AIDE MEMOIRE
INTRODUCTION/JUSTIFICATION
1. Nine out of ten cases of malaria worldwide occur in Africa south of the Sahara. Malaria is a major cause of over one million deaths annually in the same region. Most of the deaths are among children less than 5 years and pregnant women. Those who suffer from and die of malaria are mostly from the poor families, who at the same time, are vulnerable to other infectious diseases because they (families) have extremely limited access to essential medicines and nutrition security. Malaria costs up to US$ 12 billion annually yet the disease can be prevented and controlled at much smaller cost. Persistent occurrence of malaria in the same individual weakens the immune system making the individual highly vulnerable to other infectious diseases and also reduces productivity.
2. It was within such context that Africa's Heads of State and Government met at a Special Summit in April 2000 in Abuja, Nigeria to deliberate on how to effectively fight against malaria. The outcome of the summit was the Abuja Declaration and Plan of Action on Roll-Back-Malaria (2000). Among other priorities in the Declaration, the Leaders committed themselves to mobilizing the whole society in order to halve malaria mortality for Africa's people by year 2010. Additionally, the Leaders resolved to:
• initiate appropriate and sustainable action to strengthen the health systems to ensure that by the year 2005;
• at least 60% of those suffering from malaria have prompt access to and are able to use correct, affordable and appropriate treatment within 24 hours of the onset of symptoms;
• at least 60% of those at risk of malaria, particularly pregnant women and children under five years of age, benefit from the most suitable combination of personal and community protective measures such as insecticide treated mosquito nets and other interventions which are accessible and affordable to prevent infection and suffering;
• at least 60% of all pregnant women who are at risk of malaria, especially those in their first pregnancies, have access to chemoprophylaxis or presumptive intermittent treatment.
3. Finally the leaders agreed that advocacy for public awareness of malaria should be strengthened. Consequently one way of promoting such awareness was to have April 25 of each year as “Africa Malaria Day” which should be commemorated in all Member States. At their Ordinary
Assembly held at Lome, Togo in July 2000, African Heads of State and Government declared 25 April as Africa Malaria Control Day. This day was selected because on 25 April 2000, African Heads of State and Government held a Special Summit on Roll-Back-Malaria in Abuja, Nigeria. Every year, the WHO Regional Office for Africa selects a theme for focus of intensified advocacy efforts in Member States. This year the theme is “ Unite Against Malaria – Together We Can Beat Malaria.”
4. Africa Malaria Control Day will be marked in Member States with appropriate country-wide awareness-raising activities. The AU Commission will organize a programme for Member State Representatives, AU Commission Staff and other Members of the International Community, to remind them that Malaria control is a responsibility of everyone, individually and collectively.
BACKGROUND TO ROLL-BACK MALARIA (RBM)
5. Roll-Back-Malaria is a global public, private and government partnership or movement which was jointly founded by WHO, UNICEF, World Bank and UNDP in 1998. It evolved from the African Initiative for Malaria Control in the 21 st Century which followed the 1997 OAU Harare Declaration on Malaria Prevention and Control in the context of African Economic Recovery and Development. The goal of RBM is to halve the malaria burden by 2010 (which is now only 5 years away). The RBM partnership includes governments, development agencies, commercial organizations, professional associations, civil society, research groups and the media. It is aimed at enabling countries take effective and sustainable action against malaria, through securing prompt access to appropriate and affordable treatment for malaria sufferers. It also promotes access to personal and community protective measures for those at risk, particularly young children and pregnant women. It encourages the community to participate in these interventions, and promotes actions towards maintaining maximum vigilance to prevent malaria epidemics and outbreaks.
6. Six Elements of RBM Strategy include:
(i) Evidence-based decisions utilizing surveillance, appropriate response and raising community awareness;
(ii) Rapid diagnosis and treatment, at or close to the home.
(iii) Multiple prevention including insecticide-treated mosquito nets (ITNs) and making pregnancy safer;
(iv) Focussed research to develop new medicines, vaccines and insecticides;
(v) Well-coordinated action to strengthen health systems;
(vi) Harmonized action to build a dynamic global movement.
DEVELOPMENTS SINCE 2000
7. Many developments in malaria control have occurred since 2000. They include :
- commitment of Member States is evident in the areas of prevention, as well as access to prompt and effective treatment although a lot remains to be done.
- Heads of State and Government reaffirmed the 2000 Declaration and Plan of Action at Maputo (2003), Addis Ababa (2004) and Abuja (2005).
- The Global Fund to fight AIDS, TB, and Malaria (GFATM) was established in 2001 by the UN General Assembly Special Session on AIDS and is helping Member States meet the high costs associated with management and control of malaria.
- Research in various areas is being promoted.
- The AU Strategic Plan 2005-2007, has been adopted and emphasizes promotion of access to Insecticide-treated mosquito nets (ITNS) and prompt access to affordable drugs.
THE MALARIA BURDEN
8. The global and continental burden of malaria is as follows:_
• 25% of the world population is at risk of malaria : at highest risk are children below 5 years and pregnant women;
• between 300-500 million clinical cases (attacks) of malaria occur per year: over 5 times as many as TB, AIDS, measles and leprosy cases combined;
• 90% of the world's cases of malaria occur in sub-Saharan Africa;
• >1 million deaths per year, about 3000 per day : > 90% of the deaths in Africa:
- an African dies of malaria every 10 seconds;
- malaria kills a child under 5 every 40 seconds;
- without prompt treatment, a child will die from malaria within 24 hours;
- death rates are reducing everywhere except Africa (although improvement is reported in some countries);
• disability from severe forms of malaria;
• with ecological and environmental changes, malaria is spreading to areas that were previously free;
• major impact on human and economic development : high costs of treatment, cause and effect of poverty, lost productivity, badly affected areas do not attract investment…..)
THEMES OF PAST AFRICA MALARIA CONTROL DAYS
9. The past themes selected by WHO are:
2001: “Malaria costs, Malaria is Preventable”
2002: “Mobilizing Communities to Roll-Back-Malaria”
2003: “Insecticide Treated Nets and Effective Malaria Treatment for Pregnant Women and Young Children by 2005”
2004: Timely Delivery of effective Malaria Control Interventions. The road to Abuja – 2005 and beyond 2010”
AFRICA MALARIA CONTROL DAY 2005 AT THE AU COMMISSION
10. Objective:
• to remind Member State Representatives, AU Commission Staff and partners of the ever present threat of malaria to individuals, families, communities and countries;
• to educate and remind individuals of their role in protecting themselves and other families from malaria;
• to urge the international community to intensify and sustain efforts to conquer malaria, a disease that it is easily curable and preventable.
PROPOSED PROGRAMME
The Programme will comprise two activities:
(i) Issue of a Press Release by the AU Commission Chairperson.
(ii) Programme in Congo Hall, AU Commission on 25 April 2005 comprising a Reception at 18:00–19:30 hours with statements by selected dignitaries, followed by a debate, and dissemination of awareness-raising material. The Media will be invited to participate actively and to disseminate information on the day.
EXPECTED OUTCOME
• Individuals are aware of the threat of malaria, and what they can do to prevent it or get prompt treatment.
• Decision-makers and implementers more committed to playing their respective role.
• Development partners more sensitized and ready to (individually or collectively) make the required support available in the framework of the RBM partnership.
• Promotion of partnerships as this is the only sure way to defeat malaria.
“Let us unite against Malaria : Together we can beat Malaria!”
