The cities and villages around Africa's Great Lake Victoria are particularly vulnerable to malaria and have become inundated with fake malaria medications. Image by Kathleen E. McLaughlin. Tanzania, 2012.

The Zimbabwean geologist sitting next to me on a plane across Tanzania from the shores of Lake Victoria to Dar Es Salaam was chatty, asking all sorts of questions about my work in the region and why I was concerned with fake malaria medications made in China. I had just left a clinic in Mwanza where the overworked medical team was trying to save malnourished twin babies. Their mother had died of complications from malaria shortly after they were born and now they weren’t getting enough food. The outlook was poor.

“Have you come to save the world?” he asked with a smile, incorrectly guessing that I was another of the thousands of foreign aid workers who travel through these parts.

He listened intently as I talked about women and children dying from malaria, the fake treatments overwhelming the market, even though there are plenty of reliably safe and effective medications available. Then he asked, with no apparent malice, the question that I suspect so many other people keep to themselves: “So let’s say we save all these women and children. What do we do with them then?”

This is the underlying question, isn’t it? In one of the poorest and most overpopulated parts of the world, basic survival of treatable illness simply is not a given. After more than three weeks of researching the issue on the ground, I came to believe that part of the reason the fake medications crisis in sub-Saharan Africa hasn’t gotten the attention it deserves is because of the nature of the victims. Women and children are particularly vulnerable to the malaria parasite, dying of it in vastly larger numbers than healthy adult men.

The disease kills 800,000 people per year, according to the World Health Organization’s 2010 malaria report. The greatest numbers of victims live in Africa. Children and pregnant women, whose immune systems are not adequately equipped to battle the parasite, are especially susceptible to dying from malaria. They are also, in countries like Uganda, which has the world’s third-highest birth rate, greatly lacking in political power.

Undoubtedly, there have been vast improvements, particularly because of new treatments. Malaria death rates have dropped by as much as a third in some parts of Africa, according to the WHO. Yet still, a child dies nearly every minute from malaria in Africa.

Global medical aid, especially the programs using the innovative malaria treatment drug developed decades ago by China, has the power to shift this equation dramatically. But deeply entrenched interests among aid groups, governmental corruption, porous borders and a mostly unspoken attitude about the value of women and children make the prospects for success far from certain.

Project

Today China focuses much of its foreign aid on healthcare in the developing world. It has achieved some success but also brought problems.

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