Any disease that each year incapacitates 220m Africans – or more than 30 per cent of the population – and kills 1m is a global emergency.
Malaria bleeds the continent to the tune of $12bn in direct costs every year, resulting in an annual loss of an alarming 1.3 per cent of gross domestic product growth.
Our fragile health systems are groaning under the strain – up to 50 per cent of patients are those suffering from the disease during the malaria season and it places great demands on already limited resources, both financial and manpower.
In some countries, 40 per cent of the public health spending is swallowed by this scourge.
Because of lost man hours, many families are not able to earn, plant, or harvest enough to survive on their own. The disease sends productivity levels plunging in critical sectors, such as farming, mining, and manufacturing, and causes children to miss school.
Five of Africa’s most populous countries – Nigeria, Democratic Republic of Congo, Ethiopia, Tanzania and Kenya – with immense agricultural, mining, manufacturing and service potential have the most malaria cases in the world. This alone is a huge blow to the continent.
In addition, there are malaria-endemic countries battling their way out of conflict, with fragile economies under enormous strain. Poor households that have little money to survive on or to send their children to school, are spending up to $7 per family member per year on prevention, care and treatment. For many, this may constitute up to 10 per cent of their annual income.
For us in Africa, the fight against malaria is an economic, social, ethical and political imperative.
It is for this reason that African heads of state and government are putting its people first. The African Leaders Malaria Alliance (Alma) views Malaria as a ferocious public enemy that must be fought until it is eliminated.
Alma has determined that in order to do this effectively the continent and its partners must achieve 5 Rs.
First we must Regroup. In Abuja in 2000, African heads of state and government agreed on a set of targets to be met by the end of this year.
The UN secretary general reinforced this in 2008, when member states resolved to achieve universal coverage with effective interventions by the end of 2010. In September last year, African leaders formed Alma. The heads of state appreciated the progress that had been made, with the support of development partners.
They felt there was enough evidence to prove that the targets were attainable. Zanzibar for example has already reached universal coverage. Alma met again in Addis Ababa in February to assess progress and identify challenges and solutions.
Second we must be Resolute. There are many competing development priorities. The dire food, fuel and financial crises that battered the globe and Africa have taken their toll, but effective control of malaria will free much needed resources to address the pressing challenges of development. Prioritising malaria means putting people and development first.
Third we must Rebuild. Africa’s health systems have suffered greatly in the past decade, as our attention was drawn away from integrated primary health care models. In Addis Ababa, the Alma heads of state and government called on partners to reach out with the technical support required to create robust integrated, comprehensive health management information systems.
Fourth we must make Resources available. Both national and international efforts have to be marshalled for the herculean task ahead.
National governments must move closer to the 15 per cent budget allocation to health that heads of state and government committed to in Abuja. Development partners must protect their investment in Africa by helping us defeat the disease. The fruits of their labours and our toil will then be more achievable in every other development area.
Fifth Africa’s people deserve Results. Universal coverage with indoor residual spraying (IRS), long lasting insecticide-treated nets (LLINs), rapid diagnostic tests (RDTs), and artemisinin combination therapy (ACT) are going to deliver the millennium development goal of reducing child mortality for our countries. In malaria -endemic countries, up to 40 per cent of deaths in under five-year-olds can be from malaria.
Delays in vital drugs and other anti-malaria adjuncts reaching those who need them have been reduced by the removal of taxes and tariffs. The banning of monotherapies means we have treatments that work. This saves lives and protects man hours spent in productive work.
“The malaria decade” ends this year. Therefore we must sustain the investments and gains we have made every year after. Alma hopes for an Africa free of malaria, a serious impediment to development and the well-being of Africa’s people.
Jakaya Mrisho Kikwete is president of Tanzania. Joy Phumaphi is interim executive secretary of the African Leaders Malaria Alliance