Dr Lina Finda: The Tanzanian Lady who impresses Bill Gates and she only ‘Just Listens!’

By Bill Gates

Dr Lina Finda’s work sounds simple.

“My job is to listen,” she says.

But the reality is much more complicated.

On a typical day, she has to walk into a village in southern Tanzania or a meeting hall in Uganda and gauge reactions to the idea of ending malaria by an unusual method: releasing more mosquitoes.

It’s not as crazy as it seems.

That’s because the mosquitoes she’s talking about in this case carry a gene that blocks the malaria parasite from developing, so the mosquito can’t get you sick even if you get bitten.

(I just wrote about the project researching these malaria-free mosquitoes, Transmission Zero, along with the other tools that are helping us fight this disease.)

Release enough of them into the wild and, in theory, the trait spreads on its own until the local mosquitoes can no longer transmit the disease.

The science is advancing, and it’s exciting.

But none of these malaria-free mosquitoes have been released in Africa yet.

Whether that ever happens is a decision that will be made by African governments and the people who live where these mosquitoes would circulate.

Finda co-founded the African Conversations Initiative to make sure those people have a say.

Her team is now working in eight countries: Tanzania, Kenya, Uganda, Rwanda, Zambia, Ghana, Nigeria, and Senegal.

The question that started it

Finda first learned about the potential of malaria-free mosquitoes in 2017, at the beginning of her PhD in public health.

“My thought was, oh my God, we might eliminate this disease in my lifetime,” she says.

All the scientists in the room with Finda were equally impressed and excited. But she knew this kind of idea would never leave a lab if there wasn’t community trust and buy-in.

So she asked herself a question: “How might other people react to this?” She dedicated the rest of her career to understanding the answer.

Listening and learning

Her first attempts to explain malaria-free mosquitoes went poorly.

The process that creates malaria-free mosquitoes is hard to describe, and Finda assumed that a farmer with no formal schooling would never get there.

So she gave up on finding the right words and told the truth instead: She didn’t know how to talk about it.

“I was honest with the community members and saying, I really don’t know what to call this or how to talk about it.”

The response surprised her.

One of those community members was Aloyce Kimario, a farmer who also teaches at a primary school outside Ifakara. He had never heard of malaria-free mosquitoes before Finda came to see him.

He had, however, spent his whole life rearing animals.

The pigs he keeps are a local breed, hardy against the diseases that circulate around Ifakara.

But they’re small. When he wants animals big enough to sell well, he crosses them with a heavier breed and hopes the piglets come out with the best traits of both sides.

There’s a Swahili phrase for this, kubadilisha mbegu, which translates to “changing the seed.”

So, Finda started asking farmers to describe their ideal animal. One told her he wanted a pig that was 90 percent of the heavy breed and 10 percent of the local one.

“So what this technology does,” she told him, “is it makes sure that you get exactly what you want.”

Aloyce can now explain the science behind malaria-free mosquitoes, and the case for them, without any help from Finda, in terms other farmers immediately understand.

What she wishes scientists understood

Finda admits to underestimating what local farmers would be able to grasp, and she says she sees the science community making the same mistake.

Worse, she says, “they assume that when someone opposes something it is because they don’t know it, and if they could know it, then they would definitely accept it.”

From my years of listening to everyone, I have learned that these groups are quite knowledgeable.

“From my years of listening to everyone, I have learned that these groups are quite knowledgeable,” she says. They may not use the scientific terminology, “but they understand it in their context.”

Finda’s team has now sat down with national malaria programs, regulators, scientists, civil society organizations, faith leaders, and youth groups from more than 25 African countries. Each group worries about something the others don’t, and all of the worries are valid.

“You don’t ever hear someone say, I want to develop a solution for this disease. Let me go talk to a priest,” Finda says.

But that’s exactly what Finda did.

One of the leaders she convened was the presiding bishop of the Moravian Revival Church in Tanzania, who had learned about genetically modified organisms while studying theology in the UK but had never encountered the idea applied to mosquitoes. He prayed about it and came out in favor.

According to Finda, many Muslim leaders she connected with reached a similar conclusion. They just had to be asked.

Making sense of the numbers

Still, Finda has encountered substantial opposition and even anger.

When she presented the latest national malaria mortality figures to a group of community leaders in Nigeria, they took the statistics as an accusation and nearly threw her out.

“You are saying that many people have died of malaria in Nigeria. Show us where they are buried,” they demanded. “Why aren’t our hospitals flooded with malaria patients?”

Finda learned a lesson from this that I’ve had to learn and relearn myself: It’s not the scale of lives lost or saved that captures people’s attention. It’s the individual stories.

The mothers want to talk about the children they lost. Those numbers do not mean anything at all.

“The mothers want to talk about the children they lost,” Finda says. “Those numbers do not mean anything at all.”

So now, when she meets with people, she starts by asking about their own experiences.

Aloyce, the teacher-farmer, told her he gets malaria roughly twice a year. So do his children, with some episodes landing them in the hospital.

The bishop told her his firstborn child died of it.

Finda herself got malaria around the age of six.

Her mother was traveling, so it fell to Finda to administer chloroquine, the recommended treatment at the time, to herself and her toddler brother twice a day for seven days, while both of them were vomiting.

She shares this experience, too.

The preparation is worth it

Finda thinks we are still at least a decade away from any government decisions to release malaria-free mosquitoes.

In the meantime, African-led research will continue to advance scientific understanding that can inform these decisions and those required to strengthen regulatory systems to govern them.

Everything she does is working up to that moment, and aimed at making it as anticlimactic as possible.

Gates notes image

“When it is released in the newspapers or the radio or TV,” she says, “that should not be the first time that people hear about this technology.”

For many people, because of Finda’s work, it won’t be.