With Concerted Efforts and Policies, We Can Stop Malaria Deaths

Joy Phumaphi | 09 Aug 2010
The East African
Nairobi — Ten years ago, 40 African heads of state convened in Nigeria and signed the Abuja Declaration, an ambitious plan to cut Africa's malaria burden in half by the end of 2010.

While Africa has made great progress against malaria over the past decade, we still have much work to do if we are to achieve the goal of reducing deaths caused by this scourge to near zero by 2015.

Malaria still claims the lives of 800,000 Africans annually, and it costs African economies an estimated $12 billion per year in health expenditures and lost productivity.

If Africa is to achieve great things in the 21st century, we can no longer afford to pay these costs.

That is why 30 African heads of state have created the African Leaders Malaria Alliance (ALMA) and that is why ALMA convened a special session at the African Union Summit to strengthen Africa's commitment to beating malaria once and for all.

Over the coming months, ALMA will be focusing on five key areas:

(1) aggressively promoting universal coverage with effective interventions such as LLINs, IPT, RDTs, ACTs, and IRS;

(2) securing sustainable financing for malaria;

(3) promoting the removal of taxes and tariffs on anti-malaria commodities;

(4) promoting a continent-wide ban on artemisinin monotherapies; and

(5) achieving support for the production of anti-malaria commodities by African manufacturers.

Over the past decade, international support from the Global Fund to Fight Aids, Tuberculosis, and Malaria; the US President's Malaria Initiative and other bilateral donor programmes; the World Bank Booster Programme; and a variety of NGOs and private foundations, has financed the delivery of medicines, rapid diagnostic tests, and more than 350 million mosquito nets to African countries.

With this funding, more mothers, children, and families are sleeping under nets, accessing safe and effective medicines, and living in houses protected by insecticides.

ALMA strongly urges donor nations to replenish the Global Fund and the World Bank's International Development Association (IDA) so that vital malaria programmes can continue to help African partners save lives.

Africans know, however, that malaria remains largely our problem, and winning the fight against the disease will require African leadership, African commitment, and African solutions.

We cannot rest assured that international support will continue, especially at a time of global economic crisis.

And that is why ALMA is working with partners on ambitious-yet-realistic programmes to build Africa's capacity to achieve a malaria-free future.

ALMA is accelerating the procurement and delivery of malaria commodities by working with Unicef to establish efficient bulk-buying partnerships and regional procurement systems.

This innovative partnership is helping African governments maximise the value of their collective resources and work together to achieve universal access to mosquito nets by the end of 2010.

ALMA is also seeking to strengthen cost-efficient access to all forms of malaria control and treatment by working with heads of state to secure the removal of tariffs and taxes on anti-malarial drugs and other commodities such as bednets, diagnostic tests, insecticides, and insecticide pumps.

Most anti-malarial commodities are still produced outside of Africa.

When governments apply import tariffs and domestic taxes to these commodities, they increase their cost and reduce the total amount of funding available for malaria control.

Taxes and tariffs also mean that individuals who seek to buy nets or medicines in shops and markets face higher prices and are less able to afford life-saving commodities.

For Africa's poor, then, taxes and tariffs can sometimes mean the difference between life and death.

African leaders can take a strong step toward stimulating demand for anti-malarial commodities by removing these unnecessary charges.

Indeed, evidence from Kenya, Tanzania, and Uganda suggests that when taxes and tariffs are removed, the cost of anti-malaria commodities decreases, and local demand increases.

This provides an economic stimulant to African producers and suppliers and benefits African entrepreneurs.

We can further increase African production of anti-malaria commodities by encouraging technology transfer and the development of manufacturing facilities in sub-Saharan Africa that have the capacity to produce mosquito nets, medicines, and other essential commodities that meet the highest standards of quality, safety, and effectiveness.

Local production can create jobs, spur development, and develop the human and technological capital required to strengthen Africa's capacity to address its own health needs.

ALMA's leaders have also resolved to prevent the emergence of malaria parasites that are resistant to artemisinin-based treatments.

Signs of artemisinin resistance have already been detected in Southeast Asia, and unless we immediately improve standards of treatment, the problem could soon spread here.

The consequences would be devastating for Africa and could include a significant decrease in the effectiveness of malaria treatment, a dramatic resurgence of malaria mortality, and a significant increase in the costs required to treat malaria.

That is why we are making a concerted effort to stop artemisinin resistance by pushing to ban the importation, production, distribution, and use of artemisinin monotherapies.

We know the malaria parasite will develop ways to survive these simpler forms of treatment.

Only complex artemisinin-based combination therapies (ACTs) appear capable of fending off resistance, and we are committed to promoting universal access to ACTs, as well as the development of a safe and effective malaria vaccine that can help us finally win the fight against malaria by preventing a new generation of African children from ever falling ill with the disease.

We owe it to current and future generations of African children to show the leadership and commitment to beat malaria once and for all.

Working together, African leaders can make a difference.