By Abigail Pratt, Gates Foundation malaria program —
As I sat down to prepare my remarks for the International Assembly, Rotary’s annual training event for incoming leaders, my little boy came down with a fever. As his temperature climbed, I felt that deep fear we all experience when caring for a sick child – whether you’re a parent, grandparent, aunt, uncle, or friend.
My immediate thought was: What do I need to do to help him now? I live in London. I live three minutes from a pharmacy, 10 minutes from urgent care, and I have a medicine cabinet stocked with treatments that work. That peace of mind is something I’m deeply grateful for.
But tragically, this is not the reality for so many families around the world. Millions of parents face the same fear I felt, but without the assurance of nearby care, without access to medicine, and often without any viable options. This is why I show up to work every. Millions of children die each year of preventable, treatable illnesses like malaria, pneumonia and diarrhea because they simply can’t access care.
It is unacceptable. Health care is a basic human right, and together, we can take concrete actions to address this inequity.
Over the last two decades, the partnership between Rotary and the Gates Foundation to eradicate polio has been one of the most impactful collaborations in public health history. Thanks to your leadership, vision, and commitment, the world is on the brink of eradicating polio.
But the end of polio is not the end of our work together. The infrastructure and lessons from polio eradication have already been repurposed to address other critical health challenges. One of the most urgent is malaria – and at the heart of this fight are community health workers.
Community health workers save lives. They are trusted and trained caregivers who play a crucial role in educating and delivering care directly to families, to their neighbors, often without pay. They treat the most pressing local health issues, including malaria, pneumonia, and diarrhea — the top three killers of children under five – bringing primary health care within reach.
I lived in South Sudan for years, working to support a fledgling health system broken after decades of war, and the best part of my job was working with the local community health workers. I remember one woman vividly, Mary Lucy Iyobo, who was tireless in her commitment, demanding services for her community, and pushing all of us to work harder every day. She wasn’t just a health worker – but a lifeline for her community, saving lives, inspiring hope and demanding action!
The model is not new: Community health workers have been providing essential care for centuries, from China’s “Barefoot Doctors” in the 1930s, who helped eliminate smallpox, to containing the 2014 Ebola outbreak in West Africa, and playing a vital role during the COVID-19 response. And as you know better than anyone, they have fought courageously against polio since the beginning.
So it was thrilling to join hands with Rotary and World Vision again on the Programs of Scale award in Zambia “Partners for a Malaria-free Zambia” – that trained 2,500 community health workers to protect over 1.3 million people from severe illness and death. These workers delivered integrated care, tackled malaria head-on, and provided a transformative blueprint for public health projects.
Building on this success, we knew that we wanted to work with Rotary on something similar, but even bigger. It needed to stay locally led by Rotary members but implemented in partnership with government, and key organizations who have expertise and resources in the public health systems.
Together we launched the Rotary Healthy Communities Challenge. This $30 million program spans four countries – the Democratic Republic of Congo, Nigeria, Mozambique, and Zambia – where the need is greatest and where you all – locally and globally – are ready to step in. Though newly launched, RHCC is already saving lives and demonstrating that this partnership model can be replicated worldwide.
We already see opportunities to scale; places where Rotary members are energized and committed to establishing community health worker programs and have already forged longstanding, trusting relationships with local health authorities.
RHCC is more than just a program; it’s a model for how Rotary and the Gates Foundation and others can continue to work together to address systemic health challenges. By leveraging each other’s strengths, we can create sustainable, scalable solutions that have a lasting impact.
But there is still much to be done. Malaria is facing resistance on every front. Many programs face fragmentation, insufficient resources, and challenges in scaling effectively. And moving beyond a project-by-project mindset to engaging in longer-term planning and resource mobilization is critical to moving from helping one child at a time to eliminating a preventable and treatable disease like malaria.
This is where Rotary shines. You are “local everywhere,” which means you can ensure community voices are heard, solutions are appropriate, and programs are locally owned.
I’m asking you to take action to help support community health workers and advance the fight against malaria, pneumonia, and diarrhea. Learn about what community health workers are doing in your communities. Take the time to understand the impact they’re having and the challenges they face. They are the bridge to care for millions of families, and knowing their stories will inspire and inform your work.
- Follow what your fellow members are doing to support community health workers and engage in the fight against malaria.
- The Global Malaria Eradication Congress scheduled immediately prior to the Rotary International Convention in Calgary will be a unique opportunity to learn more about the Rotary Healthy Communities Challenge and the growing coalition to continue Rotary’s legacy of supporting healthy communities.
- Rotary’s area of focus lead for global health, Dr. Nyreese Castro-Espadas is a great expert and now a friend through this incredible partnership. She and I are available to provide technical partnership to make sure Rotary programs align with global guidance and integrate seamlessly into national Ministry of Health plans.
- Coordinate in your districts and zones to develop global grants. These grants are powerful tools to fund community health worker programs, and we at the Gates Foundation are ready to join and support your efforts.
- Engage community members in the design, implementation, and monitoring of programming. Melinda French Gates always talked to us about being humble, being open to listen and to maintain perspective. Listen to those who are most affected, they are actually your most important partner, not us.
Let’s reflect on the incredible legacy you’ve already built through polio eradication efforts and know that each new investment in strong community health systems is not only protecting the legacy and promise of a polio-free world. It is a commitment to healthy communities. Because I know that each of you want your children, grandchildren, and all of their neighbors to have access to the care they need when they need it.
Abigail Pratt is a Senior Program Officer on the Malaria Team at the Gates Foundation. This post is adapted from the speech Pratt gave to incoming leaders at Rotary’s annual training event in Orlando, Florida, USA, 12 February.
https://blog.rotary.org/2025/02/20/health-care-is-a-basic-human-right/