The unending fight of malaria in Africa: Do women have any role to play?

The African Continent is one of the most affected regions in the world in terms of malaria transmission and deaths. Malaria is caused by parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes.

According to the World Health Organisation (WHO), the African region carries a disproportionately high share of the global malaria burden. In 2021, for instance, the region was home to 95 per cent of malaria cases and 96 per cent of malaria deaths.

Similarly, children under five years accounted for about 80 per cent of all malaria deaths in the African Region. This makes malaria one of the life threatening diseases in Africa, sending many people—both young and old, to their early graves.

Due to the high burden of malaria in Africa, African governments turn to spend a huge chunk of their revenues on malaria related activities, particularly on prevention, treatment and elimination efforts.

Even though malaria is a life threatening disease, in fact, a killer disease, it is preventable and curable. Children and pregnant women are the most vulnerable group when it comes to malaria transmissions and deaths. 

For instance, in 2021, there were an estimated 247 million cases of malaria worldwide with an estimated deaths of 619, 000.

Considering the dire nature of malaria, many organisations across the world have been contributing their expertise and resources to fight the disease, especially in sub-Saharan Africa, where the disease is a major public health challenge. 

And many of these organisations have stressed the need to actively involve women in the prevention and elimination of malaria. One of such organisations playing a key role in the fight against malaria in Africa is the Ecobank Foundation.

Graphic Online engaged the Chief Operating Officer of the Foundation, Elisa Desbordes-Cissé, on her thoughts on malaria prevention and elimination in Africa, the role women in the fight, and the practical steps that needed to be taken to ensure that the African Region wins the war against malaria transmissions and deaths.

The Ecobank Foundation is the Corporate Social Responsibility arm of the Ecobank Group, the leading Pan-African Banking Group. It has over the years made significant progress in Africa through its focus on three pillars, namely education, healthcare and financial empowerment. 

Zadok Kwame Gyesi (ZKG): First of all, let me thank you for accepting to grant me an interview on this subject. I also want to commend you for your keen interest in the fight against malaria in Africa. But could you share with me what has been the driving force or the interest of Ecobank Foundation in this malaria fight in Africa?
 
Elisa Desbordes-Cissé (EDC): Access to health has been a major focus of Ecobank Foundation since its establishment in 1995. We know that being healthy enables every individual to grow healthy and unlocks the potential for human development on the continent. Through our commitment we seek to strengthen public health systems and end epidemics such as malaria which have a huge economic impact on the continent. 

Economic losses due to malaria are estimated at USD 12 billion each year in Africa. This represents a huge loss of revenue and as a pan-African bank, it is a fact that should not be overlooked. With this in mind, we decided to launch the "Zero Malaria, Businesses Leadership Initiative" in 2020 with Speak Up Africa and the RBM Partnership to end malaria. This initiative complements a movement launched in 2018 by the African Union called "Zero Malaria Starts With Me". 

"Zero Malaria, Businesses Leadership Initiative" aims to leverage national resource mobilisations for sustainable malaria funding by engaging local businesses and leaders to become more involved in the fight against malaria. Currently the initiative is being implemented in 5 countries including Burkina Faso, Benin and Senegal since 2020, Uganda since 2022 and Ghana where it will be launched shortly. As part of this initiative, the Ecobank Foundation has set up a catalytic fund of USD 120,000 at the level of the branch offices in these five countries. 

This means that Ecobank is making an initial contribution of $120,000 in these countries to encourage companies of all sizes to support financially, or in kind, the efforts of national malaria programmes. In addition to the financial contribution, we also have an awareness and information component, because for us it is also important to explain to business leaders the role they can play in the fight against malaria. For us, the role of the private sector is crucial for the achievement of the sustainable development goals and in particular goal 3 on health.

ZKG: How would you assess the impact of Ecobank Foundation in terms of its contribution towards the fight against malaria in Africa?

EDC: As mentioned earlier, the goal "Zero Malaria, Businesses Leadership Initiative” is to mobilise additional resources by engaging local businesses. In just two years, from 2020 to 2022, we have managed to mobilise 1.3 millions USD through financial and in-kind contributions in the 5 countries. 

We have about 60 companies that have already mobilised through this initiative alongside national malaria programmes in the five countries. For us, these are unprecedented results, as this is the first time that we have had a mobilisation of the African private sector to end a disease. 
These results also show that there is a very strong will from the private sector and I take this opportunity to call on companies to join and support the initiative. At the moment we are just at 5 countries, but soon we hope to extend the initiative to several other countries.

