TalkAfrique

Ellen Johnson Sirleaf and Robert B. Zoellick

We have encouraging news out of Africa this week of World Malaria Day, as we take stock of the illness and death caused by this longtime scourge.

Eleven countries in Africa had slashed the number of confirmed malaria cases, malaria-related hospital admissions or deaths by more than 50 percent by the end of 2009. When 2010 data becomes available we expect it to show that even more countries have shown similar progress. In a region that has borne a heavy malarial burden of death and debilitating illness, part of the good news stems from the fact that approximately three-quarters of the people at risk of contracting malaria were using insecticide-treated mosquito nets by the end of 2010. With a decisive push, the goal of protecting Africa’s population with bed-nets and effectively preventing the fevers and crushing headaches that are the dreaded symptoms of malaria appears within Africa’s reach.

Even as we mark what may be a turning point, we know that malaria is an ancient foe we can never underestimate. Although global deaths from malaria have fallen from nearly a million a year in 2000, the disease continues to exact a great toll, killing 781,000 people across the world in 2009. More than 90 percent of these deaths occurred in Africa, where the disease accounted for about one in six child deaths.

The collective success is substantial, but is also fragile and must be sustained. The consequences of losing the focus on malaria would be deadly. Mosquito bed-nets last about three years and a failure to replace the over 300 million nets blanketing Africa over the coming three years could lead to resurgent malaria illness and deaths. Just this past year, Zambia faced a resurgence of malaria in a few provinces when mosquito nets were not replaced in time. Deaths and illness increased within months. Rapid action to address this increase has since been taken by the Zambian government, together with the World Bank, UN Foundation, Bill and Melinda Gates Foundation, Stanbic Bank, the African Leaders Malaria Alliance (ALMA), and the UN Special Envoy’s Office. While funding is important, it is really the partnerships that have been built with citizens, governments, and healthcare providers as well as the increasing reliance on and use of science, technology and the body of global knowledge on what works that can accelerate progress in this area.

For instance, beyond the wide distribution of mosquito nets, ending malaria deaths will require making sure that effective diagnosis and timely treatment become available to every patient. Health authorities need to keep better track of where malaria still exists and which drugs produce the best health outcomes. We want funding to be effective, not simply throwing money at the problem.

In the wake of the financial crisis, we face difficult choices with limited resources. In Liberia, the priority is to end deaths from malaria above many other pressing needs, for both health and economic reasons. As a result, Liberia is on track to protect its entire population by year’s end. Liberia is not alone. Thirty-nine African countries have united against the disease under ALMA, chaired by Tanzanian President Jakaya Kikwete. We have determined that the only way we can overcome the disease is through working together. No country is an island when it comes to malaria; mosquitoes do not respect borders.

In mobilizing the money, the bed nets, and the treatment, and in strengthening supply chains for lifesaving medicines, our bedrock guiding principle must be stronger accountability. ALMA’s flagship accountability initiative is a simple tool, commonly employed in the private sector: a scorecard. Currently under development with our partners in the Roll Back Malaria Partnership, the scorecard will track progress, identify what is working, what is not, and highlight where intervention is required. We will further expand the use of new technology platforms, such as SMS and Twitter, to reach hundreds of millions of people to create positive pressure at all levels, and to encourage demand for transparency, accountability and results by citizens.

Africa’s partners, including the World Bank, are committed to ending deaths from malaria. Last year the Bank pledged US$200 million to anti-malaria efforts in Africa, largely to provide bed-nets to families in the Democratic Republic of Congo, Ethiopia, Ghana, Kenya, Mozambique, Sierra Leone and Zambia. This helped to close emergency gaps. Consistent with the priorities of African countries, we expect new financing mobilized from the latest replenishment of the International Development Association, the Bank’s fund for the poorest countries, to be committed to the fight against malaria, including through our work on helping African countries build stronger health systems.

So, as we take inspiration this World Malaria Day from African countries that now have malaria in retreat, we also need to recommit to finish the job. Allowing hard-won gains to be reversed cannot be an option.

Robert B. Zoellick is President of the World Bank Group;

Ellen Johnson Sirleaf is President of Liberia, and the incoming Chair of the African Leaders Malaria Alliance (ALMA), which comprises African Heads of State and Government working to end malaria-related deaths in Africa.

by Tony Blair and Ray Chambers

LONDON: The tsunami in Japan, the earthquake in Haiti, and Hurricane Katrina are among the world’s most notorious recent natural disasters. Their fierce devastation claimed thousands of lives, destroyed vital infrastructure, and crippled economies. The communities affected could not be more different from one another, and yet the similarities in the responses are striking. The worldwide outpouring of support demonstrated what humanity is capable of at its best.

