Statement by Dr Luis Gomes Sambo, WHO Regional Director for Africa, to the Africa Leaders Malaria Alliance (ALMA) meeting at the occasion of the African Union Summit, 25-26 July, 2010, Kampala, Uganda
- His Excellency, President of the African Union,
- Your Excellencies, ALMA Heads of States and Governments
- Chairperson of the African Union Commission,
- UN Deputy Secretary-General,
- African Union Commissioners,
- Health Development Partners,
- Distinguished Delegates,
- Ladies and Gentlemen:
I am very pleased to represent WHO in this dialogue of the African Leaders Malaria Alliance (ALMA).
The African Region accounts for 85% of malaria episodes and 89% of malaria deaths worldwide.
- It is estimated that one in every five childhood deaths is attributable to the effects of malaria.
- In pregnancy, the disease can results in miscarriage and low birth weight with maternal death rates ranging from 10 to 50%. Malaria impacts negatively on MDGs 4 and 5.
- The consequences on productivity and household spending are also catastrophic with important decrease in gross domestic product.
The UN General Assembly declared the period 2001–2010 as the Decade to Roll Back Malaria. In 2006, the AU Heads of States adopted the Abuja Call for Accelerated Action towards Universal Access to HIV and AIDS, Tuberculosis and malaria services.
Over the last decade, African countries have scaled-up proven malaria interventions which are (1) vector control using long lasting, insecticide-treated nets (LLINs), indoor residual spraying (IRS), (2) Intermittent preventive treatment in pregnancy (IPTp), and prompt and (3) effective diagnosis and treatment.
Your Excellencies, Distinguished Ladies and Gentlemen,
We are encouraged to see that many countries are reporting a decline in malaria burden when a comprehensive package of interventions is implemented. We have evidence that Eritrea, Rwanda, Sao Tome and Principe, Zambia, Botswana, Cape Verde, Namibia, South Africa, Swaziland and Zanzibar in Tanzania -- were able to reduce the number of malaria cases by 50 per cent.
This success is associated with strong leadership from Heads of States and community leaders. To reach the same critical milestone, the remaining countries need to scale-up the coverage of interventions to reach universal coverage.
Due to their very low malaria transmission and based on robust epidemiological evidence and feasibility assessments, some countries are contemplating transition from sustained control to elimination. Towards this endeavor, governments should address critical challenges including:
- Securing adequate domestic and external funding for sustained commitment;
- Strengthening national malaria control programs in a context of broader health systems strengthening;
- Strengthening human resource capacity at central, district and community level;
- Establishing strong logistics, information and surveillance systems as well as early detection mechanisms for response to malaria epidemics and complex emergencies:
Sound cross-border and transnational collaborative initiatives are relevant in this regard.
Your Excellencies, Distinguished Ladies and Gentlemen,
The use of oral artemisinin monotherapy is a potential driver for emergence of resistant malaria parasites. In May 2007 the World Health Assembly adopted resolution WHA60.18 that urges Member States to deploy recommended artemisinin-based combination therapies (ACTs) and withdraw oral artemisinin-based monotherapies.
By July 2010, 30 countries in the African Region had taken regulatory measures to withdraw oral artemisinin-based monotherapies. The remaining countries should urgently develop similar policies to stop the marketing of oral artemisinin-based monotherapies.
Your Excellencies, Distinguished Ladies and Gentlemen,
We have ample evidence that reliable and sustained funding for malaria is central to saving many lives. We do acknowledge the much needed support from the Global Fund, the US President’s Malaria Initiative (PMI), the World Bank Malaria Booster Program for Malaria Control in Africa, DFID, Bill and Melinda Gates and other agencies and foundations which have peaked up at around US$ 1.6 billion per year. However, this represents only 25% of the estimated financial resources needed. Replenishment and sustainability of this external funding will be key to attain the MDGs targets .
I warmly congratulate President Jakaya Kikwete and AU and ALMA for the decisive impetus that they are generating in the fight to conquer malaria.
I call upon funding partners to support countries to cover the funding gap for universal coverage with key interventions.
Your Excellencies, Ladies and Gentlemen,
In conclusion, I wish to appeal to your visionary leadership to:
- Foster leadership for improved intersectoral collaboration to eliminate malaria as a public health problem in Africa
- Increase domestic funding for malaria control and accelerate progress towards MDGs 4, 5 and 6
- Support viable initiatives for local production of quality medicines and other commodities
- Eliminate taxes and tariffs on antimalarials and other public health essential commodities
- Ensure free access to malaria diagnosis and treatment for vulnerable groups such as children and pregnant women in addition to universal access to LLINs.
I wish to assure you of WHO constant commitment to work with the AU, ALMA and Health Development partners in order to realize the vision of a Malaria free Africa.
Thank you