Africa Malaria Day 2006 is being commemorated soon after the milestone date set for the attainment of the Abuja targets. In many malaria-endemic countries of Africa, appreciable progress has been made in the pursuit of these targets. The proportion of the population at risk with prompt access to effective malaria treatment has increased compared to the situation in the year 2000. Out of the 42 malaria-endemic countries, 33 have adopted the more efficacious Artemisinin-based Combination Therapies (ACTs) for the treatment of malaria cases in line with WHO recommendations. Significant strides have also been made in the area of prevention, with a number of countries reporting coverage levels for Insecticide Treated Nets (ITNs) in excess of the Abuja target.
However, across the continent many countries did not reach the targets and malaria continues to be a major public health problem. It is estimated that each year, about 60% of the 350-500 million clinical malaria episodes and over 80% of the more than 1 million deaths globally occur in African countries. Health services continue to be burdened by malaria cases. At the same time, absenteeism among school children and diminished or lost worker productivity continue to make malaria a significant contributor to low economic growth in endemic countries.
This year, the focus of Africa Malaria Day is on ensuring that all who suffer from malaria have access to effective treatment without hindrance. We recognize that malaria disproportionately afflicts the poor in our countries, trapping them in a vicious circle of poverty. Our collective efforts to reduce poverty and make progress towards the attainment of the Millennium Development Goals should therefore start by addressing issues of access by the most vulnerable to effective treatment for malaria..
In January 2006, the Word Health Organization released new malaria treatment guidelines. They re-emphasize the use of ACTs for the treatment of uncomplicated malaria. There is increasing concern that the deployment of artemisinin monotherapy will compromise the long term efficacy of the artemisinin derivates. As we commemorate Africa Malaria Day 2006, we call on all stakeholders – patients, health workers, governments, pharmaceutical companies, donors and partners – to “Get their ACT Together” so that ACTs are effectively deployed across countries of Africa.
We are delighted to note the recent announcement by Norvatis that it will produce 100 million treatments of Artemether/Lumefantrine in 2006, up from the 30 million treatments produced in 2005. The pharmaceutical industry is also expanding the sources of the required raw material through partnerships with a number of African countries for growing of the Artemisia annua plant from which the raw material is extracted.
There is still more work to be done to make available ACTs that are simple to take and at prices that are affordable. We appeal to the Research and Development community to intensify efforts to produce easy-to-use and cheaper ACT formulations, particularly fixed-dose formulations for young children, to complement the existing co-packaged ones. We call on governments and partners to subsidize the cost of ACTs to ensure that price does not constitute an obstacle to access by those in need and that these effective drugs are available near every home. There is also need for joint efforts by stakeholders to tackle the health system barriers to access to treatment for the vulnerable population.
We count on the support of donors and funding partners, such as the Global Fund, the World Bank and bilateral organizations, to continue to make available resources for the procurement of the ACTs. At the country level, governments will need to move faster to translate their decisions to change their treatment policies into implementation of the new ACT policies, so that at the end of the year, all 33 countries will be fully implementing the ACT policy. There will also be a need for closer collaboration with all stakeholders, including the private sector, to ensure that there is no more artemisinin monotherapy in the countries.
As we commemorate Africa Malaria Day 2006, we also need to aggressively pursue new approaches that will enhance other cost-effective strategies to ensure that our long term goal of halving the burden of malaria by the year 2010 is achieved.
I believe that if we all “Get our ACT together”, we can ensure that every one in need, irrespective of race, social status or gender, will have access to effective malaria treatment.