Together we can beat Malaria
It is exactly five years to the day that, in an unprecedented and historic setting, a gathering of the highest political leadership of Africa was convened to deliberate upon a single issue considered inimical to development and progress of the peoples of the continent.
On that 25th day of April 2000, African Heads of State and Government, with Senior Representatives from 44 malaria-endemic countries participated in the first-ever Summit on a health problem - Malaria - in Abuja, Nigeria.
At the Summit, the leaders recognized the intolerable and unacceptable burden of malaria on the people of Africa, and signed the Abuja Declaration and Plan of Action. They committed their governments to work with partners in a multi-pronged and multi-sectoral approach, to halve the burden of malaria in Africa by 2010.
Since that historic meeting, the 25th day of April of each year has been commemorated as the Africa Malaria Day (AMD). Africa Malaria Day 2005 is special and unique as it marks the year set in the Abuja Declaration for the achievement of the mid-term targets. In the Declaration, African Heads of State agreed that at the end of 2005, at least 60% coverage levels would have been achieved in a combination of different prevention and control interventions for the target groups.
Five years after the Summit, malaria remains a major contributor to the disease burden in Africa. About 60% of the estimated 350-500 million global clinical malaria episodes and over 80% of the over 1 million deaths globally each year occur in African countries. The burden on the health systems, absenteeism among school children and diminished or lost worker productivity, all contribute to make malaria a significant contributor to low economic growth in endemic countries, estimated at costing African countries about US $ 12 billion annually.
However, African countries have recorded appreciable progress in pursuit of the Abuja Targets. The proportion of the population at risk with prompt access to malaria treatment has increased in many countries. The strategy for home management of malaria is being implemented in 19 countries. In line with WHO recommendations, 21 countries in the continent have adopted the more efficacious Artemisinin-based Combination Therapies for the treatment of malaria cases.
In the area of prevention, insecticide treated nets have become more readily available in most countries. Political commitment towards making nets available to the populations has increased considerably. At the end of 2004, 20 countries had taken action to reduce or waive the taxes and tariffs on mosquito nets and insecticides and the cumulative number of nets available in Africa was estimated to be about 20,000,000. Although these dramatic increases demonstrate the magnitude of efforts made by national ITN programs, coverage levels among the vulnerable groups remain low and much more nets need to be distributed free of charge to vulnerable groups if we are to reach the Abuja target.
In the area of In-door Residual Spraying, we have noted improvements in the quality of application and the coverage of target populations and structures. The coverage levels averages over 85% in 7 countries of the sub-region where information is available.
Recognizing the particular danger posed by malaria during pregnancy, 19 countries have adopted policies to provide intermittent preventive treatment to pregnant women. Furthermore, the research community has recorded significant advances in the development of new tools, including malaria vaccines.
The establishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria, has dramatically increased the financial resources available for malaria control activities in African countries. By the end of 2004, the Global Fund's allocation for malaria to 35 countries of the African Region had totaled approximately US$ 700 million.
The commemoration of Africa Malaria Day 2005 provides an opportunity for stock taking and a sober reflection of our collective efforts in tackling this major public health problem. In the course of the year, countries will be undertaking surveys to ascertain the level of achievement in the different intervention areas and we hope to have information to report back to the highest political leadership of the continent.
Available data do not yet allow us to categorically state whether we have collectively brought down the burden of malaria in Africa by significant levels since the Summit in Abuja. Even then, the impact of the efforts would only become obvious after some years of sustained high coverage levels of the different interventions have been achieved. However, we are encouraged with the evidence coming from many countries of the clear progress being made in scaling up coverage of the interventions.
We continue to face some challenges in expanding coverage of the major interventions to the most vulnerable groups. However, the commemoration of this year's Africa Malaria Day under the theme "Unite against Malaria" and the slogan "Together we can beat malaria" is a call to all stakeholders in the fight against malaria in the Region - communities, governments at all levels, NGOs, research institutions, private sector, development partners, and others - that the fight against malaria can only be won if we all work together.
It is likely that many countries would not have achieved the Abuja targets at the end of 2005. However, much has been done. Let us celebrate our successes and rejoice over the cases of ill health and deaths we have averted through our combined efforts. Let us rededicate ourselves collectively to a more coordinated fight against this public health challenge facing our continent.
I believe that if we remain "United in the fight against Malaria, Together we can beat Malaria".
Dr Luis G. Sambo
Regional Director