Opinion - I survived cerebral malaria, but millions of others won't without American leadership

Yahoo

25-04-2025

Each December, I mark the anniversary of my survival from cerebral malaria. That near-death encounter left me partially blind, profoundly changed and forever aware of the precarious nature of global health.
I contracted malaria in 2012 while working on a project in Liberia funded by the U.S. Agency for International Development. What started as fever and chills after a weekend in a coastal village spiraled into unconsciousness. Within days, I was in a coma, with parasite-laden blood cells swelling my brain.
I only survived because of an extraordinary improvised coalition of friends, colleagues and an overstretched clinic doctor who arranged my emergency evacuation to Paris. Millions of other people aren't as lucky.
Today, malaria remains the leading cause of death in Liberia, a nation of 5.5 million people. Roughly one in 10 Liberian children dies before their fifth birthday — many from preventable causes like malaria. In the rainy season, roads become impassable, and rural families often walk for miles to reach a clinic — only to find no medicine, no trained staff and no tests.
For nearly two decades, America had been a beacon of hope in this fight. That ended with the dismantling of USAID.
The President's Malaria Initiative was the U.S. government's largest program to combat malaria. Led by USAID and co-implemented with the Centers for Disease Control and Prevention, the initiative partnered with countries that account for around 90 percent of the world's malaria cases and deaths. It was one of the most effective foreign assistance programs in modern history. Alongside its local partners, the initiative made it possible for families to protect themselves.
In Liberia, the President's Malaria Initiative supported the training and payment of community health workers, distributed long-lasting insecticide-treated nets, provided diagnostic tests and lifesaving treatment, and supported the national malaria control strategy. These efforts have helped cut child malaria prevalence by more than half over the last six years.
Globally, the impact has been even more striking. Since 2000, the President's Malaria Initiative and its partners have helped save 12.7 million lives and prevent 2.2 billion malaria cases, according to the World Health Organization. This includes 177 million malaria cases and 1 million deaths averted in 2023 — in just one year.
Strikingly, death rates from malaria in countries that partner with the President's Malaria Initiative have dropped around 50 percent since 2006.
However, despite this life saving effect, some are now asking whether it is really worth it. Can we really afford to invest in a disease halfway across the world?
Here's the truth: Malaria interventions are among the most cost-effective in global health. A rapid diagnostic test costs just 28 cents, treatment is 87 cents and a protective bed net is under $2. These low-cost tools save lives and deliver a high return on investment — preventing missed work for parents, missed school for children and millions in avoidable healthcare costs across countries where the disease is endemic.
But the case for continued investment goes beyond compassion and cost-effectiveness. Development is not charity — it's strategy. Supporting malaria prevention strengthens our diplomatic relationships, builds resilient health systems and makes the world — and the U.S. — more secure.
In his confirmation hearing, Secretary of State Marco Rubio underscored why this matters for American interests. 'The impact that malaria has is not simply a health crisis or a humanitarian crisis,' he said. 'It has deep economic implications … It literally sets people and communities back … And the cost-benefit of an investment, leveraging private partnerships to deal with things like malaria, pays extraordinary dividends … as part of an overall approach to Africa, [it can] improve our prosperity, our security.'
Helping partner countries combat malaria fosters goodwill, trust and stability in regions critical to U.S. long-term strategic goals. It is soft power at its most effective — saving lives while reinforcing the kind of partnerships that prevent conflict, build economic ties and counter the influence of adversaries. In a world where global health threats cross borders with ease, our investment abroad is an insurance policy at home.
The President's Malaria Initiative wasn't just about fighting mosquitoes. It was strengthening local health systems, creating stability and supporting nations to build healthier, more resilient futures. That's why its dissolution — alongside USAID — is so dangerous.
When the U.S. walked away, progress stalled. Pregnant women have lost access to preventive care. Children are dying without basic medicine. Community health workers — the frontline defense in rural villages — are going unpaid and unsupported.
And malaria will now come roaring back, just as it had in the past when vigilance faded. In fact, internal USAID estimates cite that more than 160,000 people will die from malaria every year from the abandonment of these programs if they are not restored.
I know what's at stake. I lived it. And I was one of the fortunate ones.
After months of recovery from cerebral malaria — including temporary blindness and severe anemia — I returned to Liberia. I went back because I believed in its people, its future and the power of global partnership.
That belief hasn't changed. But the political will to stay in the fight might.
Malaria is beatable. The tools exist, the science is sound and the return on investment is clear. What we need now is continued leadership, not retreat.
In honor of this year's World Malaria Day, let's not abandon one of the greatest public health success stories of our time. Let's finish what we started.
Jessica Benton Cooney is a USAID staff member. This piece was written in her personal capacity.
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