SUMMARY

Nigeria will host a Summit Meeting of African Heads of State on April 25th 2000. This will set targets for action to tackle Malaria. It will focus on actions to increase the impact of malaria control, through partnerships to "Roll Back Malaria". Working closely with Heads of Development Agencies, and in co-operation with WHO, Heads of State will demonstrate their political commitment to this intensified effort. They will demonstrate the level of resources that they propose to make available. Events taking place at the same time as the summit are likely to attract international interest. Roll Back Malaria is committed to a halving in the world's malaria burden by the year 2010.

THE CHALLENGE OF MALARIA

Malaria causes more than one million deaths each year. The majority who die are the children of Africa. Deaths linked to malaria in Africa are on the increase due to changes in the environment, movement of populations arising from political instability and civil strife, resistance of malaria to common and inexpensive medicines, resistance of mosquitoes to insecticides, and limitations in national health services.

Malaria keeps Africa's people poor. It prevents adults from working and children from attending school. Each year a family spends several months' earnings on malaria treatment and prevention. Malaria during pregnancy is also of great concern, since it adversely affects the mother's health and may result in a baby born too small to survive.

It does not have to be like this. Malaria is preventable, treatable and curable. Four elements of the Roll Back Malaria (RBM) strategy point to a solution:

1. People at risk can prevent malaria if they sleep under insecticide treated mosquito nets.
2. Pregnant women, especially those who are pregnant for the first time, can take medicines to prevent and treat malaria.
3. People can treat malaria with a wide variety of effective medicines, and they can cure malaria if they seek and receive treatment early, with effective medication, within - or close to – their homes, and finally,
4. 4) Families and communities can be empowered to predict and prevent a malaria epidemic and contain it within one week of its being confirmed.

But, people cannot prevent and treat malaria alone. Governments, health services and all development partners must make sure that low cost mosquito nets, genuine and inexpensive medicines, and timely and accurate information about malaria are available in every neighbourhood and village.

AFRICAN LEADERSHIP

In the past decade, Africa's leaders have called for concerted action to address the impact of malaria on their people. In June 1997, African Heads of State signed the Harare Declaration on Malaria. This was followed by the African Initiative on Malaria (AIM), which was endorsed by the African Region of the World Health Organization in 1998. The World Bank, the African Development Bank, WHO, UNICEF and UNDP have responded and were supported by several member nations of the Organization for Economic Co-operation and Development (OECD) thereby, accelerating malaria control efforts throughout the continent.

Renewed backing for malaria control by WHO began with the election of Dr. Gro Harlem Brundtland, former Prime Minister of Norway, as Director General of WHO in 1998. She committed the organization to intensified support of malaria control - especially in Africa, and through her leadership the Roll Back Malaria (RBM) initiative was launched by WHO, UNICEF, the World Bank and UNDP on October 28, 1998. Partnerships between Governments, development agencies and private groups are now supporting RBM action in more than 20 countries.

More vigorous action is needed, particularly in communities within tropical Africa. Success has been reported in situations where Governments work closely with other bodies, both public and private, in movements to Roll Back Malaria.

African Heads of State are now providing the political leadership required of RBM movements. In particular, President Olusegun Obasanjo of Nigeria proposed in 1999, that an African Summit on Malaria be held and offered to host the Summit with the date set for April 25, 2000, in Abuja, Nigeria. The President has invited WHO and other development partners to work with the Nigerian Government to plan the Summit. At the Summit, Heads of State will reflect on the economic and social burden of malaria and commit themselves to strategies and targets for its reduction.

More that 50 African Heads of State, G8 Heads of State, the Heads of 10 international development agencies, and more that 12 Development and Health Ministers from OECD countries have been invited to the Summit, and many have already accepted.

PLANNING THE SUMMIT

Intensive planning is in progress with input from various African Countries and international agencies. A high-level inter-governmental steering committee meets weekly in Abuja, Nigeria. Several subcommittees including a Technical Committee and a Publicity Committee have been established. A Summit Secretariat has been set up to meet the needs of invited dignitaries and guests. A Summit venue with capacity for over 1000 persons is being prepared. A communication campaign to highlight the aims of the Summit is underway.

EXPECTED OUTCOME

The Technical Committee is developing scientific papers on various aspects of malaria in Africa. These papers will form the basis of a Declaration that will be considered by African Heads of State at the Summit. In general terms, the Declaration will call for a re-commitment to the intent and goals of the Harare Declaration and a renewed commitment to Rolling Back Malaria. Specific issues that the Heads of State will address include alleviating poverty through reducing the burden of malaria on the citizens of Africa, setting realistic targets based on the four elements of the RBM strategy (as mentioned above), supporting needed research that will make RBM strategies more effective, and encouraging development partners to work with governments and communities to mobilise and better manage the financial and human resources needed to Roll Back Malaria.

