In less than two weeks, leaders from around the globe will descend upon New York City for United Nations Week and the annual General Assembly meeting. The agenda features an historic summit on global issues known as the “Millennium Development Goals” (MDGs) and the Social Good Summit, a program on the role digital industry, policy, and media technology, especially social networks, can play in addressing global health and humanitarian issues.
Malaria No More creator Ray Chambers will join Ted Turner, Jessica Jackley, Chris Hughes, and many other prominent speakers to discuss the ways in which social media can be used as a catalyst and platform for sharing ideas and information. The Social Good Summit is open to the public and will enable millions to join the conversation in person or via live-streaming. More information on accessing the livestream can be found here.
Participants at the event will include:
· Chris Hughes, co-founder of Facebook and founder of Jumo, an innovative startup that aims to link millions of individuals to organizations working to change the world beginning this fall. Hughes also directed online organizing for Barack Obama’s presidential campaign.
· Howard W. Buffett, Policy Advisor in the Executive Office of the President of the United States under President Barack Obama.
· Jessica Jackley, Co-founder of Kiva, the world’s first peer-to-peer online microlending website and one of the fastest-growing social benefit websites in history.
· Judy McGrath, CEO of MTV networks, overseeing MTV, MTV2, Comedy Central and Nickelodeon among other media properties.
· Pete Cashmore, CEO/Founder of Mashable and one of the Huffington Posts’ Top 10 Game Changers in 2009.
· Ray Chambers, the United Nations’ Special Envoy for Malaria, and founder of “Malaria No More.”
· Susan Smith Ellis, CEO of (RED), who has partnered with iconic brands like Apple and Nike to leverage the collective power of consumers and raise funds for the Global Fund to Fight AIDS, Tuberculosis and Malaria.
· Ted Turner, the Chairman of Turner Enterprises, Inc. and former Vice Chairman of Time Warner Inc., the world’s leading media company. He is the founder of CNN, an environmentalist and a philanthropist. Turner created the UN Foundation 1998 with his historic gift in support of the United Nations.
A majority of that money, Sh 3.1 billion ($38 million), had been allocated specifically for malaria prevention. The money was part of the seventh round of grants from the Global Fund and will go towards programs implemented by the government to provide means to citizens to fight and eliminate the threat of malaria in Kenya.
The government also responded to concerns about the decision to reward the money to Kenya, saying the country was committed to implementing programs for the benefit of its citizens. Weak proposals for the eighth and ninth rounds of grants had been denied to Kenya and the proposal for the tenth round was on time, but just barely, last month. The government has also been forced to return money in the past due to failures to use it sufficiently during the allotted time frame.
Malaria is the cause of death for 34,000 Kenyans each year and remains a critical health concern in that country. Ms. Mugo reiterated the fact that the Global Fund had demonstrated full confidence in Kenya with the presentation of this round of allocations and the government issued reassurances that the money would put to proper and efficient use.
At least 10 people in Mali were arrested yesterday after it was found that millions of euros of appropriations from the UN Global Health Fund against AIDS, Tuberculosis and Malaria had not reached the people they were meant to assist.
Among those arrested were several government health workers entrusted with allotting the funds. Police have gathered thousands of documents relating to the case which includes sums of money much larger than originally estimated.
According to officials the funds totaled several hundreds of millions CFA francs (at least 300,000 euro) and were used mostly in the form of forged checks. The state prosecutor revealed, however, that the the initial figures were low and documents showed that considerably more money was involved.
A anonymous UN diplomat was quoted saying that “several billions of CFA francs (several million euro) had not been spent to treat people.”
The UN Global Health Fund against AIDS, Tuberculosis and Malaria consists of private donations from the Bill and Melinda Gates Foundation. Mail has recieved over $76 million from Global Fund since it inception in 2002.
Professor Lucas believes that required early diagnosis and treatment, which the Patent Medicine Vendors (PMVs) can help support due to their nationwide coverage, will save countless lives.
National Coordinator, National Malaria Control Programme, Dr. Babajide Coker, is also calling for partnerships that would ensure the poor in the society assess malaria treatment, stated that this would be central to reducing deaths from malaria to the barest minimum.
Ensuring that African nations, like Nigeria, are able to rapidly and accurately test for malaria helps start the process of treatment for malaria or any other disease that has malaria like symptoms. We must continue to support building such capacity.
