24April 2002 Africa Malaria Day 2002: Message of the Regional Director
Tomorrow, the 25th of April 2002, the malaria control community in Africa and its partners around the world commemorate the Second Africa Malaria Day. The day is historic. On 25 April 2000, recognizing the devastation caused by malaria in much of the continent, African Heads of State and Government or their Senior Representatives signed the Abuja Declaration and Plan of Action in which they committed themselves to halve the number of deaths from malaria in Africa by the year 2010. The battle against malaria in Africa remains a formidable one. A million people worldwide die from malaria each year. Of these, 90 per cent are in Africa. Most of those killed are children. Indeed, one out of every five African children dies from malaria before the age of five. Pregnant women in Africa are also highly vulnerable. With pregnancy, the ability of many African women to survive life-threatening bouts of malaria is cut by half. Yet further, their infection is a major cause of peri-natal mortality, low birth weight and anemia in children. Meanwhile, Africa is seeing a resurgence of malaria as resistance to common anti-malaria drugs becomes an increasing threat. Barely 15 years ago, chloroquine was a cheap, widely available and highly effective drug against the illness. Today, one in two cases of malaria in East and Central Africa cannot be treated effectively with chloroquine because of resistance to the drug. Sadly, experts agree that a quarter of the increased child deaths in Africa can now be attributed to the rapid spread of anti-malarial drug resistance. Newer drugs have shown some promise. Their higher cost, however, means they may not be as readily accessible. Malaria-transmitting mosquitoes in some areas have also developed resistance to insecticides while civil strife and emergencies have resulted in population movement to highly affected areas, thus exposing these migrant populations to high malaria risk. The economic burden of malaria is heavy. On average, those affected, either personally or through the need to care for an affected child, lose 12 days of productive output. In parts of the continent, the illness is often chronic, leading to even greater economic loss. The picture is grimmer when one recalls that Africa's farmers are at greatest risk during the warm and rainy seasons, the height of agricultural activity. Further, fear of malaria prevents investment and tourism in the most endemic areas, denying them valuable incomes and development opportunities. A recent study by the World Health Organization, Harvard University and the London School of Tropical Medicine and Hygiene notes that sub-Saharan Africa's GDP in the year 2000 would have been a colossal 32 per cent higher had malaria been eliminated some 35 years before. Malaria, it is abundantly clear, is a major obstacle to progress and a critical development issue. Yet there is hope. The marginal costs of rolling back malaria in sub-Sahara Africa remains relatively small and, according to the study cited above, the short-term benefits of control can be estimated at between US$3 billion and US$12 billion a year. Our Heads of State have enunciated a clear way forward in the Abuja Declaration and Plan of Action. Prevention and the rapid diagnosis and early treatment of the illness are key. Notable progress is being made in this direction. In line with the theme of this year's commemoration, Taking Malaria Treatment and ITMs to the Home, community-based malaria control interventions are being promoted and implemented in most countries. Some countries have introduced the use of pre-packaged anti-malarials, which has increased the correct treatment of malaria in the home. These pre-packaged drugs are easy to administer and increase caretaker compliance with recommended dosages. In the WHO Regional Office for Africa, we are working with our partners in Roll Back Malaria to build effective capacities for the prevention and treatment of the illness. The initiatives, at both the national and community levels, include the training of health workers and mothers to quickly detect symptoms of the illness and ensure prompt and correct treatment, as well as the provision of anti-malarial medication in line with national treatment policies. For the prevention of malaria, insecticide treated nets remain a simple and potent yet inexpensive tool. WHO, the private sector, African governments, NGOs, donor and other partners are working to ensure that the nets are made available at minimum cost. Meanwhile, it is gratifying to note that a number of African States have reduced or waived taxes and tariffs on nets and insecticides in keeping with commitments in the Abuja Declaration. If the Abuja targets are to be met, much remains to be done. By the end of 2001, for example, only one in 10 African children under-five were sleeping under a treated nets. The proportion for pregnant women in Africa was much the same. Similarly, only one in 10 children under-five had correct treatment within 24 hours of the onset of fever. It is my sincere hope that these statistics will significantly change for the better by 2005. As we commemorate the Second Africa Malaria Day, there is a need for concerted efforts by all stakeholders, including the private sector and particularly the communities, to focus attention on preventing and treating malaria in the home. This is where we can and must make a difference. We have the tools. We have the economic and moral justification. Let us now muster the will to Roll Back Malaria. (Signed) | |||||||||
