schoolkids in frica
Expert Opinion: Sherwin Charles

What if? There was no more Funding for Public Health Initiatives

Sherwin Charles, CEO and Founder of the global non-profit Goodbye Malaria and Member of the Board of the Global Fund, considers what could – and might – happen without collective investment in public health.

Sherwin Charles
Credit: Sherwin Charles, Bayer AG


Sherwin Charles, CEO and Founder of the global non-profit Goodbye Malaria and Member of the Board of the Global Fund

What if there was no more funding for public health initiatives? This is a particularly relevant question at this moment. Since 2000, the push to meet the United Nations Millennium Development Goals has led to unprecedented success. The Global Fund, through its country grants, has saved more than 27 million lives across a range of illnesses, including a 60 percent reduction in malaria-related mortality.

But at the moment, progress is stalled. In the case of malaria, WHO’s 2018 report indicates an increasing number of cases in the highest burdened countries. Add to this scenario wavering political commitment and funding gaps, and the current public health landscape reveals that, when it comes to malaria, we are not on a trajectory to meet the United Nations Sustainable Development Goal 3: “Ensure healthy lives and promote wellbeing for all at all ages.”

The Case of Malaria

To articulate a frame, we can ask: What if there was no more funding specifically for malaria? Overall, the current impact of malaria in Africa – at current levels of public health investment – is still estimated to cost 12 US billion dollars every year. In Africa at present, malaria strains national economies, impacting some nations’ gross domestic product by as much as an estimated five to six percent. African households lose up to 25 percent of income due to the disease. It also affects land use patterns and crop selection, which results in suboptimal agricultural production, reduced labor productivity and, ultimately, impairs learning. In some areas, malaria accounts for 15 percent of health-related absenteeism from school. It is estimated that in endemic areas, malaria may impair as much as 60 percent of the schoolchildren’s learning ability.

Amidst this current scenario, there is a powerful antidote: Research shows that for each US dollar invested in public health initiatives, the return is at 19 US dollars in health gains and economic returns. Clearly, any investment pays for itself. When it comes to a disease like malaria at the moment, more investment is required to fight this public health scrouge.

Schoolkids in Africa
Credit: Michelle Cornu, Bayer AG


In some areas, malaria accounts for 15 percent of health-related absenteeism from school. 

The fight against malaria has been one of the biggest public health successes of the 21st century. Malaria, however, remains a disease that has probably killed more human beings than any other in history despite the expensive, decades-long effort to contain it. Of the roughly three billion US dollars a year spent to turn back malaria, the United States is by far the biggest contributor, giving almost 40 percent of all funding. But, by nature, the malarial burden in malaria-eliminating countries like the United States is low; consequently, malaria may be no longer fully understood as a public health threat. 

In such scenarios, there is the risk that funding is often diverted to other health priorities. In other words, a “what if” scenario of reduced public health spending is not purely hypothetical. But we have the evidence that, with continued – and increased – investment, we can win this fight. 

Related Content

Science & Innovation
What If…? Tropical Diseases Spread Across Europe
Read more
Yao Kouamé Kan Serge Alain, master student in Medical and eterinary Entomology at the Université Alassane Ouat tara, Ivory Coast
People & Perspectives
In the Footprints of Renowned Researchers
Read more