His Excellency, President Jakaya Kikwete, penned an op-ed on malaria in The Guardian today. Coming out of the African Union Summit, President Kikwete focused on what Africa can do in the fight against malaria. Read the article below.
During the African Union summit this week, leaders met at a watershed moment in the quest to eliminate malaria across the continent.
Successes in malaria control have been substantial. Mosquito-net coverage in 20 African countries is at least five times higher today than in 2000, leading to significantly fewer cases of disease and death.
Today, at least 10 countries in Africa are reporting significant decreases in malaria cases and declines in malaria deaths of up to 80%. But challenges remain.
African countries and global development partners can either capitalise on the successes of the past few years or slide backwards. To save lives, more must be done, more quickly, and the current momentum to expand malaria prevention and treatment must be sustained.
The African Leaders Malaria Alliance (Alma) of 30 African countries, which I chair, met this week. Malaria is already a global health priority enshrined in the UN’s Millennium Development Goals (MDGs). But Alma has set goals far higher than the malaria MDG to “halt and begin to reverse the incidence of malaria”.
We have two primary strategic goals: achieve universal mosquito-net coverage by the end of this year; and eliminate preventable malaria deaths by 2015 by scaling up coverage of all other available interventions (including access to rapid diagnostic tests, treatment with artemisinin-based combination therapy (ACT), intermittent preventive treatment, and indoor residual spraying).
These are audacious goals. But with more than 680,000 African children dying each year from malaria, audacity is a moral imperative.
With the right resources, success is achievable. In Rwanda, for example, large-scale mosquito-net distribution and increased availability of ACT has resulted in a 40% reduction in childhood malaria deaths between 2001 and 2008.
On the Tanzanian island of Zanzibar, the combination of high mosquito-net coverage, ACT availability, and indoor residual spraying reduced malaria deaths by over 90%. More importantly, under-five deaths from all causes fell by almost three-fifths.
Malaria control is vital to achieving the health-related MDGs. As a major killer of children, and a major cause of morbidity among pregnant women, success against malaria directly impacts MDG goal four (child mortality) and five (maternal health).
The indirect benefits are equally important. As the availability of malaria prevention and treatment has expanded, childhood deaths not just from malaria have also fallen dramatically, as resources are directed to other causes.
As chair of Alma, I would like to acknowledge the UK’s commitment to malaria. The UK government has recently committed significant funds and it has made future pledges for malaria to remain a priority. It is essential now that funding is spent in the best possible way.
Alma calls for the full replenishment of both the Global Fund and the International Development Association of the World Bank. We ask all European donors to support the replenishment process.
African heads of state must continue to take the lead, as they have this past year. Among the measures Alma commits to supporting are: universal access to ACTs to prevent drug resistance; removal of taxes and tariffs on essential anti-malaria products; increased local production in Africa of high-quality, safe and effective anti-malaria interventions; scaling up of proven malaria interventions including indoor residual spraying and long-lasting insecticide-treated nets.
We are continuing our fight to make Africa a malaria-free continent. As Alma, Africa’s heads of state envision a future in which no African child dies a preventable death from malaria. Whether that future is near or distant depends on the joint efforts of Africa’s leaders and our national and global partners. We must make a final push for universal coverage against malaria.
In today’s Wall Street Journal, President Jakaya Kikwete and President Yoweri Museveni of Uganda authored an opinion piece on ending taxes and tariffs on approved malaria interventions. The entire text is below.
This month Uganda has the honor of hosting the annual meeting of the African Union, which brings together more than 40 heads of state to discuss issues of critical importance to our continent. More than ever before, Africa needs strategic leadership, vision and courage to address the challenges we face. We must harness Africa’s enormous potential, opportunities, and resources for the development, prosperity and well-being of its people.
One of the greatest challenges we face is malaria. And in this area, strategic leadership in part means getting government obstructions out of the way.
Malaria causes illness and productivity loss for close to 200 million people in Africa annually. The scourge claims the lives of more than 800,000 Africans each year, most of whom are babies and mothers.
