Remembering Dr Tewolde Gebremeskel, a pioneer in the fight against malaria
By Kate Macintyre
I was saddened to learn that Dr Tewolde Gebremeskel, Head of the National Malaria Control Program (NMCP) in Eritrea, has died at the age of 60. His intelligence, fierce drive, transparency, work ethic and energy, supported by an able, well-organised team, have been largely responsible for Eritrea’s successful malaria control programme in the last 15 years.
After graduating from Gondar School of Public Health in Ethiopia in 1977 with a Bachelor’s degree in Public Health, Dr Tewolde served for 14 years as field surgeon and general medical practitioner on the war front in Eritrea. After Eritrea became independent, he was awarded a medical degree (MD) based on his field experience. He was selected by the Ministry of Health to study for a Masters in Public Health at the University of New South Wales, Sydney, Australia, supported by the Australian Agency for International Development (AusAID). In 1997, he became head of the NMCP. In September 2012, he was awarded the McKay Medal by the Royal Society for Tropical Medicine and Hygiene.
After spending most of his early career in clinical medicine in challenging circumstances, Dr Tewolde quickly acquired new skills to revitalise, reorganise and implement a very successful malaria control programme. His return to Eritrea coincided with the peak of a malaria epidemic in the Horn of Africa caused by the el Nino event in the late 1997/8. Dr Tewolde took charge of the programme and mobilised international donor support without relinquishing control or oversight of the programme to outsiders.
The programme quickly achieved full national coverage through the distribution of insecticide-treated nets for all age groups, and through other control methods. It reduced malaria from the top cause of death in the late 1990s to a minimal problem today and is a model for other malaria endemic countries.
The NMCP has been the principal recipient for three Global Fund malaria grants in Eritrea with a total value of $46.5 million. In a report on its recent diagnostic review of active grants in Eritrea, the Office of the Inspector General (OIG) said that there was strong evidence of a successful national response to malaria. The OIG said that because of the malaria programme, the proportion of all health facility visits for malaria went from one-third in 1999 to less that 3% in 2010.
In 2006, Eritrea became the first African country to reach the Abuja Roll Back Malaria targets adopted at the Abuja Summit in the year 2000. It was also one of the first countries to use multiple interventions in an integrated way.
Dr Tewolde, although private, was not a shy man. He knew that communication mattered greatly in the context of malaria. He gave weekly radio interviews on the malaria programme, which earned him the nickname Mr Malaria. He always supported training for his staff as a prerequisite of outside support, and was instrumental in the development of a new course at the University of Asmara for public health technicians who graduated with good malaria control skills. His integrity, tenacity, willingness to learn new skills and ability to motivate others to achieve results was inspiring. These attributes, together with the desire to apply his extensive clinical medical knowledge and public health training to help his country, benefitted people of all ages.
I worked with Dr Tewolde for four years and admired his energy and enthusiasm. He loved to work hard, and at the end of the day enjoyed having coffee with friends of all ages, creeds and backgrounds. I recall sitting in a meeting that Dr Tewolde had called for donors, the Ministry of Health and technical advisors. He was telling us how he planned to sustain the gains made in malaria control. One of the advisors whispered to me: “When Dr Tewolde tells you the train is leaving the station, you better get on it. He doesn’t wait for anyone.”
His “train” has left the station but we will always remember that sense of humour and dynamism. Our sympathy goes to his family and to that wide circle of friends who benefited from knowing and appreciating the man.