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The State of Malaria Control Global Conference on Health & Lifestyle Thomas Teuscher, MD Senior Advisor Policy, Strategy & Governance Roll Back Malaria Partnership Secretariat Uni Mail, Geneva, 7 July 2009 Malaria: a disease without borders 3,3 billion people at risk of malaria in 2006. Almost 1 million malaria deaths in 2006 247 million malaria cases in 2006, of which 86% were in Africa. (WHO) High global deaths Low global deaths Elimination Malaria-free / prevention of reintroduction Source: World Malaria Report 2008. Geneva, WHO (2006 data) 1 Malaria: a multisectoral impact Individual: malaria is the leading cause of child mortality in Africa, accounting for 20% of all child deaths. Households: malaria absorbs up to 25% of household revenues in high-burden countries. National Health Systems: 30% to 40% of all hospital consultations in high-transmission countries are due to malaria; and the disease absorbs 40% of these countries' public health budgets. Education: malaria, a leading cause of illness and absenteeism in children and teachers, impairs attendance and learning and can cause lasting neurological damage in children. Economy: Malaria costs Africa at least $US 12 billion every year; it also stifles tourism and foreign investment and contracts the economies of hard-hit countries by 1,3% each year. 2 2. Major developments in the fight against malaria: what has changed? 3 The Roll Back Malaria Partnership is a public-private global health initiative for mobilizing resources, forging consensus and coordinating partner efforts Donor Countries Multilaterals NGOs Research & Academia Private Sector Ex officio members Foundations Clinton Global Initiative UN Special Envoy for Malaria 4 Increased awareness : Roll Back Malaria "champions" Her Royal Highness Princess Astrid of Belgium Youssou N'Dour Yvonne Chaka Chaka 5 Increased funding: rapid & significant growth (US$ million) 1'200 1'127 x 2.8 900 701 608 600 440 300 249 0 2004 2005 The Global Fund 2006 PMI World Bank 2007 Other USAID 2008e Others 6 Increased impact: rapid & significant reduction Rwanda, 2001-2007, 19 health facilities Ethiopia 2003-2007, 7 in-patient facilities In-patient malaria and non-malaria cases in children <5 years old. In-patient malaria and non-malaria cases in children <5 years old 12000 10000 LLINs, ACTs Sep-Oct 2006 LLINs, ACTs 2,500 ACTs 3,000 9000 10000 8000 2,500 2,000 7000 8000 4000 1,500 1,000 Non-malaria cases 5000 1,500 Malaria cases Malaria cases 6000 Non-malaria cases 2,000 6000 4000 1,000 3000 2000 Malaria cases 2000 Malaria 500 Non-malaria cases 0 0 2001 2002 2003 2004 Year 2005 2006 2007 500 Non-malaria 1000 0 0 2003 2004 2005 2006 2007 Year Source: WHO 2008 7 7 Increased alignment & harmonisation: GMAP 1. One plan to eliminate all malaria species 2. Global Plan 3. Built on good practice 8 3. The Global Strategy 9 The GMAP: a strategy of unprecedented ambition The Global Malaria Action Plan, or GMAP, launched in 2008, guides the malaria community in: • Providing universal coverage of malaria control interventions by 2010 • Eliminating the disease where possible • Paving the way for global eradication of malaria (which will require the development of new tools) 10 GMAP proposes a 3-part global strategy to achieve targets 1 CONTROL Scale-up for impact (SUFI) 2 Sustained Control 3 ELIMINATIO N RESEARCH 11 Annual GMAP costs 12 The RBM Partnership supports countries in many ways Humanitarian crises Monitoring & evaluation Communication & behavior change methodologies Advocacy Resource mobilization Support for 109 malarious countries Financing Policy & regulatory In-country Planning Procurement & supply chain management Support to be strengthened for Resource Mobilization, Communication / BC and Humanitarian Crises 13 4. High-transmission countries 14 Goals of high transmission countries The targets of the GMAP are to: • Achieve universal coverage, as recently called for by the UN Secretary-General, for all populations at risk with locally appropriate interventions for prevention and case management by 2010 and sustain universal coverage until local field research suggests that coverage can gradually be targeted to high risk areas and seasons only, without risk of a generalized resurgence; • Reduce global malaria cases from 2000 levels by 50% in 2010 and by 75% in 2015; • Reduce global malaria deaths from 2000 levels by 50% in 2010 and to near zero preventable deaths in 2015; • Eliminate malaria in 8-10 countries by 2015 and afterwards in all countries in the preelimination phase today; and • In the long term, eradicate malaria world-wide by reducing the global incidence to zero through progressive elimination in countries. 15 What gaps do these countries currently face? • Financial gaps • Need for stronger health systems: – Human resource gaps – Reaching remote populations – Inadequate disease surveillance and M&E systems • Unaffordable Artemisinin-based Combination Therapy • Insufficient private sector and community involvement • Bottlenecks in supply chain management • And other gaps…… 16 Country 2010 Targets LLINs ACTs Operational Angola Benin Botswana Burkina Faso Burundi Cameroon Cape Verde CAR Chad Comoros Congo RBM Harmonization Working Group, May 2009 17 Country 2010 Targets LLINs ACTs Operational Côte D'Ivoire Djibouti DRC Equatorial Guinea Eritrea Ethiopia Gabon Ghana Guinea Guinea Bissau Kenya RBM Harmonization Working Group, May 2009 18 Country 2010 Targets LLINs ACTs Operational Liberia Madagascar Malawi Mali Mauritania Mozambique Namibia Niger Nigeria Rwanda Sao Tomé RBM Harmonization Working Group, May 2009 19 Country 2010 Targets LLINs ACTs Operational Senegal Sierra Leone Somalia South Africa Sudan (North) Sudan (South) Swaziland Tanzania The Gambia Togo Uganda Zambia Zanzibar Zimbabwe RBM Harmonization Working Group, May 2009 20 How to enhance your local successes in malaria control? 1. District level : Participate in District Health Plan design and implementation e.g. expand delivery capacity to ensure universal access 2. National level : Participate in GFATM application processes by using your comparative advantage e.g. commodities for remote populations, community engagement in malaria control, monitoring & evaluation 3. Subregional level : Participate in identification & resolution of implementation barriers e.g. through making available institutional capacity in sharing of good practices across countries in a subregion 4. Global level: Participate in Good Practice Working Groups e.g. Behavior change communication or participate in Global Governance e.g. through engaging in Northern NGO delegation 21 Together, we can make a difference! www.rollbackmalaria.org 22