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.
We also note the tremendous contribution of the Global Fund to Fight Aids, Tuberculosis, and Malaria, and the World Bank in helping to finance malaria control in Africa.
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.
Jakaya Mrisho Kikwete, the president of Tanzania.