FURTHER INFORMATION FOR PARTICIPANTS FROM INTERNATIONAL ORGANIZATIONS AND OECD GOVERNMENTS

A     Proposed Summit Objectives and Technical Programme for the Summit:

This Summit is crucial for securing political commitment to the scale up of activity needed for Rolling Back Malaria in Africa. The President wants a working Summit dedicated to addressing, and preparing to solve, a major impediment to Africa's development.

The following Summit objectives have been proposed and are being examined (late February 2000) by the Summit Technical Sub-Committee and technical advisers from WHO:

1. Heads of State recognise that malaria is a major impediment to the development of Africa's people.
   
   
2. Heads of State rededicate themselves to the agreements made at the Harare Heads of State meeting and declaration on malaria in 1997.
   
   
3. Heads of State could commit themselves to a goal and targets. These are currently under discussion. The proposed goal would be halving Africa's malaria burden over the next 10 years
   
   

   Fulfilment of the following targets to enable this goal to be fulfilled:

   1. a substantial increase, throughout Africa, in the proportion of children and women who are protected through the use of insecticide-treated mosquito netting (desired proportion: at least 60%)
      
      
   2. a ten-fold increase in the proportion of persons who can access effective treatment for their malaria within 24 hours of the onset of symptoms
      
      
   3. a substantial increase in the proportion of pregnant women at risk who receive protection from malaria's effects during pregnancy (desired proportion: at least 60%)
      
      
   4. all African nations to have capacity to detect, and respond effectively - within one week - to malaria outbreaks, and to prevent re-introduction of malaria into areas from which it has been eliminated
      
      
   5. greater emphasis on research capacity to develop cost-effective anti-malaria products in Africa
      
      
4. Heads of State identify, and propose, a series of policy and programme emphasis necessary for these targets to be fulfilled (greater emphasis on home care, on community-based movements and inter-sectoral action, on responding to the interests and needs of poor people, and on partnerships with the private sector).
   
   
5. Heads of State secure the support of development partners to the goal, targets and policy/programme changes needed. At least one significant financial commitment to scaling up Roll Back Malaria efforts in Africa should be made at the summit.
   
   
6. Heads of State agree follow-up mechanisms

The timing is as follows: the sub-committee will establish proposed targets by end February. The draft declaration is due to be prepared March first week. The Technical issues will be presented in a background technical document. This will include outlines of a plan of action for Rolling Back Malaria in Africa, and proposed follow- up mechanisms (an annual report to Heads of State). The declaration and plan of action will be circulated for comment in advance of the Summit: it is expected that they will be modified and then endorsed in Abuja by Ministers of Health before the Heads of State summit (April 24th).

B     Proposed Technical Programme for the Summit

It has been proposed that the Summit itself will take place over one long day on April 25th (8am start 7pm finish) with four sessions of - say - one and a half hours each, separated by 30 minute refreshment breaks and a one and a half hour lunch break. It is suggested that the presentation of issues will be split between all four sessions: the first could focus on issues, sessions 2 and 3 on responses and session 4 on future action (including the declaration). Some Heads of State and leaders of development organisations will be asked to present during these plenary sessions. The President and Dr Brundtland would make keynote speeches and contribute to the declaration part at the end. There will be more opportunities for Heads of State and International leaders to make scheduled public statements and answer questions about their particular contributions and plans in parallel media events. It is proposed that the President will host a dinner on the night of the Summit (25th).

C     Summit Venue

The Summit will take place in the NICON Hilton hotel. This has capacity for 1500. The Summit is likely to have around 400 official participants, many of whom will be hosted by the Government of Nigeria. It is not yet clear whether there will be opportunities for others (private sector, researchers etc) to participate through the summit in parallel sessions.

D     Management of Summit Preparation:

A high-level inter-governmental steering committee meets each week, with the involvement of several subcommittees. Several international and bilateral development organisations are members of this steering committee. The Summit secretariat will handle the expected 50 Heads of State, and their teams, the 20 Heads of international agencies active in health, and the many others who will participate. WHO is participating fully in the preparations for the Summit - particularly the Steering Committee and the various sub-committees. The Summit preparation plan and budget have been agreed, and the communications infrastructure for the Secretariat will be in place within a week. WHO has offered to support the strengthening of capacity both within the Government of Nigeria and the WHO country representative's office to help with Summit preparation. The budget for WHO's contribution includes resources for technical advisers and a consultant summit manager.

