It’s a late post- and yet still on my mind as I think back to my last trip. I went to a semi-regular meeting on malaria called Multilateral Initiative on Malaria, or MIM, in Senegal this past April. Every few years, a country in Africa hosts the meeting, with the host nation on rotation. The last conference held in Senegal was the inaugural MIM - hosted in 1997! (this was the 7th annual conference so there is no doing the math on how many years apart the conference occurs!) The conference is driven by African researchers, scientists, and thought- leaders and complemented by other malaria experts and donors around the globe.
My colleague, Patience, who I'm supporting to get her research published. She supports me too!
In some ways big gains have occurred since 1997 with artemisinin combination therapy, or ACTs, and even the prototype malaria vaccine that is currently in clinical trials, and in other ways, it seems we’re in the same spot. One step forward, two steps back? Many countries on the path to malaria elimination are seeing prevalence numbers slowly increasing: indoor residual spraying of insecticide is effective, and yet governments cannot afford to keep it on steady rotation and once the chemicals wear off, transmission rates climb again; bed-nets are also effective however after numerous behavior studies, no one can pin down why people do not sleep under them; vector control and keeping bugs out of the home is also a moving target based on the mosquitos anopheles and time of the day it typically bites- could something as simple as a solid door be the solution for keeping mosquitos out? And what if your house is hot and you want to open the door? Of course, resistance to treatment and spraying is on the rise and something to be watched as many health care providers subscribe treatment based on symptoms and not diagnostic results. Rapid tests are present, and yet only can really detect symptomatic carriers. Much of the undertone of the conference is that new tools are necessary to combat malaria- and of course, this is what my organization is working on- however making something effective and affordable aside- integrating new tools into homes and primary care settings is not simple.
On top of seeing colleagues, listening to fantastic presentations, and giving a couple of talks myself, I really enjoyed being in Dakar. Dakar! It’s gorgeous- right on the water, the food is divine, and everything feels cosmopolitan. I’ve traveled throughout the country years ago as far north as the Mauritania Border and as far south as The Gambia- and I’m glad I know the reality of countryside. I’m glad I ate Yassa Poulet in an oversized bowl with my hands with the family who was hosting me, and I’m glad I understand the vastness of the dessert, the prayers of the people, and challenges it is to bring basic health care to remote locations.
Cumbersome logistics kept all conference goers real. The conference facility was an hour away from the city center so everyday we were picked up at our respective hotels at 7:30 in the morning and dropped back at our hotels as late as 8:30 pm. I got to stay at a posh hotel with an incredible pool. So every night (one of my #1 travel rules is to always bring a swim cap and goggles wherever I travel) I jumped into the outdoor pool in the pitch dark and swam laps. While the silence was deafening, my brain doesn’t move unless my body does and I needed the release at the end of the long days. A very cool visit.