Over the past decade, an unprecedented effort has been launched to defeat malaria, supported by funding from the Global Fund to Fight AIDS, Tuberculosis, and Malaria; the World Bank; key bilateral partners, and other private sources around the world. Thanks to this funding, a huge volume of rapid diagnostic tests, life-saving medicines, and nearly 350 million mosquito nets will be delivered to Africa by the end of 2010. Other efforts, such as spraying households with insecticides, are being scaled up as part of a comprehensive attack on the disease.
African governments are also stepping up the fight against malaria. The African Leaders Malaria Alliance (ALMA), representing 28 heads of state, recently established a regional effort to facilitate cost-effective bulk procurement of mosquito nets, working together and with UNICEF. This approach will allow the accelerated delivery of nets to the countries that need them most.
We must now commit to overcoming barriers to malaria control and treatment, and a key area here is tax and tariff removal. Most anti-malaria commodities are currently produced outside of Africa, and when the ships that transport nets, medicines, and other essential health products arrive in African ports, their cargoes are often subjected to taxes and tariffs that absorb precious funds, reducing the volume of health goods that can be purchased, and creating inordinate delays in distribution.
The problem with imposing taxes and tariffs on essential anti-malaria commodities is that they hurt our poorest citizens, who cannot afford to purchase nets and medicines in the private sector, and must rely on public distribution. Essentially, imposing taxes and tariffs on malaria drugs and commodities taxes Africa’ s already fragile health system and makes malaria prevention and treatment less available to the poor. Evidence from our countries—Uganda and Tanzania—strongly suggests that removing taxes and tariffs strengthens the fight against malaria and benefits the poor the most. Several years ago, when we removed taxes and tariffs on all anti-malaria commodities, the cost of mosquito nets sold in local markets decreased, local demand for nets increased, and more small businesses entered the market to produce and supply these essential commodities. Since then, our countries have increased access to anti-malaria commodities and have become significant manufacturers of insecticide-treated nets that are exported to other African countries. Tax and tariff removal can, therefore, be good for Africa’s people and good for African entrepreneurs.
Careful attention must be given to the way in which taxes and tariffs are removed, however. Some countries have opted to grant waivers or exemptions for donated goods, but the reality is that obtaining these waivers can be time-consuming and expensive. In some countries, legislation requires that exemptions be renewed every year, and this process can cause months of delay. Removing taxes and tariffs altogether is by far the most equitable and effective solution.
Along with tax and tariff removal, malaria-endemic countries must pay attention to improving customs procedures so that public-health commodities are correctly identified when they arrive at ports. This is important not only to ease the flow of goods into countries, but also to maintain important quality standards as we battle the global problem of counterfeiting and sub-standard products that can lead to drug resistance. If African countries are to achieve universal access to critical health-care commodities and meet the goal of reducing malaria-related deaths to near zero by 2015, we need to take definitive steps now. Tax and tariff removal is one of the steps that we should take, and doing so will help African leaders demonstrate the depth of their commitment to ending malaria.
The global fight against malaria over the past few years has redefined the standards and expectations that we apply to development assistance. We have set measurable targets that we are working hard to achieve, and we are seeing great reductions in malaria thanks to more strategic applications of funding and greater accountability for donor spending. Just as international donors have increased their commitments, it is time for African leaders to intensify theirs by removing costly and counterproductive obstacles to effective malaria control. Through effective partnership, we can give Africa’s children a malaria-free future.
Mr. Kikwete is the president of the United Republic of Tanzania and the current convener of ALMA; Mr. Museveni is the president of the Republic of Uganda and a member of ALMA.
African leaders from 26 countries have launched a fresh drive to eliminate malaria using a combination of bed nets, insecticides, and medication, announced Tanzania’s President Jakaya Kikwete. Almost one million people die annually worldwide from malaria, and 85% of these deaths are in Africa.
“We believe that if we cover everybody in Africa with bed nets, insecticides, and medication by the end of this year, we will have zero deaths or near zero deaths from malaria in Africa by 2015,” said Ray Chambers, U.N. special envoy for malaria. Coverage of all at-risk people from malaria by the end of this year would make this Millennium Development Goal target not only attainable, but probable.
In Zanzibar, the three-pronged approach utilizing bed nets, insecticides and medication cut malaria cases in Zanzibar to less than 1% from previous levels of 40 percent.
U.S. Malaria Coordinator Timothy Ziemer said the U.S. government has made a budget request of $680 million for the fight against malaria in FY2011, including $100 million for the Democratic Republic of Congo and Nigeria, which together account for about half of the world’s malaria cases. Malaria costs Africa over $40 billion each year in treatment and sick days.
