One of the boldest ideas in the nonprofit world today—embraced by the Bill & Melinda Gates foundation and others—is the eradication of malaria, which for thousands of years has killed millions of children. Recent advances offer powerful leadership lessons applicable to a wide range of nonprofits and underscore the degree to which we are all held back not just by failures of financing or strategy but by failures of imagination.
On August 9, the journal Science published the results of the newest clinical malaria vaccine trial by a company called Sanaria showing that for the first time ever, 100 percent of the trial volunteers who received a high dose of a unique vaccine were protected. CNN, Reuters, U.S. News and World Report, and dozens of other news outlets around the country ran headlines like: “Malaria Vaccine Yields Unprecedented Protection in Clinical Trials.” The lead researcher for a competing effort by the giant pharmaceutical GlaxoSmithKline was quoted as saying “This is a really important, really exciting proof of concept.”
Nearly three years ago, I wrote about Sanaria’s CEO, Steve Hoffman, in The Imaginations of Unreasonable Men. I was drawn to his story because of the parallels to so many social-change efforts in the nonprofit world – knowing that something was solvable, knowing that existing solutions worked but were hard to scale, and knowing that doing so might seem expensive, unrealistic, or unreasonable. Hoffman’s standard—that good is not good enough—was akin to our view at Share Our Strength that feeding kids is not good enough but that we need to end childhood hunger.
The book was published just as Steve was taking his vaccine into clinical trials. His approach, which depended on extracting weakened but live malaria parasites from the dissected salivary glands of mosquitoes, was ridiculed in some quarters as impractical to produce and administer. The early trials went badly. The vaccine, administered by injection, failed, and the volunteers exposed to malaria contracted it (though they were immediately cured by aggressive medical intervention according to standard protocols). Hoffman faced some dark days.
But Steve knew that weakened parasites triggered immunity to protect against malaria when they entered the human body through multiple mosquito bites. So he refused to give up, even as some abandoned their support. Instead he doubled down. He increased the dosage and settled on an approach truly beyond imagination: administering the vaccine through an IV, something entirely impractical across Africa, where children need it the most. But his strategic objective at this stage was not scale, it was proof of concept.” Now that proof of concept has been affirmed, financial support that had once dried up has begun to flow back and will be devoted to additional trials, scale, and sustainability.
Steve refused to allow supporters to dictate his strategy. He remained undeterred by critics who labeled him naive. He focused not on incremental change but on the transformational. He dedicated himself not just to years of work but to decades. And he remained dedicated to the most vulnerable and voiceless–poor children in Africa, who have no markets competing to serve them.
The history of malaria suggests no more than cautious optimism is warranted at this point. There is still a long way to go. But Steve Hoffman’s long journey has been dramatically accelerated by proving the concept. And the lives of millions of children stand to benefit.Return to Top