ZKG: It is a known fact that Africa is a continent that has more women population than men. How Does gender inequalities come in when we are talking about malaria elimination efforts in Africa?

EDC: Let me start by calling out a simple fact that malaria affects both men and women. No matter what gender you are, you can contract malaria. But in some situations the disease affects women and girls disproportionately to men. In the particular case of pregnant women and girls, for example, it is estimated that more than 11 million pregnant women will contract malaria in 2019 - a huge number when you consider that malaria is a preventable disease. 

As you probably know, in many contexts women are not in a position to choose whether or not to use a mosquito net. In some cases women will not be able to access care without the initial approval of a man or without being accompanied by a man. 

Their low financial power may also be a barrier to accessing treatment. These are socio-cultural constraints and norms that prevent women from benefiting from the interventions or prevention tools that are vital to them. These mentioned inequalities - and many others - are very important and crucial elements to take into account when designing strategies for a more effective response to malaria.

ZKG: What specific actions should be taken to empower women to become key agents in the fight against malaria in Africa?

EDC: The first action in my view would be information and awareness-raising. Information and awareness-raising should ideally be done in the local languages that women understand and by reaching out to them. This information and awareness-raising is important because it will have an impact on the health of women but also of the community, since women are often also responsible for the health of their children and the rest of the community. Informing and sensitising a woman is therefore empowering her to protect her health but also that of her community. 

The next step is to strengthen women's decision-making power. And for that, it is necessary to guarantee a safe legal and social environment for women. There is also a lot of work to be done on mentalities within communities to give women the space to make decisions for their health and that of their children. It is also important to promote women's economic autonomy so that they can take care of themselves when they need it. 

It is also important to point out that when we talk about community health workers, who are essential to ensure access to care in our communities, 70% of them are women. This means that today we have a critical group of women who are involved in the fight against malaria. But unfortunately, their work is often not valued or even paid for. This is also an area that needs to be worked on to end malaria.

ZKG: How does the lack of women involvement really affect malaria elimination efforts and progress made so far in Africa?

EDC: First of all, I think that if we want to stop malaria , we must be able to eliminate the disease from the whole population. Since women represent most people affected by malaria, it is imperative to develop specific strategies based on their specific needs to ensure that they have access to prevention tools and treatment. Failure to take their specific needs into account is half the battle. 

In research, there is unfortunately not much data on the impact of malaria on the capacities of women and girls. This data is important to guide decision-making and to find innovative solutions to address the specific needs of these groups of people.  I would really like to emphasise that involving women is also about making sure that the whole community, including children, is protected. Involving women and integrating the gender issue in the fight against malaria is therefore essential to prevent and limit the effects of the disease.

ZKG: Reducing gender inequality is now at the heart of the public health and development agendas in Africa. How can the Ecobank Foundation contribute to achieving gender equality in Africa?

EDC: We have various programs that aim to contribute to the achievement of gender equality. In October 2022, the Ecobank Foundation signed an agreement with UN Women to promote gender equality in Africa. We also have a "Stop Prejudice" campaign which is a series of webinars and awareness raising spots with women from various backgrounds such as sports, technology and business. The aim is to promote the sharing of experiences to break down prejudices and stereotypes about women in various sectors and show women that they can do anything. 

In a similar vein, we work with the Global Partnership for Education, which is an advocacy platform for education. We support them in their awareness campaign with the aim of encouraging girls' education. In Zimbabwe, for example, we have distributed nearly 2,500 solar radios to communities to enable girls to have access to educational content, and we have used the opportunity to broadcast messages to encourage girls to return to school. 

With the Covid-19-induced school closures, many girls who left school in Zimbabwe have not yet returned.  In Kenya and Ghana we are focusing much more on women's access to information and communication technologies and their representation in STEM. 

The last programme I want to mention is the Africa Excellence Programme launched with our partner Share in Togo and Côte d'Ivoire. This is an extra-curricular programme for female students regardless of their field of study. For two years, they receive international training on all soft skills, particularly entrepreneurship, public speaking, leadership and project management. The idea is to be able to give the girls.

The idea behind all these programmes is to give girls and women the tools they need to be autonomous, to become more emancipated, to have access to finances, to access the world of employment.

Story by Zadok Kwame Gyesi