The most powerful weapon in the malaria fight

By Hailemariam Dessalegn and Jakaya Kikwete - 6 February 2016 at 7:54 pm
The most powerful weapon in the malaria fight

United States Navy

It wasn’t long ago that an Africa without malaria seemed like an impossible dream. Today, that dream is becoming a reality, thanks to the most powerful weapon we have in the malaria fight: strong leadership.

Malaria progress has been unprecedented in the past 15 years, and nowhere is the progress more pronounced than in Sub-Saharan Africa, which carries about 90 percent of the global burden of this deadly disease. Since 2000, malaria mortality rates have fallen by 66 percent on the continent overall, and by 71 percent among African children under five.

African Heads of State and Government, working with their Ministers of Health, have played a leading role in this stunning progress. Building on the pivotal efforts by donors like the Global Fund to Fight AIDS, Tuberculosis, and Malaria, the United States’ President’s Malaria Initiative, the United Kingdom’s Department for International Development, and France’s multilateral and bilateral contributions, many African leaders have made malaria a priority focus and committed domestic resources to the fight.

The African Leaders Malaria Alliance (ALMA) is a groundbreaking coalition of 49 heads of state who have come together to fight malaria through high-level advocacy and action. To help hold leaders accountable and encourage a continued focus on malaria, ALMA issues each country a quarterly scorecard tracking malaria progress, identifying bottlenecks and stimulating action. Each year, ALMA honors countries that have made significant progress. Last year, ALMA adopted an elimination agenda for the continent.

On January 30th, these leaders met in Addis Ababa, Ethiopia, on the sidelines of the 26th Ordinary Session of the African Union Summit, to celebrate the progress and renew their commitment to eliminating this deadly disease from the continent.

Malaria is entirely preventable and treatable. Mosquitoes that carry malaria in Africa bite at night so the massive distribution of insecticide treated nets – more than 1 billion since 2000; and the use of indoor residual spraying has played a major role in saving lives. This has led to significant improvements, especially in countries that are moving towards malaria elimination. Rapid diagnostic tests and artemisinin-based combination therapies have also played a critical role. The tools at our disposal mean that no one has to die from malaria, but it takes strong and sustained national commitment to ensure every citizen has access to them.

We both saw this firsthand in our own countries: when you make fighting malaria and the whole health sector development work a priority, it pays off.

The Federal Democratic Republic of Ethiopia was one of the first African countries to scale up distribution of long-lasting insecticide treated nets with a “universal coverage” net campaign back in 2006 and has continued to be a leader in malaria efforts. The engagement of community health workers, thousands of whom are serving communities across the country, has helped fuel the progress.

In the United Republic of Tanzania, to ensure the success of a universal coverage campaign, top musicians and media partners helped educate the public on the importance of sleeping under a net and taking measures against malaria. Through a partnership with Sumitomo Chemical, the country built the largest insecticide treated mosquito net factory in Africa. The factory produces 30 million nets a year and since 2008 has shipped more than 150 million nets across the continent.

As a result of our efforts, based on modeling by the World Health Organization, the United Republic of Tanzania and the Federal Democratic Republic of Ethiopia both reduced malaria incidence between 50 and 75 percent from 2000 to 2015. Zanzibar, a cluster of islands that is part of the United Republic of Tanzania, has reduced malaria incidence by more than 75 percent and is well on the road to elimination.

Strong leadership in other countries has also translated into fewer malaria cases and deaths. As a result, this year, ALMA recognized eight countries for meeting the malaria target in the Millennium Development Goals (MDGs) and reducing the incidence of malaria by 75 percent: Botswana, Cape Verde, Eritrea, Namibia, Rwanda, São Tomé and Principe, South Africa and Swaziland. (The MDG goal was to “have halted by 2015 and begun to reverse the incidence of malaria and other major diseases.”)

ALMA also recognized Rwanda, Senegal and Liberia for their performance in malaria control, and Mali, Guinea and Comoros for the most improvement in malaria control. Both Ethiopia and Tanzania have received awards in the past. It’s especially impressive that Sierra- Leone, Liberia and Guinea were able to stay on track with malaria progress despite the devastating toll of Ebola in their countries.

Across the continent, momentum is building. Leaders are stepping up, dedicating their attention and resources to combating this killer. Later this year, the Africa Union is set to endorse a roadmap for elimination by 2030.

Across the world, U.S. President Barack Obama included malaria in his final State of the Union speech, declaring that: “we are on track to end the scourge of HIV/AIDS” and “have the chance to accomplish the same thing with malaria.” He added that he would be pushing Congress for funding.

As we celebrate our progress, we cannot lose our focus. Malaria is the oldest and deadliest disease in human history. It still kills 395,000 Africans every year – one of our children dies every two minutes. The dual threats of insecticide and drug resistance must be urgently addressed. Mosquito resistance to insecticides is increasing in Africa, and artemisinin resistance in Southeast Asia is a serious threat.

The progress of the past 15 years proves that eliminating malaria is within reach. Many countries on this planet have been able to eliminate it. Why not us on the African continent? Malaria ignores borders, so no country can do it alone. Every country has a role to play.

Malaria has stolen our loved ones. It has kept us out of work and school. It has damaged our economies and burdened our health systems. It has held us back from our true potential of making poverty history. We must recommit ourselves; let’s say enough is enough and act. Let’s be the generation that makes history. Let’s free Africa of malaria once and for all.

Hailemariam Dessalegn and Jakaya Kikwete

Hailemariam Dessalegn and Jakaya Kikwete

Hailemariam Dessalegn is the Prime Minister of the Federal Democratic Republic of Ethiopia. Jakaya Kikwete is the former President of the United Republic of Tanzania.

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