Malaria remains the number one cause of hospitalisation and death in Africa

Interview with Sylvester Jobic, Bayer’s Head of Environmental Science based in South Africa.

By Ronald Chawatama: Animus Sustainability Portal (

Malaria is a disease that has been around for a while, according to WHO, about 63% of people in the southern African region are living in areas that are affected by the disease, with pregnant women and children under the age of five being more susceptible. Around 627,000 of the people subsequently died (WHO malaria report, 2013). Where are we going wrong in effectively reducing mortality for this preventable and treatable disease?

It should be noted, that malaria mortality rates have in fact decreased in recent years. Significant efforts have been made by governments, non-profit organisations (NGOs) and the private sector alike, to continue reducing the impact of malaria in Africa by scaling up on intervention methods.

Despite this decrease, Malaria is still the number one cause of hospitalisations and deaths in Africa. In fact, malaria causes more deaths than HIV and tuberculosis, considering that there is a malaria related death every 30 seconds in Africa, predominantly among women and children.

The battle is far from over with Malaria still the biggest killer in sub-Saharan Africa. Despite increased initiatives to combat Malaria, the challenge is that there continues to be major gaps in intervention coverage. Further, 278 million of the 840 million people at risk of malaria in sub-Saharan Africa live in households that do not have a single insecticide treated mosquito net and, between 56 and 69 million children with malaria do not receive anti-malarial drugs. Another factor working against malaria prevention efforts, is the high rate of insecticide resistance in a number of countries.

In the fight for malaria, various stakeholders are involved however there seem to be a silo approach.  What has been your company’s experience?

We have been able to work with a variety of stakeholders across sub-Saharan Africa that are both in the public and private sector including NGO’s and donors. This multi-stakeholder approached to malaria prevention has proven beneficial in the countries within which we have worked with these partners.

For example, as a member of Roll Back Malaria and the Global Business Coalition for Health (GBCHealth), we are able to engage with a number of stakeholders to ensure alignment across the board. In addition, we are actively working to foster our ongoing partnerships with the Malaria Consortium, USAID, WHO and various Health Ministries within the SADC, including most recently, the Mpumalanga Government and the NICD Sandringham – to name a few, on pro-active preventative and effective intervention initiatives that will help combat the endemic. Furthermore, a successful Indoor Residual Spray (IRS) program for e.g. is a factor of effective collaboration between the public and private sectors.

We have witnessed that the combined efforts of the private sector and the governments of Mozambique, South Africa, Swaziland, Zambia and Zimbabwe, are registering positive impact of IRS on fighting malaria. Mozambique, which has very poor health infrastructure, has managed to sustain a well-run IRS program for over seven years by partnering with neighboring South Africa and Swaziland in the Lubombo Spatial Development Initiative.

If various interventions are in place, what is the main challenge in ensuring we reduce death rate as result of malaria to zero, ie is it that Drugs are they non accessible, expensive, or non effective or is it that alternatives such as mosquito nets are non accessible, unaffordable, difficult to use, or that the mosquitos are getting resistant to the insecticide-treated nets (ITN) and what are the remedies?

Following from the response to question 1, the challenge is that there continues to be major gaps in intervention coverage. 278 million of the 840 million people at risk of malaria in sub-Saharan Africa live in households that do not have a single insecticide treated mosquito net and, between 56 and 69 million children with malaria do not receive anti-malarial drugs.

Prevention has proven to be the best form of intervention in the case of malaria, with the two most successful methods found in insecticide-treated mosquito nets and insecticides that are used to spray in-and-around houses (indoor residual spraying). While a number of products are available, the quality and durability of nets aren’t all the same and overtime mosquitoes have built up resistance to certain chemical classes used in developing insecticides.

What is the contribution being made by your company and the motive behind your drive, as a private company your business goal is to make a profit and ensure shareholders get equity? How can you help drive away malaria  when there is business opportunity for you, or if this is part of your CSR if so what strategies are you putting in place to address the challenges of the poor in reducing risk of infection and death?

Bayer is committed to our mission of “Science for a Better Life” and has been a long time player in the fight against Malaria. In several African countries, such as Ethiopia, Uganda, Zambia and Malawi, Bayer has actively participated for many years in the fight against malaria, which is transmitted by the Anopheles mosquito.  As Bayer, the eradication of the disease would come as good news given the research and innovation that has gone into this. We would happy to be recognised as one of the stakeholders that helped in the fight to end fatal effects of malaria.

Bayer has further committed itself to Malaria prevention, through innovation. To this end, we have increased our investment in Research and Development ten-fold in the last five years alone. Further, because our products are manufactured in South Africa for Africa, we have a solid understanding of the African environment that enables us to continue innovating products and solutions and demonstrate our commitment to business in Africa.

Generally, our products are made available to communities free of charge by their government, often in partnership with NGOs.

What economic, social and even physical efforts is your company making to ensure you cover most communities whilst meeting the needs of vulnerable demographic groups especially children and what current challenges are you ?

Bayer is part of community mobilisation in the areas in which we work. This means that we provide training, marketing and communication to the Public Health Officer and communities to ensure the success of malaria prevention campaigns. We also ensure Anti Packaging Management through the incineration of all our packaging to reduce any potential risks. In our IRS programme, we however face a lot more challenges. As a company we participate in IRS through providing training and capacity building. The challenge is on implementation.