The PMI’s activities in Ethiopia involve educating the community for successful malaria interventions, integrating PMI resources to maxmize impact and sustainability of health programs, making malaria diagnosis accurate, and studying the susceptibility of mosquitoes to insecticides to guide malaria interventions.
The PMI supports Fayyaa Integrated Development Association (FIDA), a nongovernmental organization working on training and involving community members on issues of malaria prevention and control. Mrs. Rawuda, for example, is the mother of three children in the Oromia region of Ethiopia and is one of nearly 95,600 people who have been trained through FIDA educational programs and community conversations on use of bed nets, early diagnosis, and malaria treatment. Since 2005, more than 20 million insecticide-treated nets have been distributed but the initiative was compromised by low net usage, a problem which these educational campaigns attempt to tackle. In particular, thousands of long-lasting insecticide treated nets were handed out by a U.S. Army Civil Affairs team. They are distributing 35,000 nets to a population in one district of Ethiopia of about 93,000 people, which represents approximately 2 nets per household. FIDA also works to increase acceptance in communities of indoor residual spraying. “Even though I had a bed net at home, I and my children were not using it because I did not believe that sleeping under the net would protect us from being infected by malaria,” explains Mrs. Rawuda. “Now that I have learned about the use of nets, my children and I started to use it correctly and consistently.”
PMI’s collaboration with FIDA is one example of how the organization works with partners to integrate resources and activities in order to maximize the impact of its investment in malaria. PMI has also collaborated with the U.S. President’s Emergency Plan For AIDS Relief (PEPFAR) programs and increased its contribution to USAID-supported maternal and child health programs to include malaria case management, supervision, and epidemic outbreak detection and response at the community level. In Ethiopia, the PMI partnered with the local government to develop disease risk maps through surveys of school children with malaria. “Leveraging other resources to fully integrate malaria interventions into the overall delivery of health services is crucial to maximize impact and ensure long-term sustainability of those interventions in Ethiopia,” says Thomas Stall, USAID/Ethiopia Mission Director.
Additionally, in many sub-Saharan African countries patients with fevers are often treated for malaria even if the disease hasn’t been confirmed by clinical examination – either by examining a blood sample under a microscope or by using a rapid diagnostic test (RDT). In Ethiopia, of the 2.5 million clinical malaria cases reported in 2007 only 38% were actually tested for malaria parasites. These trends not only lead to inefficient management of treatment resources but can also pose a risk that parasites will develop resistance to anti-malarials through their overuse. To strengthen malaria laboratory diagnosis in Ethiopia, PMI procured 820,000 RDTs, 57 microscopes, 40 centrifuges and other laboratory equipment for health facilities in Oromia Regional State. This will help ensure that malaria cases are confirmed and that the two parasite species causing malaria in Ethiopia, P. falciparum and P. vivax, are differentiated, important because they require different medications. PMI is also helping to strengthen diagnostic capacity through extensive training and establishment of quality assurance and quality control systems.
Finally, throughout 2009 PMI supported entomological monitoring activities at 11 sites in Oromia in order to determine and characterize the dominant mosquito species in the area, as well as to test mosquitoes’ susceptibility to three classes of insecticides, including organochlorine insecticides such as DDT, pyrethroid and organophosphate insecticides, and carbamate insecticides. Indoor residual spraying (IRS) of homes in Ethiopia has been one of the primary tools to prevent malaria transmission for over 40 years. “The findings are crucial to ensure that future IRS operations remain effective and will have the desired impact on malaria transmission,” states Alemayehu Getachew, focal person for PMI’s IRS implementing partner.
PMI combined activities in Ethiopia provide an example of how education and integrated and ongoing research and development at all levels of malaria interventions can have immense effects and ensure that these initiatives remain effective.
The third joint retreat for Civil Society delegations to the leading global health initiatives and networks, which took place this May, recently released a draft of its report. The retreat was attended by representatives from UNAIDS Program Coordinating Board, the Global Fund, UNITAID, GAVI Alliance, International Health Partnership, Roll Back Malaria, Stop TB Partnership, and the Partnership for Maternal, Newborn and Child Health, and focused specifically on developing a more strategic approach for working together as civil society to better influence and shape policies to ensure renewed commitment and action to achieving the Millennium Development Goal targets by 2015.
