Malaria is still killing people in Kenya, but a vaccine and local drug production may help

MIGORI, Kenya (AP) — As the coffin bearing the body of Rosebella Awuor was lowered into the grave, heart-wrenching sobs from mourners filled the air. Her sister Winnie Akinyi, the guardian to Awuor’s orphaned son, fell to the ground, wailing.

It was the latest of five deaths in this family attributed to malaria. The disease is common in Kenya, and it is preventable and curable, but poverty makes it deadly for those who can't afford treatment.

In the family’s compound in the western county of Migori, three other graves are visible, that of Awuor’s husband and their other two children who died from malaria before the age of 2.

Awuor, 31, fell ill in December and lost her five-month pregnancy before succumbing to malaria. Her 11-year-old son is the family's only survivor.

Malaria is still a significant public health challenge in Kenya, though some progress may be coming. Parts of Kenya participated in an important pilot of the world’s first malaria vaccine, with a reported drop in deaths for children under 5. Kenya's health ministry hasn't said when the vaccine will be widely available.

The biggest impact is felt in regions characterized by high temperatures like Kenya's Indian Ocean coast, and places with high rainfall like the western region near Lake Victoria.

Kenya had an estimated 5 million malaria cases and over 12,000 deaths reported in 2022, according to the World Health Organization.

Most of those affected are children under 5 and pregnant women.

Kenya continues to combat malaria with traditional methods such as distributing bed nets that are treated with insecticides, spraying breeding areas, and promoting prompt diagnosis and treatment, but experts say progress against the disease with those approaches has plateaued.

Public health expert Dr. Willis Akhwale, special adviser for the Kenya End Malaria Council, said the COVID-19 pandemic slowed down distribution of drugs and treatment.

He said innovative treatment methods are needed in the wake of drug resistant cases reported in parts of Africa.

“We need to start looking at investments in new generation medicines. That should then be able to counter any resistance in (the) foreseeable future,” he said.

Akhwale said other needs include more funding and logistical support.

“In Kenya the shortfall in terms of the need is almost $52 million, so we need to close that gap,” he said, citing health ministry data. He recommended domestic funding and private sector support amid donor fatigue with crises around the world.

Wilson Otieno has been admitted to a hospital three times for malaria and has received outpatient treatment countless times. It's expensive for the 33-year-old accountant and father in the lakeside city of Kisumu.

Malaria is never “pocket friendly," he said.

Some progress has been made with local manufacturing of crucial medication.

The Kenya-based Universal Corporation Limited last year received the WHO’s approval to produce an antimalarial drug known as Spaq, a combination of sulfadoxine-pyrimethamine plus amodiaquine.

The approval was an important step in Africa’s capacity to make lifesaving medications, a new focus for governments and public health officials after vulnerabilities were exposed by the COVID-19 pandemic. Africa relies heavily on drug imports.

“It will really help in lowering the dependency for imports as we saw during the COVID era, where whatever was being imported actually had huge supply disruptions,” said Palu Dhanani, the founder and managing director of UCL.

If you don’t get the right medicine at the right time, malaria can cause unnecessary deaths, Dhanani said.

Tiro reported from Nairobi, Kenya. Evelyne Musambi in Nairobi contributed to this report.

The Associated Press receives financial support for global health and development coverage in Africa from the Bill & Melinda Gates Foundation Trust. The AP is solely responsible for all content. Find AP’s standards for working with philanthropies, a list of supporters and funded coverage areas at AP.org.

Friends and family prepare to lower the casket of Rose Bella Awuor, 31 years, after a funeral service at her home in Awendo, Migori County, Kenya Thursday, April. 11, 2024. Awuor fell ill in December and lost her five-month pregnancy before succumbing to malaria. It was the latest of five deaths in this family attributed to malaria. The disease is endemic to Kenya and is preventable and curable, but poverty makes it deadly for those who can't afford treatment. (AP Photo/Brian Ongoro)

Humphrey Kizito holds death certificates of his parents who died of Malaria at their home in Siaya, Kenya Saturday, April. 13, 2024. Even after parts of Kenya participated in an important pilot of the world's first malaria vaccine, with a reported drop in deaths for children under 5, the disease is still a significant public health challenge. Kenya's health ministry hasn't said when the vaccine will be widely available. (AP Photo/Brian Ongoro)

