The malaria fighter

Since US Rear Admiral Ziemer became coordinator of the President’s Malaria Initiative in 2006, deaths from disease have dropped 40 pc

By: New York Times | Published:October 26, 2014 12:14 am
Many countries now use tactics Ziemer adopted. That includes free distribution of nets impregnated with insecticide, indoor pesticide spraying and medicines for pregnant women. Many countries now use tactics Ziemer adopted. That includes free distribution of nets impregnated with insecticide, indoor pesticide spraying and medicines for pregnant women.

After a chat with the chief of the hamlet of Ba Wa Pin in Myanmar, as rain hammered the tin roof, US Rear Admiral R Timothy Ziemer reached into his pocket for his usual thank-you gift.

The local malaria clinic where the meeting was taking place was well run, and there was a big turnout of mothers grateful for the free mosquito nets. Accepting the thick gold-coloured coin with President Barack Obama’s face on it, the chief looked thrilled. “They’re not official,” Ziemer confessed later. “I buy them in a souvenir shop in the Reagan office building for $4.50 each.”

The moment, however, illustrated how this 67-year-old retired Navy flier who is the coordinator of the President’s Malaria Initiative gets things done: on the ground, with little cash and less fanfare, in faraway African and Asian villages.

Although he does nothing to court publicity in status-obsessed Washington, many malaria fighters call him one of the most quietly effective leaders in public health.

“All the organisations fighting malaria work more closely than they did eight years ago,” said Ray Chambers, the private equity investor and co-founder of Malaria No More who is now the UN Secretary General’s Special Envoy for Malaria. “That’s due in no small part to Tim. He’s not seeking individual credit and works for the team — but his trains run on time.”

Since he took the job in 2006, worldwide malaria deaths have dropped 40 per cent, to about 600,000 a year from 1 million.

Many countries now use the tactics Ziemer adopted. For prevention, they include free distribution of nets impregnated with insecticide, indoor pesticide spraying and doses of malaria medicine for pregnant women. For diagnosis and treatment, they include rapid blood tests and pills that combine a new fast-acting Chinese drug, artemisinin, with one of several longer-lasting drugs.

He toured rural Myanmar because the region is the cradle of drug-resistant malaria and his agency is fighting it by subsidising two-drug pills. If artemisinin becomes ineffective, malaria experts say, it would be a disaster equivalent to losing chloroquine, a former “miracle cure”.
Ziemer’s self-effacing, penny-pinching approach — he flies coach everywhere, even when executives of other relief organisations travelling with him buy business-class tickets, an aide said — has helped make him a political survivor.

Since he was appointed by George W Bush, he has outlasted three global AIDS czars. He drafted a resignation letter after Obama was elected; it was declined. He prepared it again after the transition team for Hillary Rodham Clinton, the new secretary of state, ousted his counterpart overseeing AIDS, Dr Mark R Dybul. But he was asked to stay.

He may attract less fire, he conceded, because his disease is less controversial. It does not involve condoms, abstinence, homophobia or prostitution, and no one lobbies for mosquito rights.

On a four-day visit to Myanmar this summer, he paid official calls on the health minister and two national laboratories. But he also flew and drove for hours to chat with village chiefs, local malaria educators, rural doctors and pharmacists, rubber tappers and road builders.

Some of his travel was through mountains off limits until two years ago because of fighting between local tribes and the army. In Ba Wa Pin, he gave another coin: to a volunteer from the Karen tribe who had hiked for two days to meet him.

At each stop, he grilled people for details: Is malaria down? How it that measured? How is the money accounted for? What obstacles remain? In Zambia, he said, he shut down a $200,000 programme “when I asked where our money was going and I got the ‘stunned owl’ look”.

He is unfailingly polite, thanking volunteers, waiters and drivers. He is so low-key that many experts who praise him know almost nothing of his past — not even that he slept under mosquito nets as a child and survived a bout of malaria.

From infancy through high school, he lived in Ban Me Thuot, in the central highlands of Vietnam. The son of Presbyterian missionaries, he spoke Rade, the local mountain tribe’s dialect, ate coconut “lakewater Popsicles”, chased French convoys begging soldiers to throw chocolate, and played in tunnels dug by the Japanese during World War II.

In 1964, he left for Wheaton, a college near Chicago. Four years later, during the Tet offensive, North Vietnamese and Vietcong soldiers overran Ban Me Thuot. Locals fled to the clinic, which then came under attack. His father was killed while negotiating an evacuation, but his mother survived — bleeding from 18 wounds.

When the North Vietnamese retreated during a counterattack, they left her in a ditch. A local man rescued her and contacted the Americans. She was evacuated to Andrews Air Force Base in Maryland, in a plane full of wounded GIs.

Facing the draft, Ziemer joined the Navy and asked to return to Vietnam. He was not avenging his father, he said. “I was taught that vengeance was the Lord’s and you defer to that,” he said.

After Vietnam, he spent years as a squadron leader, hunting Soviet submarines before being promoted into the Pentagon. After retirement, he headed World Relief.

The malaria initiative was founded in 2005. At the time, the government’s anti-malaria efforts were in a shambles. They were backing outdated drugs, and most of the budget went to consultants designing ad campaigns telling Africans to buy mosquito nets — which most could not afford.

Congress authorised $1.2 billion for the first five years, specifying that the bulk of it be spent on goods to be given away free or at subsidised prices.

The initiative now supports efforts by 25 countries in Africa and Southeast Asia. “My motivation is to keep it moving — and to look out for the kids I brought onto the team,” Ziemer said.

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