The report contains progress updates and background information on achieving the MDGs and improving access to health services, strengthening health systems, current gaps in international health financing, and an overview of Global Fund replenishment campaigning efforts, which it cites as the overarching priority for all participants, pointing out, “Most agree that it will be extremely difficult if not impossible to meet the health MDGs if donors are not willing to support the Global Fund adequately over the next three years.” The Global Fund and advocates agree that $20 billion, which would allow for the continuation of funding for existing programs and significant scaling up of well-performing programs, is the minimum amount that donors should pledge in order to be effective. Advocates are pessimistic because donors have signaled that they will provide far less, but many also believe that effective advocacy regarding the MDGs over the next few months could help increase the odds in their favor.
Roll Back Malaria in particular is focusing their efforts particularly on the 2010 Global Fund replenishment campaign, the success of which is considered especially crucial because the Global Fund provides about 57% of all international funding for malaria control and treatment. RBM is also stressing the importance of promoting an integrated approach among MDGs 4, 5, and 6 to ultimately strengthen health systems.
The overall goals of the Global Malaria Action plan are to achieve universal malaria control coverage by the end of 2010 and to eliminate malaria as a public health problem by 2015. The report claims that these goals will almost certainly not be met if the current funding and support climate persists. Although nearly 200 million insecticide-treated nets have been distributed, that represents less than two thirds of the estimated current need. In addition, access to effective treatment lags in many parts of the world because of difficulties with procuring ACTs, the proliferation of fake drugs, and the persistent use of less effective and resistance-enhancing monotherapies. Scale up of indoor residual spraying and access to diagnostics, the two other main pillars of malaria control, has also slowed in recent years.
The recommendations the report makes regarding malaria are:
Strengthen civil society participation and community-based action: more community systems strengthening is needed to complement government services
Sustainable, predictable funding and good governance: Political will is key
Holistic approach for the MDGs with disease-specific control programs
Partnership
Civil Society Participation: The history of malaria and other endemic diseases clearly shows that without community involvement in the provision of health services many people would not have access to basic health prevention and care. The contribution of community health workers is crucial to meeting the health MDGs, but the essential role that communities play in mobilizing people to access health services, providing care to complement government services, and in particular in reaching marginalized or hard-to-reach communities is not yet widely acknowledged. Malaria can kill within 24 hours. Community participation is also key to ensuring good governance and country ownership.
Predictable Funding: Current investments in malaria control have saved lives and provided far-reaching benefits for countries, but additional sustainable and predictable funding needs to be available to build on successes and strengthen community involvement. In some locations, due to extensive and successful malaria control efforts, the entire cohort of children lack immunity from malaria because they have been protected from exposure. These groups remain susceptible to more severe infections until malaria transmission is greatly reduced and eliminated. Support for new drugs and insecticides development is also essential to minimizing future risk and costs and to reverse resistance. Without sustained and predictable funding, the significant contribution of malaria control towards the achievement of the health MDGs could be reversed.
Holistic Approach: Each MDG is interrelated and interdependent, which requires a more integrated and holistic approach. For example, achieving maternal and child health goals would be impossible without targeted support for malaria, which disproportionately affects children and pregnant women. A holistic approach would help to break the cycles of in which each symptom further contributes to the rest, creating a trap.
Partnership: Finally, donor agencies, governments and development partners should also ensure strong inclusive, effective global and local partnerships to improve collective action. Getting rid of the burden of malaria is a huge task that requires effort and collective action from all sides. Reaching the MDG targets will only be possible through a significant scale-up in program implementation – effective prevention and treatment coverage – that no single agency or government can achieve on its own.
In more than a third of the 108 malaria-endemic countries, recorded cases and deaths due to malaria have fallen by 50% since 2000, which shows that MDG targets can be achieved with high coverage of populations with mosquito nets, improved access to effective diagnostics, and treatment. However, malaria still kills approximately 850,000 people a year, 85% of them children in Africa, and it is four times more likely to strike pregnant women than other adults. Increased participation by civil society and advocacy for these issues are crucial steps in helping to raise the additional funds necessary to sustain the momentum against malaria, continue to make gains and consolidate successes to guard against future risks.