Humphrey Kizito, centre, with his brother and sister in law, stand by their parents gravesite at their home in Siaya, Kenya Saturday, April. 13, 2024. Even after parts of Kenya participated in an important pilot of the world's first malaria vaccine, with a reported drop in deaths for children under 5, the disease is still a significant public health challenge. Kenya's health ministry hasn't said when the vaccine will be widely available. (AP Photo/Brian Ongoro)

Friends and family carry the casket of Rose Bella Awuor, 31 years, after a funeral service at her home in Awendo, Migori County, Kenya Thursday, April. 11, 2024. Awuor fell ill in December and lost her five-month pregnancy before succumbing to malaria. It was the latest of five deaths in this family attributed to malaria. The disease is endemic to Kenya and is preventable and curable, but poverty makes it deadly for those who can't afford treatment. (AP Photo/Brian Ongoro)

Winnie Akinyi, elder sister to Rose Bella Awuor, 31 years, holds her late sister's portrait ahead of her burial in Awendo, Migori County, Kenya Thursday, April. 11, 2024. Awuor fell ill in December and lost her five-month pregnancy before succumbing to malaria. It was the latest of five deaths in this family attributed to malaria. The disease is endemic to Kenya and is preventable and curable, but poverty makes it deadly for those who can't afford treatment. (AP Photo/Brian Ongoro)

A laboratory technician holds malaria blood test slides at the Nightingale Medical Centre, in Kisumu, Kenya Tuesday, April. 16, 2024. Even after parts of Kenya participated in an important pilot of the world's first malaria vaccine, with a reported drop in deaths for children under 5, the disease is still a significant public health challenge. Kenya's health ministry hasn't said when the vaccine will be widely available. (AP Photo/Brian Ongoro)

A mourner views the body of Rose Bella Awuor, 31 years, during her funeral service at her home in Awendo, Migori County, Kenya Thursday, April. 11, 2024. Awuor fell ill in December and lost her five-month pregnancy before succumbing to malaria. It was the latest of five deaths in this family attributed to malaria. The disease is endemic to Kenya and is preventable and curable, but poverty makes it deadly for those who can't afford treatment. (AP Photo/Brian Ongoro)

Medical staff attend to Malaria patients at Nightingale Medical Centre, in Kisumu, Kenya Tuesday, April. 16, 2024. Even after parts of Kenya participated in an important pilot of the world's first malaria vaccine, with a reported drop in deaths for children under 5, the disease is still a significant public health challenge. Kenya's health ministry hasn't said when the vaccine will be widely available. (AP Photo/Brian Ongoro)

A nurse administers an injection to a malaria patient in a ward at Nightingale Medical Centre, in Kisumu, Kenya Tuesday, April. 16, 2024. Even after parts of Kenya participated in an important pilot of the world's first malaria vaccine, with a reported drop in deaths for children under 5, the disease is still a significant public health challenge. Kenya's health ministry hasn't said when the vaccine will be widely available. (AP Photo/Brian Ongoro)

Friends and family lower the casket of Rose Bella Awuor, 31 years, after a funeral service at her home in Awendo, Migori County, Kenya Thursday, April. 11, 2024. Awuor fell ill in December and lost her five-month pregnancy before succumbing to malaria. It was the latest of five deaths in this family attributed to malaria. The disease is endemic to Kenya and is preventable and curable, but poverty makes it deadly for those who can't afford treatment. (AP Photo/Brian Ongoro)

OMAHA, Neb. (AP) — Tens of thousands of investors once again descended on an Omaha, Nebraska, arena Saturday to vacuum up tidbits of wisdom from billionaire Warren Buffett. But a key ingredient will be missing from his annual Berkshire Hathaway shareholders’ meeting: It's the first since Vice Chairman Charlie Munger died.

“He was the sriracha sauce in the Berkshire Hathaway meeting," said investor Bill Smead, a regular at the event for 14 years. "He gave it a lot of flavor.”

