UN Secretary-General’s Special Envoy for Malaria Progress Report
United Nations Secretary-General’s Special Envoy for Malaria
Progress Report
Last week marked the one-year anniversary of the appointment of the Secretary-General’s first Special Envoy for Malaria. As of today, only 671 days remain until 31 December 2010, Secretary-General Ban Ki-moon’s deadline to provide all endemic countries essential malaria control interventions, which include long-lasting insecticidal nets (LLINs), indoor residual spraying where appropriate, antimalarial medicines – artemisinin-based combination therapies (ACTs) – and intermittent preventive treatment in pregnancy.
At this moment, we can point to definite indicators of progress, with data revealing that LLINs now have been distributed to more than 40 percent of the population in endemic African nations, compared to less than 10 percent in 2005. This news signifies perhaps the most encouraging development in a year that featured many noteworthy accomplishments, including the United Nations General Assembly’s malaria resolution (A/63/L.62), pledges of over $3 billion in malaria funding and the declaration that the world can achieve near-zero preventable deaths from the disease by 2015. Moreover, this unprecedented distribution level should fuel the entire malaria community with the momentum required to overcome the enormous challenges of the next 22 months, specifically related to the provision and utilization of interventions throughout Sub-Saharan Africa.
Clearly, the Secretary-General’s call on World Malaria Day for universal distribution rallied a broad coalition of funding and implementation partners throughout the world to bolster their commitments to the prevention of malaria, a disease that exacts a human toll of nearly one million people each year and an economic cost of $40 billion in lost productivity.
African nations rose to the occasion, adopting a resolution at the African Union Summit in July 2008 that articulated their commitment to malaria control. With the support of the Roll Back Malaria Partnership’s Harmonization Working Group, malaria-endemic countries submitted an aggressive set of proposals to the Global Fund to Fight AIDS, Tuberculosis and Malaria. In response, the Global Fund awarded a record $1.57 billion for malaria as part of their eighth funding round. Of equally significant note, the Global Fund and Harmonization Working Group are working with nations to reduce the time between the award of grants and the availability of funding, thereby activating these resources for use toward the 2010 deadline.
The Global Fund also has joined with the World Bank, the World Health Organization, UNICEF and other partners to concentrate specifically on Nigeria and the Democratic Republic of the Congo, two countries struck most severely by malaria that will serve as barometers of success moving forward. Additionally, the World Bank expanded upon its existing $450 million commitment to its Booster Program for Malaria Control, adding $1.1 billion for Africa and $250 million for malaria control in India. Finally, the President of the United States signed into law the PEPFAR reauthorization bill, dedicating $5 billion to malaria over the next five years.
The sum of these commitments formed a singularly dramatic display of global support during the unveiling of the Roll Back Malaria Partnership’s Global Malaria Action Plan at the Malaria Summit on 25 September 2008, when these resources were declared together with others in the presence of Prime Minister Gordon Brown, Dr. Margaret Chan, Dr. Awa Marie Coll-Seck, Bill Gates Jr., Rajat Gupta, President Paul Kagame, President Jakaya Kikwete, Ms. Ann Veneman, Robert Zoellick and other world and business leaders. The Secretary-General announced the total of over $3 billion in malaria funding that had been dedicated in order to reach the 2010 deadline. The $3-billion figure obviously grabbed attention, but another number highlighted at the Malaria Summit deserves notice: zero, which refers to the 2015 target to lower malaria deaths to near zero.
The possibility of realizing this scenario by 2015 arises not from aspiration, but from accounts of rapid intervention-induced declines in malaria deaths in Ethiopia, Eritrea, Ghana, Kenya, Rwanda, Sao Tome and Principe and other countries. The Tanzanian island of Zanzibar already has reduced deaths to near zero. In Zambia, malaria parasite prevalence in children has lowered by 50 percent. These examples demonstrate rather powerfully the promise of our mission.
At this time, we can cite evidence supporting the claim that we can achieve the Secretary-General’s goal. As mentioned, African countries have surpassed a 40-percent LLIN distribution level, with an over 60-percent LLIN distribution level in 18 nations. The Alliance for Malaria Prevention, part of the Roll Back Malaria Partnership’s Harmonization Working Group, estimates that over 140 million LLINs have been distributed over the past three years, offering protection to nearly 300 million people.
While we have not crossed the threshold the Secretary-General has outlined, the figures should instill confidence in the global community that we can attain the universal provision of interventions if we amplify our collective efforts over the next 22 months.
With over 240 million LLINs already financed for delivery between now and December 2010, attention has focused on reinforcing management structures within countries, such as Nigeria, so that distribution and utilization plans are implemented and executed. Partners have devoted assets to demand-creation campaigns, with the possibility of hosting Malaria Summits in several countries, as well as launching contests to spark participation among citizens. Additional initiatives emerging from nations include the intention of Heads of State to form the African Leaders Malaria Alliance, a consortium conceived to anticipate, prevent and overcome obstacles on the path toward malaria elimination. With the great progress that has been, and is being, made with respect to the distribution of nets, the African leadership is now putting forth great efforts to make their people aware of the lifesaving benefits of interventions, like nets, and exhorting everyone in endemic areas to sleep under the nets each and every night.
At the worldwide level, we will work to advance the Global Fund’s crucial replenishment and the financing of Round Nine, as well as encourage donor nations to fulfill commitments already made to malaria. Conversations with the manufacturers of LLINs and ACTs remain ongoing to confirm that they can continue to meet forecasted demand.
In the coming year, we will apply the same thought and energy that guided LLINs in 2008 to the universal targets for treatment in public health facilities, with planning for and deployment of rapid diagnostic tests and effective antimalarials to cover every health facility, as concurrent measures advance to improve access in the private sector. Efforts throughout the malaria community will proceed to ensure that we will have an adequate number of ACTs produced for affected populations.
With so much activity underway within the next 22 months, we must maintain a constant awareness of where we stand as we balance multiple priorities and projects across a wide landscape. We intend to collaborate with the malaria community to track the progress of several key indicators on a quarterly basis, in order to supply the Secretary-General and the public with a regular assessment of how closely we approach his ultimate goals.
At this unique moment in history, when dedicated leadership, proven interventions, available resources and collective will have converged to turn the tide against this scourge, we cannot permit complacency to dull our resolve. We have witnessed notable returns and sit poised to complete an undertaking previously viewed as impossible.
The Secretary-General’s vision has guided the world to this remarkable humanitarian opportunity. His leadership, especially his statements on the need for donor nations and international organizations to not forget the plight of the developing world during this financial crisis, will continue to serve as the most valuable asset in the global fight against malaria.
Raymond G. Chambers
United Nations Secretary-General’s Special Envoy for Malaria
27 February 2009