A good way to understand the vision behind Project Muso’s Community Based Malaria Program is to read the World Health Organization’s 2008 World Health Report, entitled Primary Care: Now More than Ever.

The WHO lays out an ambitious vision for what primary care should be: “Primary care provides a place to which people can bring a wide range of health problems – it is not acceptable that in low-income countries primary care would only deal with a few ‘priority diseases… primary care requires adequate resources and investment, and can then provide much better value for money than its alternatives. It is not acceptable that, in low-income countries, primary care would have to be financed through out-of-pocket payments on the erroneous assumption that it is cheap and the poor should be able to afford it.’”

This is why Project Muso’s Community Based Malaria Program must be about more than malaria. True, the program aims to stop malaria deaths in Yirimadjo by providing early and effective treatment. But the scope of the program is deeper, and more ambitious. If we are successful at rolling back malaria, what legacy do we leave behind? What primary health care systems need to be in place to sustain our achievement, to make sure malaria does not reemerge a few years later?  If we do succeed with malaria, how will we take on the other health crises that Malians face?  If the poor are still excluded from care by unjust health care financing policies, will we have succeeded? 

Project Muso recognizes that, to achieve sustained improvements in health, we need to both fight malaria and strengthen primary health care systems. Every aspect of the malaria program’s design, including Community Health Worker outreach, clinical training, infrastructure development, and removing financial barriers to care, also builds stronger and more equitable primary health care systems.

The WHO’s report advocates for four reforms that are at the core of Project Muso’s Community Based Malaria Program:

·         Universal coverage reform to “contribute to health equity, social justice, and the end of exclusion” by ensuring universal access to health care.  In Mali, health care has only been available to those who can afford to pay, excluding all those too poor to pay for care. Through the Solidarity Fund, Project Muso is working to provide health care to all of Yirimadjo’s citizens regardless of their ability to pay.

·         Social delivery reform to “re-organize health services around people’s needs.” Our well-trained team of Community Health Workers have enabled us to re-organize health care delivery, reaching out to patients in their homes, identifying and removing roadblocks to recovery.

·         Public policy reform to strengthen primary care is also key to Project Muso’s approach. By partnering with the Malian Ministry of Health to design, implement, and evaluate our Community Based Malaria Program, we are creating a platform for evidence-based policy change in Mali.

·          Leadership reform: Community Health Workers, along with the Community Action Committee and participants in Project Muso’s adult education program organize their communities to take the lead in improving community health.