Lifeblood: How to Change the World One Dead Mosquito at a Time

  • Alex Perry
PublicAffairs, 2011 256 pp., hardcover, $25.99 1610390865 | ISBN: 1-610-39086-5

Lifeblood focuses on the efforts of entrepreneur and multimillionaire Ray Chambers, the Special Envoy for Malaria of the Secretary General of the United Nations, to help eradicate malaria in Africa by aiding in the distribution of insecticide-impregnated bed nets through his nongovernmental organization Malaria No More (MNM). Alex Perry, Time magazine's Africa bureau chief, reports on his travels with Chambers and writes about malaria, which has haunted Africa for at least 10,000 years. Perry discusses how malaria affects business and society, and much of the book is a perspective on the politics of present-day Africa. Lifeblood is worthwhile reading for those individuals involved in the fields of health, research, economics, trade and aid, as well as for people who wish to learn about these topics.

The prevalence of malaria is currently down 25% from the beginning of the twenty-first century. Since 2008, it has been on an even greater decline in the wake of Chambers's efforts with MNM, which works with partners such as the governments of developing countries and the World Health Organization (WHO) to share best practices, skills and tools other than bed nets to tackle malaria. The funding for the bed nets comes from various sources, including the Global Fund to Fight AIDS, Tuberculosis and Malaria, the governments of developed and developing countries and the WHO. Remarkably little is known by the general public of Chambers's involvement and campaign, which had facilitated the distribution of nearly 300 million nets by December 2010. In areas where these nets were used, malaria rates fell, and Chambers now aims to end all malaria-related deaths by 2015.

Perry describes how Chambers is fighting malaria by using his knowledge of politics and business. Perry relates how Chambers in 2006 began to understand the dire consequences of malaria and wanted to “fix it,” coming up with business concepts that he hoped would save a million children a year. Perry describes how Chambers made his fortune by initially buying into nursing homes and then later during the 1980s by using financial leverage techniques. Perry relates how Chambers also uses his economic leveraging technique—getting more from less—in 'fixing' malaria. Chambers's approach has three pillars: political leadership, business leadership and the use of the media; this book is therefore an integral part of the strategy. Chambers approached the political-leadership aspect by using his extensive network and by arranging malaria summits in which all the global players involved in the eradication effort meet with world leaders.

Chambers and Perry argue that malaria eradication efforts must now use methods from the business world, including accountability and goal setting. However, Perry does not tell readers enough about previous attempts at malaria eradication, and he makes it clear he is not fond of traditional aid methods, which he claims are often patronizing. However, it should be remembered that traditional aid methods have helped eradicate smallpox and have also drastically reduced the number of cases of measles and tetanus, facts that argue that there are several ways to alleviate the burden of a disease. Africa has changed over the last 20 years, and the situation is more promising than ever, with economic growth (as determined by the gross domestic product) of more than 5% per year in many parts of Africa and with stronger political leadership in many countries.In addition, the African Union has taken on political and health-related responsibilities today that it did not previously.

One interesting portion of the book is dedicated to the history and the current situation of malaria. This portion relates some of the basic findings of malaria epidemiology and the research data on which the impregnated bed net initiative is based. However, this part of the book would have been more effective had further polishing of the text been done, as some stated facts are wrong: chloroquine, a drug currently used to treat malaria, is not a synthetic version of quinine, and malaria was not present in every country of the world at the end of World War II, both of which Perry claims.

Perry seems to believe that we already have the tools needed for malaria eradication. His opinion about the scientists involved in malaria research is that they work in this field “because that was where the money was.” However, I am concerned that these views are naive and may mislead decision makers to cut funding to applied or basic malaria research. In fact, it is important to develop new tools for malaria elimination to subsequently eradicate malaria; we must find new ways to fight the parasite. There is no paradox in focusing on both elimination and research, as interest and funding for one will not compete with those for the other. Original, new approaches must be developed, and a deeper understanding of the basic biology of malaria is needed as long as it persists and there is no vaccine. Impregnated bed nets are important, but the presence of nets means that mosquitoes that bite during the daytime are naturally selected for, and malaria parasites are developing resistance to the drugs that are currently used.

Chambers's strategy involves focusing on the seven African nations where malaria most affects the population. He elicits help from religious leaders and politicians and raises money in unorthodox ways. He is currently transferring the bed-net effort to African heads with the help of the newly created organization African Leaders Malaria Alliance, an intergovernmental organization that is dedicated to ending malaria deaths. The continued efforts of Chambers and his partners are laudable, and the publication of this well-written book will certainly achieve its goal of making these efforts more widely known.