While international support in a time of crisis demonstrates a seemingly innate moral response to the suffering of others, it also highlights with disquieting clarity that the same level of empathy is more difficult to evoke when a crisis is chronic instead of sudden, unexpected, and dramatic.

One of the most devastating global health challenges on the planet is malaria, which claims more than 800,000 lives annually, primarily among young African children. According to the Roll Back Malaria Partnership, 2,000 children die of the disease each day. Yet, unlike the aftermath of a natural disaster, there are no photographs to capture the scope of this tragedy. The loss of life is every bit as devastating, but without the onslaught of grisly images, it is much easier to become indifferent to malaria’s victims.

Malaria deaths represent nothing less than a moral issue. This is why the United Nations, World Bank, Global Fund, Tony Blair Faith Foundation, African heads of state, and many other governments, organizations, and individuals have felt compelled to act.

In 2008, United Nations Secretary-General Ban Ki-moon declared the goal of ensuring universal access to malaria-control interventions by the end of 2010 for all those at risk of the disease, with the ultimate goal of reaching near-zero malaria deaths by 2015.

Since those goals were set, major progress has been made. Hundreds of thousands of lives have been saved, and the international community now is redoubling its efforts to reach the 2015 milestone. Three years ago, when more than $3 billion in new money was committed to the malaria effort, mosquito nets and indoor spraying protected less than 20 percent of Africa’s at-risk population. Today, the proportion is more than 90 percent.

These gains occurred only because of the commitment of leaders, agencies, and individuals who realized that lessening the malaria burden is not only an opportunity, but also a responsibility.

No organization better embodies the moral imperative of ending malaria deaths than the African Leaders Malaria Alliance (ALMA). Formed during the UN General Assembly in September 2009 under the leadership of President Jakaya Kikwete of Tanzania, and supported by the African Union, the group has added government advocacy and accountability to the combined efforts being made to halt and reverse the spread of malaria on the continent.

Recognizing that the death of a child from a mosquito bite is unacceptable in the twenty-first century, ALMA leaders understand that the most effective way to ensure that recent gains are sustained is to assume leadership and ownership of the challenge. They are taking concrete actions, such as ensuring that essential malaria-control interventions are exempted from taxes and tariffs that add unnecessary costs to life-saving items, and that supplies are purchased in bulk to reduce costs.

Most powerful of all, perhaps, is an innovative “scorecard,” which is being prepared to track progress in the struggle to end malaria deaths, and to “flag” problems that arise before they reach a critical stage. The scorecard will be open and accessible to all.

While African political leaders have ultimate responsibility for protecting their citizens, faith communities share deeply in this commitment. The Tony Blair Faith Foundation is conducting a global campaign, Faiths Act, which calls for greater engagement by faith communities in preventing malaria deaths. Supporters of every religion in 106 countries have answered the call.

Though accurate statistics are hard to come by, the World Health Organization estimates that faith communities provide, on average, 40% of total health-care services in sub-Saharan Africa.

What faith communities have working in their favor are networks, infrastructure, and influential leaders to deliver health messages. In many instances, they can reach deep into inaccessible rural areas to deliver services. When well resourced, faith leaders can adopt holistic approaches to major killer diseases and use their networks effectively for immunization and combating pandemics.

In Nigeria, which accounts for one-quarter of the continent’s malaria deaths, the Nigerian Inter-Faith Action Association has been particularly effective in training religious leaders for health messaging against malaria and in the correct use of bed nets. This initiative has received the backing of the Sultan of Sokoto, Sa’ad Abubakar III, the country’s leading Muslim, and the Catholic Archbishop of Abuja, John Oneiyekan. There is a full-time, centrally organized office and team to co-ordinate this program. If it succeeds, the impact will be dramatic – and not just in Nigeria.

For example, Sierra Leone, with its small population, excellent Muslim-Christian relations, and uphill struggle to improve its health-care system after the depredations of civil war, has a longstanding relationship with the United Kingdom. The Tony Blair Faith Foundation has been in consultation with the country’s religious leaders and inter-faith association to develop a national program with the Ministry of Health that would promote the government’s key public-health messages, participate in education for bed-net use, and use available health assets and faith community networks.

Now is no time for indifference. Much significant progress has already been made; now we must consolidate our gains. As foreign aid stands to suffer from cutbacks around the world, we must remember that malaria is a “natural disaster” that is devastating communities every second of every day. Earthquakes, tsunamis, and hurricanes can never be stopped. Malaria can be.

Tony Blair is founder of the Tony Blair Faith Foundation, which works to mobilize faith communities to fight malaria. Ray Chambers is the United Nations special envoy for malaria. This commentary is published by DAILY NEWS EGYPT in collaboration with Project Syndicate (www.project-syndicate.org).

Copyright: Project Syndicate, 2011