To the African Summit on Roll Back Malaria
Abuja, Nigeria, 25 April 2000
Your Excellency President Obasanjo, Heads of State and Government, the Secretary-General of the Organisation of African Unity, Distinguished Heads of United Nations Agencies, the World Bank, the African Development Bank, Distinguished Delegates, Colleagues:
Let me begin by thanking President Obasanjo for hosting this extraordinary Summit meeting -- and for serving as Conference Chairman.
The presence of such a large number of Heads of State and Government bears testimony to the political commitment of Africa's leaders in tackling this devastating disease -- and I have every confidence that this meeting will result in concrete decisions that will help elevate the fight against malaria to the highest reaches of the international agenda.
Peace and stability is a vital prerequisite for health and development -- and Nigeria's role in this gathering is consistent with its important contributions to peace in the region, where civil strife and the displacement of populations only worsens the effects of diseases like malaria, HIV/AIDS and others.
Malaria, in tandem with HIV/AIDS, stands in the way of social progress and better standards of life at every level, from children's intellectual and physical development to the growth of national economies.
The Convention of the Rights of the Child, which has been ratified by virtually every country on Earth, affirms that every child has a right to good health and nutrition. That right will not be fulfilled if malaria is not rolled back.
Malaria kills a child somewhere in the world every 30 seconds, the majority of them in Africa. Of the more than 1 million people who die of malaria-related causes each year, 90 per cent are in Africa.
We are talking about a disease that is a major factor in Africa's high rate of infant and maternal mortality; that is the single biggest cause of low birthweight among new-borns; and is the leading cause of school absenteeism, as well as low productivity in farming and other industries.
The impact of HIV/AIDS has compounded the crisis. Malaria affects most of the same desperately poor countries that are also reeling from the HIV/AIDS pandemic.
Indeed, in many ways, Africa's future development is inextricably linked to the success of malaria and HIV/AIDS prevention and control.
There has been a rapid acceleration of political commitment to address HIV/AIDS as a threat to global peace and security, as the Security Council demonstrated in January, and last week, with the pledge by World Bank officials to step up the fight against HIV/AIDS in poor countries.
Mr. President, we must not treat malaria and HIV/AIDS as competing priorities, but move forward on both, looking for synergies that will allow progress in one area to carry over into the other.
Malaria is truly a disease of poverty. It afflicts primarily the poor, who tend to live in malaria-prone areas, in dwellings that offer few, if any, barriers against mosquitoes. And by sapping peoples' health, strength and productivity, malaria generates still more poverty.
Where malaria exists, it is one of the major impediments to child development and survival -- and UNICEF is committed to supporting all low-cost practical interventions for which there is evidence of effectiveness.
Tackling the impact of malaria will be a crucial element of UNICEF's a new Global Agenda for Children, which stresses the importance of early child care and development.
There is also a growing consensus on the need to expand malaria prevention and treatment programmes beyond the health infrastructure and into communities and homes.
Ministries of Health and the health sector have a central role to play -- but the task cannot be left to these entities alone. An effective attack on malaria will require the active involvement of many different sectors of society.
The Roll Back Malaria Initiative, led by WHO, UNDP, the World Bank and UNICEF, emphasises the importance of forming strong partnerships -- an objective to which UNICEF is fiercely committed.
In recent years, there has been increasing involvement by a wider range of sector ministries and non-governmental and community organisations - and the pledging of more national and international financial resources.
The Bamako Initiative and the Integrated Management of Childhood Illnesses Initiative, the product of partnerships between WHO, UNICEF, governments and communities, also offer effective tools that can be harnessed to strengthen malaria prevention and treatment.
The Bamako Initiative, which has been endorsed by the OAU, has shown that even during times of severe economic difficulties, communities that have implemented Bamako Initiative programmes have been able to maintain basic essential health services for their people.
But for all of these successes, the reality is that tens of millions of families in Africa simply have no access to affordable bed nets or insecticide.
There are millions of children who do not receive appropriate treatment within eight hours of the onset of the symptoms of malaria.
And there are very few pregnant women who are benefiting from the new discoveries concerning intermittent treatment for malaria during pregnancy.
Distinguished Delegates, I have seen the Draft Declaration that you will soon be considering. It is an excellent document that offers concrete guidance on some of the key actions that can, and must, be supported.
In order to roll back malaria to a significant degree and to achieve the ambitious goals that Heads of State are now considering for the year 2005, we must find ways to increase the use of the available interventions for the people who are most affected.
We are now in the fortunate position of having a technical consensus on a number of practical and cost-effective actions that, if implemented on a wide scale, could make a major difference to the lives of people living in the countries most affected.
First, we must ensure that affected communities are fully aware of what can be done to control malaria.