Dr Evarist Njelesani (WHO country representative) is based in Lagos and is spending most of his time working on preparations for the Summit. In his office, Malaria is handled by Dr Lola Sadiq. The capacity of Dr Njelesani's office has been strengthened with the secondment from WHO headquarters of Norma Johnston, Roll Back Malaria Campaign Manager (based in Abuja till the Summit: in Geneva 25th February till March 1st) and Obi Nwaorgu, attached to Roll Back Malaria on a Rockefeller Fellowship (similarly based in Abuja). Both stay at the Sheraton Hotel. Melville George, from the WHO Africa Regional Office in Harare, has also been seconded to the WHO country office, with particular responsibility for supporting Technical aspects of summit preparation.

E     Handling Invitations:

The GON has sent invitations to the Heads of State of all African nations - through their embassies in Nigeria. The OAU has been invited, also Heads of State of G8, heads of African and international development agencies, development co-operation Ministers from many OECD countries, president of the EC etc.

The President plans to speak personally with a number of African leaders to explain his intentions for the Summit. He will ensure that details of his intentions are circulated to Embassies of African and G8 nations so that they know the objectives and significance of the Summit. An up to date list of attendees will be maintained by the Summit Secretariat: this will be equipped to with effective communications, for handling enquiries about the summit, for tracking responses, for sending follow-up information to those who want to know more before making decisions etc. WHO country representatives will receive detailed briefings about the Summit objectives and agenda during early March 2000.

F     Accommodation, logistics, security and protocol Arrangements

The accommodation sub-committee has made plans to ensure the accommodation for invited guests. The transportation sub-committee will ensure that Heads of State, Heads of International Agencies and other invitees will have the vehicles they need. The Government is paying a great deal of attention to security matters.

Transportation for international guests is receiving special attention. The Summit on Roll Back Malaria in Africa comes straight after Easter, and there are limited direct flights from Europe to Abuja on April 24th. The Summit is followed by a conference on Education in Dakar Senegal on April 26th.

Some of the key guests (International organisations and development partners) need additional air connections into and out of Abuja if they are to come to the Malaria summit. British Airways is being asked to extend its London to Lagos flight on to Abuja on 24th April evening. In the absence of scheduled flight connections, participants will be able to buy tickets for a special flight from Abuja to Dakar late evening 25th April or early morning 26th April. A 30 seater plane will be arranged for the Abuja to Dakar segment in the first instance: additional capacity will be made available if there is demand (WHO Geneva would like to know of demand as soon as possible).

G     Communication, publicity and PR

A major programme of publicity is planned and is being worked on jointly by WHO and the publicity sub-committee.

1. The manufacture and display of the world's largest FUNCTIONING mosquito net, together with competitions for different designs on mosquito nets (there will be opportunities for a variety of messages to be displayed on the millions of mosquito nets that will be used by people throughout Africa over the next decade)
   
   
2. The launch of an association between African football (particularly goalkeeping) and Roll Back Malaria over the next 10 years, with the theme "GET IN THE NET"
   
   
3. The launch of a major report on the economics of malaria in Africa prepared by teams led by Jeffrey Sachs (Harvard University) and Ann Mills (London School of Hygiene and Tropical Medicine)
   
   
4. A "people speak to the summit" event in which people of Africa speak to the Summit about the malaria problems they face

There is a possibility that a commemorative postage stamp will be released to coincide with the summit. Documents for the Summit will be prepared in French, English, Portuguese and Arabic.

Further Information:

Dr Eduge Abebe (Summit Manager), Director, Primary Health Care & Disease Control
(Tel/fax +234 9 523 8190)
Dr Antoine Kaboré, Director of Communicable Diseases, WHO Africa Region, Harare, Zimbabwe (Tel +1 407 733 9244, Fax +1 407 726 5062)
Dr Evarist Njelesani, Dr Lola Sadiq, Dr Melville George and Dr Obi Nwaorgu,
WHO Country Office, Lagos, Nigeria
(Tel +234 9 774 1718, Fax +234 9 545 2179)
Ms Norma Johnston, Campaign Manager, Roll Back Malaria, [Attached to WHO country office - c/o Sheraton Hotel, Abuja]:
(Tel +234 9 523 0225 - 244, Fax +234 9 523 1570 - 1)
Dr David Nabarro, Manager, Roll Back Malaria, World Health Organisation Geneva
(Tel +41 22 791 2769, Fax +41 22 791 4824)