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Africa Malaria Day, April 25, 2004
Children for Children to Roll Back Malaria


This year, people across Africa and the world will commemorate Africa Malaria Day on and around April 25, 2004.

Introduction
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Malaria

Sue Anthony, USAID mission to Ethiopia’s Health Population and Nutrition leader, and village elders listen to a mosquito net use and care informational session.
SOURCE: Chris Thomas
Sue Anthony, USAID mission to Ethiopia’s Health Population and Nutrition leader, and village elders listen to a mosquito net use and care informational session.

An estimated 500 million cases of malaria occur every year, directly and indirectly causing more than 1 million deaths . Ninety percent of these deaths occur in Africa, and most of the victims are young children. Recent studies confirm that malaria is responsible for at least 20 percent of all deaths among children under age 5 in Africa. Malaria also places a huge burden on already fragile health systems, representing 30 to 50 percent of outpatient visits and hospital admissions. It continues to drain the resources of poor households throughout the tropics and is a major underlying barrier to economic development in Africa, inhibiting regional gross domestic product by as much as $12 billion annually.

Four years ago, African leaders signed the Abuja Declaration to Roll Back Malaria, reaffirming the common goal to halve Malaria by 2010 and committing themselves to specific, attainable steps to reducing the impacts of malaria – steps that only they can take.

USAID has played an important role in developing the global initiative Roll Back Malaria. At the regional and national level, USAID activities have established, strengthened, and expanded country programs throughout the world. Effective treatment is a cornerstone, along with prevention, of USAID’s comprehensive program to reduce the tremendous burden of malaria in Africa. Relieved of this terrible burden Africa nations can realize the full benefits of social and economic development.

USAID’s Position on Treatment of Malaria.

This year USAID has committed just over $80 million for malaria programs. This represents nearly a four-fold increase since 1998. The U.S. government is doing more than ever before. The Bush administration has made a significant investment in the Global Fund. The U.S. Government has contributed $623 million to the Global Fund and will contribute up to $547 million in Fiscal Year (FY) 2004. Secretary of Health and Human Services Tommy Thompson is serving as the Global Fund Board Chair and Assistant Administrator for Global Health. Dr. E. Anne Peterson serves as the U.S. Board Member as Secretary Thompson serves as chair. And USAID played a key role in establishing the Secretariat of the Global Fund to Fight AIDS, Tuberculosis, and Malaria and in creating the Fund’s monitoring and evaluation strategy.

USAID’s malaria strategy is to reduce malaria-related deaths and illness by:

  • Preventing malaria infection and illness;
  • Promoting effective treatment of malaria illness;
  • Protecting pregnant women from malaria;
  • Responding to the emergence and spread of drug-resistant malaria;
  • Developing new tools and approaches for malaria prevention and control; and
  • Addressing the needs of populations in complex humanitarian emergencies.

Implementation of this strategy has involved building malaria control networks among U.S. government agencies, multilateral and other bilateral donors, and nongovernmental organizations; working with the private sector to provide malaria control commodities and services to communities at affordable prices; and strengthening malaria programs in more than 20 African countries as part of local RBM partnerships. USAID also supports operational research to improve access to interventions and to develop new prevention technologies such as vaccines. USAID works closely with UNICEF, the World Bank, and WHO on the global RBM initiative to develop links with maternal and child health programs and foster innovative strategies for preventing malaria transmission.

The Agency also invests in development of new tools, particularly vaccine development and the response to increasing drug resistance. In collaboration with public and private partners, USAID is focusing on developing and testing malaria vaccines through its Malaria Vaccine Development Program. In the latest step forward, field-testing has begun in Kenya of a single-component malaria vaccine.

Malaria’s greatest impact is felt by very young children in Africa. As much as a quarter of child deaths in endemic areas are attributable to malaria. But infection of women during pregnancy takes a huge toll: on the health of the mother herself and on the development of her unborn child. Placental infection is a significant contributor to low birthweight and subsequent neonatal death. One of USAID’s main areas of focus in its malaria strategy is to protect pregnant women from malaria. Virtually every country we work with in Africa has embraced this new policy on intermittent preventive treatment (IPT) of malaria in pregnancy as part of a focused ante-natal package.

USAID is addressing malaria in humanitarian emergencies after it was determined that which are estimated to account for up to 30 percent of Africa’s malaria deaths occur in countries in the midst of war, civil strife, food shortages, or large population displacements.

Key Achievements

Dr. Peterson dips a mosquito net at a demonstration as USAID mission director in Ethiopia William Hammink and others look on.
SOURCE: Chris Thomas
Dr. Peterson dips a mosquito net at a demonstration as USAID mission director in Ethiopia William Hammink and others look on.

Effective treatment and Malaria in pregnancy. USAID technical partners in the Malaria Action Coalition provided expert technical assistance to countries in Africa in the areas of effective treatment and prevention of malaria during pregnancy, including intermittent therapy.

Over the last year this technical assistance has contributed significantly to revisions of outdated treatment policies in Senegal, Ghana, Rwanda, and Zambia, and to increased implementation of revised policies on appropriate drugs in Madagascar, Ghana, Senegal and Kenya. Among women attending antenatal services in Tanzania, delivery of intermittent preventive therapy has increased from less than 30 percent to more than 60 percent.

Sustainable provision of affordable bednets. The NetMark Project, the Global Health Bureau’s innovative public-private partnership for increased sustainable access to insecticide-treated bednets in Africa, has launched activities in six African countries. Sales of nets have topped 1 million in the first year of activity. NetMark also brought together key RBM partners to identify and document models for targeting subsidized nets to pregnant women and infants. Models for targeted subsidies are now being widely implemented in Malawi, Mali, Ghana, Uganda, Zambia, Senegal, and Tanzania.

Vaccine development. A promising candidate vaccine for malaria developed by the Bureau for Global Health’s malaria vaccine program is undergoing safety evaluation in Kenya. The U.S. National Institutes of Health plan to test it for safety at a second site. With support from the Malaria Vaccine Initiative, funded by the Gates Foundation, this candidate vaccine is scheduled for an efficacy trial in fiscal year 2004.

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