For decades, Munger shared the stage with Buffett every year for the marathon question and answer session that is the event's centerpiece. Munger routinely let Buffett take the lead with expansive responses that went on for several minutes. Then Munger himself would cut directly to the point. He is remembered for calling cryptocurrencies stupid, telling people to “marry the best person that will have you” and comparing many unproven internet businesses in 2000 to “turds.”

He and Buffett functioned as a classic comedy duo, with Buffett offering lengthy setups to Munger's witty one-liners. Together, they transformed Berkshire from a floundering textile mill into a massive conglomerate made up of a variety of interests, from insurance companies such as Geico to BNSF railroad to several major utilities and an assortment of other companies.

Saturday is set to kick off with the company releasing its first quarter earnings a couple of hours before the meeting. In addition to its biggest interests, Berkshire Hathaway owns a vast collection of manufacturing and retail businesses, including Dairy Queen and See’s Candy. Its massive stock portfolio is anchored by huge stakes in companies including Apple, American Express and Coca-Cola.

Munger often summed up the key Berkshire’s success as “trying to be consistently not stupid, instead of trying to be very intelligent.” He and Buffett also were known for sticking to businesses they understood well.

“Warren always did at least 80% of the talking. But Charlie was a great foil,” said Stansberry Research analyst Whitney Tilson, who was looking forward to his 27th consecutive meeting with a bit of a heavy heart because of Munger's absence.

That absence, however, may well create space for shareholders to get to know better the two executives who directly oversee Berkshire's companies: Ajit Jain, who manages the insurance units, and Greg Abel, who handles everything else. Abel will one day replace the 93-year-old Buffett as CEO.

Morningstar analyst Greggory Warren said he hopes Abel will speak up more this year and let shareholders see some of the brilliance Berkshire executives talk about. Ever since Munger let it slip at the annual meeting three years ago that Abel would be the successor, Buffett has repeatedly reassured investors that he's confident in the pick.

Experts say the company has a solid culture built on integrity, trust, independence and an impressive management roster ready to take over.

“Greg's a rock star,” said Chris Bloomstran, president of Semper Augustus Investments Group. "The bench is deep. He won’t have the same humor at the meeting. But I think we all come here to get a reminder every year to be rational.”

For more AP coverage of Warren Buffett look here: https://apnews.com/hub/warren-buffett. For Berkshire Hathaway news, see here: https://apnews.com/hub/berkshire-hathaway-inc. Follow Josh Funk online at https://www.twitter.com/funkwrite and https://www.linkedin.com/in/funkwrite.

Berkshire Hathaway Vice Chairman Greg Abel poses with shareholders Friday, May 3, 2024, in Omaha, Neb. Abel is set to be the next CEO after Warren Buffett is gone. (AP Photo/Josh Funk)

Berkshire Hathaway shareholders watch a model BNSF train run past a model town filled with other Berkshire companies Friday, May 3, 2024, in Omaha, Neb. Buffett will spend hours answering questions at a meeting Saturday. (AP Photo/Josh Funk)

Berkshire Hathaway shareholders line up to take selfies with Greg Abel Friday, May 3, 2024, in Omaha, Neb. Abel will one day replace Warren Buffett as CEO. (AP Photo/Josh Funk)

Berkshire Hathaway investment manager Ted Weschler, center, talks with Brooks Running CEO Dan Sheridan, Friday, May 3, 2024, in Omaha, Neb., one day ahead of the annual shareholders meeting. (AP Photo/Josh Funk)

Berkshire Hathaway shareholders pose with a cutout poster of CEO Warren Buffett, Friday, May 3, 2024, in Omaha, Neb., one day ahead of the annual shareholders meeting. (AP Photo/Josh Funk)

Berkshire Hathaway Vice Chairman Greg Abel poses for pictures with shareholders while touring the booths Berkshires companies set up, Friday, May 3, 2024, in Omaha, Neb. Abel will succeed Warren Buffett as CEO one day. (AP Photo/Josh Funk)

Berkshire Hathaway Vice Chairman Greg Abel checks out the flight simulators offered by one of Berkshires companies, Flight Safety as he toured the exhibit hall Friday, May 3, 2024, in Omaha, Neb. ahead of Saturday's meeting. Abel is set to succeed Warren Buffett as CEO one day. (AP Photo/Josh Funk)