On June 17, Admiral Ziemer spoke at the Lower Mekong Initiative Infectious Disease Conference in Vietnam to discuss the successes and challenges of implementing the International Health Regulations in the Lower Mekong Initiative countries and identify gaps that could be addressed through regional health collaboration. He outlined the Obama Administration’s four main development goals:

1. Commitment to honoring the Millennium Development Goals (MDGs)
2. Ensure country ownership and growth through trade, cost-effective and long-term investments, and diplomacy
3. Use science and technology to develop and deliver transformative tools and innovations
4. Ensure that the U.S. government is planning and implementing foreign assistance in the most efficient way

Admiral Ziemer cited significant progress towards meeting the MDGs in the Mekong region, saying that we should recognize, celebrate and support these achievements. However, there are still gaps, and “the road ahead will likely be more difficult than the road already traveled,” he asserted. “For this reason, we will be even more determined as we strive to meet the MDGs in five years.”

The U.S. Government has prioritized global health and food security as the two focal points of development efforts. Building upon President Bush’s PEPFAR and Malaria initiatives, President Obama has launched a $63 billion 5-year initiative to focus attention on broader global health challenges that adopts a more integrated approach to fighting diseases, improving health, and strengthening health systems. One of the main goals of this Administration’s Global Health Initiative is improving the sustainability of health programs through better integration and partnerships.

There has been substantial progress in malaria control in the Mekong region under this initiative, particularly in Vietnam where the number of malaria cases has declined from about 190,000 in 1991 to less than 15,000 by 2008. However, the region is beginning to experience parasite resistance to artemisinin, the most effective anti-malarial compound. First detected in western Cambodia in 2007, there are now indications of artemisinin resistance in southern Burma and in southern Vietnam near the Vietnam-Cambodia border. “Malaria and drug resistance is a regional issue and we’re taking a regional approach,” explained Admiral Ziemer. “Managed out of our regional office in Bangkok, we work closely with WHO and the National Programs to coordinate an effective response.”

USG funding through the regional office has been over $24 million since 2006, which represents a tripling of funding since 2000. U.S. investments for malaria in the region focus on strategic capacity and information, particularly on drug resistance, drug quality and improving the efficiencies of national program implementation. A key part of the regional malaria strategy is eliminating the fake and substandard medicines that contribute to the development of resistance and to malaria mortality. As Admiral Ziemer states, “trafficking in fake drugs is murder.” Addressing this issue will require a higher focus on accountability and efficiency in malaria systems at the community health level.

Congressman Payne and Dr. Carucci

The World Health Organization (WHO) released the 2009 World Malaria Report yesterday.  To help promote the report and its positive findings, the Congressional Malaria Caucus held a briefing in conjunction with the U.N. Foundation and Malaria No More.  Admiral Tim Ziemer, U.S. Malaria Coordinator, Mark Green, Managing Director of the Malaria Policy Center and Dr. Daniel Caruccia, Vice President of Global Health at the U.N. Foundation all spoke on the results of the World Malaria Report.  The briefing was highlighted by Congressman Donald Payne who gave comments on the importance of fighting malaria and the challenges that lay ahead. 

Dr. Carucci from the U.N. Foundation

As for the substance of the report itself, one of the most promising results  was the tremendous effects investing malaria is having on the well being of children under five.  Large decreases in malaria cases and deaths have been mirrored by steep declines in all-cause deaths among children under the age of 5.  In Zambia, all cause child mortality rates fell by 35% during the same period that corresponding malaria infection rates fell.  

Admiral Ziemer and Mark Green

But the 2009 World Malaria Report also demonstrates we have a long way to go.  There are still countless numbers of people suffering and dying from malaria—a tragedy that is completely preventable with low-cost interventions.  The need for continued funding is great as continued expansion into the largest, malaria-endemic countries.

The crux of the 2009 World Malaria Report is that we are in a tough fight.  We are in the middle stages of a long bout with a disease that has plagued mankind since the beginning of recorded history.  These results demonstrate progress, but we cannot mistake progress with ultimate success.  The world must resolve itself to stay the course so that in just a few short years—by the end of 2015—we can achieve the first great humanitarian victory of this century, an end to malaria deaths.  With leadership like that of Congressman Payne, Admiral Ziemer, the U.N. Foundation and others, we can make this goal a reality.

The U.S. Government recently announced over $10.5 million in grants through the President’s Malaria Initiative and its parent department, The U.S. Agency for International Development (USAID). The grants would go to seven organizations working in six separate countries in Africa to extend malaria prevention and control.

The grants were provided through the President’s Malaria Initiative and are going to target communities most affected by the disease, with a particular focus on children under 5 and pregnant women.

“I am committed to expanding the work of nongovernmental and faith-based organizations, and other community-based entities to reach people with the tools and knowledge to control malaria,” said Admiral (Retired) Tim Ziemer, U.S. Malaria Coordinator. “The key to saving lives, especially children, is to expand proven approaches and interventions until they reach each and every child who needs them.”

The Grantees include: HealthRight International in Kenya, Merlin in Kenya, Episcopal Relief and Development/Nets for Life in Ghana, The Aga Khan  Foundation in Mozambique, Lutheran World Relief in Mali, Catholic Medical Mission Board in Zambia and Medical Teams International in Uganda.