Excuse me if I chuckle at the analogy between a 3-day meeting on malaria and Woodstock, or even the Oscars. I mean really, as one of my colleagues says, how could Woodstock measure up to malaria? There has been a certain amount of ceremony - starting with the stagey introductions that emanate from behind the tall curtains - and a rock-star build-up to the presence of Bill and Melinda Gates at the meeting this morning. But apart from the very-real parallels that some participants might make to the 1969 Woodstock concert - intermittent rain, out-of-the-way venue, a bevy of big names - the Gates Foundation Malaria Forum has the very real ambition of becoming a legendary moment in the history of fighting malaria.
The centerpiece of the discussion has been around the "E word." A lively debate yesterday about the wisdom of trying to eradicate malaria raised real and perceived barriers. They included the need to retain a viable drug pipeline in the presence and promise of resistance, the difficulty in maintaining political momentum as the burden of malaria diminishes, the need for better statistics about numbers of cases and transmission patterns, a lack of trained health workers for distributing and implementing control tools, and perhaps most importantly to the weary community of malaria fighters: the fear of failure again. This is far from a new topic and the malaria community still is more known for failure and insecurity than great successes.
Nonetheless, the debate about whether to aim for eradication or not - at least for purposes of this meeting - was effectively settled yesterday morning when Melinda Gates declared that "the only way to end death from malaria is to end malaria" and said the Foundation has set a very very long-term goal of eradication with all the risks that entails. Bill and Melinda Gates outlined the steps needed to achieve eradication - use of a multi-pronged strategy, coordinating use of the control tools, using community capacities outside the health sector, investing in R&D on multiple drug and vaccine targets simultaneously (yesterday's encouraging news on the safety and efficacy of the RTS,S vaccine for infants is one of many technology developments expected in the next 2 years), knowing that some will fail, taking advantage of growing political and financial interest from such unlikely new partners as the Women's NBA, and retaining financial and political commitments from the post-Bush PMI and other donors. For their part, the Gates put themselves and their Foundation behind the "audacious" goal of eradication today.
There are about 250 people assembled here in Seattle, all with a role in fighting malaria. The hand-picked participants are mostly CEOs and other lead actors in organizations addressing the many challenges of malaria: basic science in drug and vaccine development, financing for implementation scale-up, global policy leadership, and the elusive element of inspiration. By the time this meeting ends tomorrow, a newly-inspired cadre will be planning historic steps towards overcoming those challenges. (And for those who regretted missing Woodstock, you need feel no such regrets thanks to the Kaiser Family Foundation.)
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