The Roll Back Malaria campaign has done a splendid job in mobilising international concern and commitment. Now we need major initiatives on the national and local level, initiatives that can help people learn about the opportunities to strike back against the disease. This will encourage community participation on an unprecedented scale, and create a demand for effective interventions.
Second, we must ensure that everyone has access to impregnated bed nets and good anti-malarial medicines.
Bed nets and insecticide are best made available, at affordable prices, to people through the commercial sector, using shops and markets or via community-based organisations. But we must also see to it that families too poor to afford even subsidised bed nets are able to obtain them.
Governments should help by encouraging the commercial sector to make quality nets and insecticide more affordable and more available. They can do this through a combination of incentives, such as exempting materials and manufacturing equipment from taxes and import duties; through tax credits for industries that wish to expand; and by creating demand for nets and insecticide through effective communication strategies.
It will also be useful for countries to convene "roundtables" in which partners from Government, the donor community, the private sector and civil society come together to take stock of the present situation of supply and demand for treated bed nets -- and to map out what needs to be done to rapidly increase their availability and use.
UNICEF is prepared to help organise such consultations at the earliest opportunity.
UNICEF welcomes the focus in the declaration on making treated bed nets readily available to pregnant women. I suggest that we might optimise scarce resources if we set ourselves an immediate goal of ensuring that every woman, during her first pregnancy, receives a treated bed net, along with instructions on how to re-treat it with insecticide.
Third, we must ensure that people suffering from malaria have prompt access to correct and affordable treatment within eight hours of the onset of symptoms.
It would be ideal if every child suffering from malaria had access to a well-supplied and properly functioning health centre, especially one that is open evenings and on weekends. But where this is not possible, governments will need to carefully balance the benefits versus the risks of making good first-line malaria treatment readily available through shops or community organisations, which may be more accessible and less likely to run out of supplies.
These actions can be further facilitated thanks to recent breakthroughs in malaria control, such as the development of insecticide-treated bed nets that can be washed 12 times before they need to be re-treated; and by reductions in the price of effective combination drugs for treating malaria to less than a dollar per treatment.
As ante-natal services are strengthened to cope with the HIV/AIDS crisis, there will be an excellent opportunities to introduce low-cost treatment of malaria in all risk areas, and to strengthen the prevention and treatment of anaemia.
Mr. President, this is the kind of synergistic benefit that can grow out of malaria and HIV/AIDS programmes.
UNICEF is already supporting governments and non-governmental organisations in implementing malaria-control programmes in 30 countries in Africa that focus on preventing malaria in young children and women.
UNICEF is committed to the rapid expansion of these programmes, using our resources; our country-level staff; our supply, procurement and logistics expertise, and our experience with supporting multi-sectoral action and communications support.
UNICEF will examine the possibility of increasing the amount of our own resources that we devote to malaria -- but whatever the amount, I am sure that it will not be enough to make the difference required. That is why UNICEF will work in partnership with governments to seek additional resources for malaria control.
Within the context of your Draft Declaration and the goals you are considering, UNICEF is prepared to work with governments and other organisations in at least 10 of the most severely malaria-affected countries in Africa to develop viable programmes and to raise the necessary resources to achieve the following three concrete and measurable objectives by the year 2005:
To ensure that, in all areas at high risk from malaria, at least 80 per cent of women during their first pregnancy acquire and use an insecticide-treated mosquito net.
To ensure that, in all areas at high risk from malaria, at least 80 per cent of pregnant women receive presumptive intermittent treatment for malaria to stave off the worst effects of the disease on themselves and their infants.
To ensure that at least 60 per cent of young children receive appropriate treatment within eight hours of the onset of malaria signs and symptoms.
For these objectives to be achieved, governments must do their part. UNICEF therefore calls on governments to exempt anti-malarial drugs, nets and insecticides from taxes and duties -- and urges them to find ways to reduce delays in deciding what types of anti-malarial drugs should be made available and how they should be distributed.
We also call on governments to give vigorous support to communications and social marketing programmes designed to reach the poorest and most marginalised groups.
And we call on other Roll Back Malaria partners to work with us on the development of sustainable support-and financing systems for community-based programmes for malaria prevention and care.
Mr. President, the goal of reducing young child mortality from malaria by 50 per cent by the year 2010 is eminently achievable.
However, significant resources will need to be mobilised if this is to happen as quickly as possible.
That is why UNICEF, along with our partners in the Roll Back Malaria Initiative, appeals in the strongest terms to all African Governments, and to all our development partners, to provide the long-term commitment and resources necessary to truly Roll Back Malaria in Africa.
Excellencies, Distinguished Delegates: The tools for the prevention and cure of malaria are in our hands. We have only to use them.