Zacharia Kafuko

1Day Africa Director @ 1Day Sooner
7 karmaJoined Working (6-15 years)


Molecular Biochemist with a passion for global health and equity! Chess player!

How I can help others

Reach out to me if you have any questions related to public health in Africa (or anything Africa related really).


The burden of malaria as it exists right now, exists even amidst the decades of use of all the available interventions (including ITNs and chemotherapies). Is there any progression of To add to that, compliance in the use of the ITNs is also challenge (several reports exists on how ITNs in Africa end up being used for fishing, or how some resell them. The ITNs reduce all cause mortality by 17% and the RTS'S vaccine reduces mortality by 13% and the projection for R21 is expected to be higher when the data becomes available.

I am not 100% certain that I follow all the math. However, when it comes to the malaria burden and which intervention is most cost effective, the general rule I'd apply is the permanence of the intervention. An intervention such as the use of ITNs may appear cost effective if you view it in a period of maximum 3 years. But because such an intervention is not permanent, the need to replenish ITN supplies to households repeatedly means that nets are a recurring cost. This implies that the actual cost of ITNs can't fully be quantified in the sense of how long malaria as a disease will continue to exist. Vaccines on the other hand are more permanent and have a predictive cost even when measured against waning immunity. 

Vaccines will bring us closer towards herd immunity and potentially the elimination of malaria and vaccines must be used complimentary to other interventions in the malaria toolkit.

This is a good programme but I think and strongly feel that the number of people that could be helped would be much higher if the programme was more global than just focused on the US and UK. Additionally, the value for money is higher in LMICs and hence impact is greater. For context the cost of tuition plus other fees for one person to attend Harvard for 4 years is roughly more than $300,000. This amount of money for example could fully pay for 50 undergraduate students for 4 years at top universities in Africa. So, if 10 awardees are selected for US/UK, the cost would be equivalent to 500 students in Africa for example being fully sponsored.

I am not implying that students in US and UK shouldn't receive scholarships but rather that a global eligibility could introduce a balance that would increase the ROI for each dollar spent.