really, really high," he said.
For this reason, Dr. Aung is focussed on vulnerable and marginalised ethnic minorities on Myanmar's borders with Thailand and India; people who may not have identity documents and could very well be dwelling in forests or working illegally.
Dr. Khuat T Oanh from Vietnam's Centre for Supporting Community Development Initiatives was also a participant in last week's civil society meetings. Dr Oanh believes putting human rights and access to health at the centre of the malaria elimination effort will yield better results.
"We can treat malaria but so often we forget about the human," Dr. Oanh said. "We try to kill the parasite with the medicine, we cover people with a bed net and separate them from the mosquito. But we forget about the human part of it and it is the human part of it that matters."