Woman prepares to travel to neighbouring communities for IRS

We currently experience a high turnover on the people available due to the toxic nature of the insecticides and the weight they have to carry.  It is also very important to note, that in order for an IRS campaign to be successful, there needs to be a well-co-ordinated community approach/implementation that requires tight logistics because the isolated or singular use of mosquito nets, does little to combat malaria in a given area.

Can SADC as a region isolate stages in the cycle of the disease from transmission to infection and apply effective interventions and how effective is your integrated pest control and what has been achieved so far?

Both South Africa and Mauritius were successful in the elimination programmes because they ran well-co-ordinated Indoor Residual Spray (IRS) campaigns. This is a clear illustration that if we use existing tools correctly, we can make great strides in places/countries that are struggling. As a company we our vector control portfolio comprises a range of complementary products, such as IRS, long-lasting insecticide-treated bed nets, space sprays and larvicides. One of Bayer’s key solutions for IRS is Ficam™. Fulfilling the requirements of the World Health Organization Pesticide Evaluation Scheme (WHOPES), it is regarded as a crucially important tool to help manage the development of pyrethroid resistance in malaria mosquitoes. In 2012, Ficam™ helped protect more than 50 million people.

The effectiveness of IRS as a malaria control intervention arises from the fact that many important malaria vectors are endophilic. That is, when searching for blood meals they enter human habitations or animal shelters where they rest on the walls, ceilings and other interior surfaces before and/or after feeding on the inhabitants. As such, the mainstay of the integrated vector control is IRS application to the inner walls of houses once or twice a year.

Workers prepare insecticides to use for the IRS

Frequency depends on the insecticide used, with different chemicals used for traditional mud and thatch buildings and Western type structures. Over the past seventy years, IRS has been a critical factor in decreasing the disease burden to levels that make elimination possible.

How positive are you as SADC enters into the Malaria week, what is Bayer sharing with other stakeholders?

In general, our outlook is positive, with advocacy for Malaria prevention in SADC remaining high on the region’s agenda. We are aware of several public-private partnerships to this end, which we believe is also key in successful Malaria prevention programmes.

What message do you have for other stakeholders in the fight for malaria especially given there has been a diversion towards other diseases, with funds getting allocated more to for eg HIV/AIDS?

Malaria, HIV and TB are all diseases that contribute poverty cycle and therefore should not be looked at in isolation. This is the view of many donors, and we therefore do not foresee a drop in funding toward Malaria prevention anytime soon. In addition, Bayer has increased our investment in this area in the last five years ten-fold and has committed to developing cost effective solutions, particularly related to further innovation in Indoor Residual Spray (IRS) solutions,  and the development of Fludora™ Fusion is testament to this. We are planning to produce Fludora™ Fusion locally in South Africa.

What hope is there for SADC region in fighting against malaria given the myriad of challenges amongst limited financial and human resources?

We remain optimistic that there is visible progress in the SADC region. Looking at the map above, you will     note that in the SADC region in particular South Africa has reached elimination level with neighboring  countries on the road to elimination. In fact, South Africa is proactively working on cross-border projects to help eliminate Malaria in these neighboring countries in the region. In general, an increasing number of countries are on the verge of eliminating malaria. In 2014, 13 countries  reported zero cases of the disease and 6 countries reported fewer than 10 cases. The fastest decreases were seen in the Caucasus and Central Asia (which reported zero cases of malaria in 2014) and in Eastern Asia. South Africa and Zimbabwe are also close to reducing their populations at risk for Malaria. Rwanda has also seen successful malaria reduction due to well-run IRS programmes.

As communities and local citizens, are there any knowledge gaps we need to be aware of?

It should always be kept in mind that Malaria is a preventable disease (i.e. there are many tools available to prevent it) and that it is not contagious. The role of communities in Malaria prevention is critical and  in order to ensure the success of prevention programmes, community involvement and good pre-distribution communication in malaria prevention programmes is key. There are various tools available to communities to help prevent infection, from IRS, insecticide prayed nets, and others. Some of the vital and basic ways the public can do to protect themselves from malaria is:

– If you live in an endemic area and there is indoor residual spray campaign, make sure your house is treated.
– When visiting malaria areas, use repellent, coils, and make sure you sleep under treated bed net.
– If you have any flu-like symptoms after visiting a Malaria prone region – do get tested as early detection is key.

Thank You

Sylvester Jobic is Bayer’s Environmental Science: Country Group Manager for Sub-Saharan Africa. He  is an internationally educated, and a professional who gained most of his experience in Business Management and Marketing working for Bayer both in France and Germany before moving to South Africa. Sylvester has a proven track record of managing challenging and demanding assignments through a mixture of creativity and outstanding management style. Through leadership by example, and exceptional motivational skills he has managed large and diverse teams including skilled and unskilled employees as well as implementing short term marketing projects. Jobic has worked as head of operations in France and did global marketing in Germany.

Animus Sustainability Portal drives stakeholder engagement and communication and focuses on companies operating in Africa.

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