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 Africa
Malaria Day 2002: Message of the WHO
Regional Director for Africa, Dr Ebrahim M Samba -
24 April 2002
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the Signed Speech (pdf format)
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.
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