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Africa Policy E-JournalAfrica: Roll Back Malaria +++++++++++++++++++++Document Profile+++++++++++++++++++++ Region: Continent-Wide +++++++++++++++++end profile++++++++++++++++++++++++++++++ Dr. Gro Harlem Brundtland, Launch of Roll Back Malaria "Why have we taken this initiative? First, because we share the concern of the rising human suffering from malaria - on all continents - but above all in Africa where this re-emerging disease represent more than 10% of the total disease burden. 3000 children die every day of malaria. Every year there are about 300-500 million clinical cases of malaria, 90% of them occuring in Africa. This is above all the disease of the poor - killing the young and the weak mostly living in rural areas in Sub Saharan Africa. Second, because we share the concern of the severe impediment malaria is putting on the economic and social development of so many countries. Some studies indicate that malaria can hold back income by as much as 12%. Where there is malaria, there is likely to be severe strains on foreign investments. Third, because we believe we can do something about it. We do not talk of eradication - that was tried some decades ago - it succeeded in some continents but failed severly on others. We are aiming at a concerted action to significantly reduce mortality and morbidity from this disease. ... We in the World Health Organization are calling Roll Back Malaria a pathfinder - and we do so for three reasons:
This is key. This is not another "rapid in - rapid out" operation. Our aim is to focus on the health sector's ability to cope with malaria - at a national level and especially at a local level. When a child gets the malaria fever, time is short - very short. Rapid access to drugs is critical. That means that we have to focus on how the health sector can provide these services - which are low-tech and not very expensive. The same goes for prevention. Malaria can be better contained - much better than today. The simple use of impregnated bednets can save scores of sleeping children from the death-carrying mosquito. So we need to get these simple tools out there where they can do so much good. And finally - we need to push for the ultimate solution - a malaria vaccine. That is not for tomorrow - but is getting within a new reach which may offer hope. Industry is engaging in Roll Back Malaria and so is research. We need to be there to take immediate advantage of scientific advances as they see the day."
Fact Sheet No 203 October 1998 ROLL BACK MALARIA Upon taking office in July 1998, the World Health Organization's (WHO) new Director-General, Dr Gro Harlem Brundtland, decided that malaria was to be one of WHO's top priorities. It was evident that malaria was both a top political priority among African leaders and that it was still a major health scourge in many parts of the world, in Africa above all. There are an estimated 300-500 million cases of malaria per year. The majority of these occur in Africa, while the vast majority of the estimated 1 million annual deaths from the disease occur among children, and mainly among poor African children. Malaria is above all a disease of the poor, impacting at least three times more greatly on the poor than any other disease. Although malaria had been a priority of WHO since its inception in 1948, malaria control efforts, Dr Brundtland found, had often suffered from a lack of financial resources and uneven implementation. She thus resolved, upon taking office, to find a means of focussing the world's attention and support on renewed and redoubled efforts to beat this scourge of the young and the poor: Roll Back Malaria. RBM's objectives Roll Back Malaria (RBM) is as an opportunity not only finally to beat a devastating disease, but also to develop endemic countries' health systems and build new means of tackling global health concerns. Thus, the goals of RBM will include:
RBM's implementation at country level will provide an indicator of the effectiveness of these health systems, while the programme will also serve as a model for WHO in developing both other global health and development initiatives and new methods of controlling infectious diseases. RBM: a new approach to malaria control WHO will establish a functioning partnership with a range of organizations at global, regional and country levels, which results in development of a sustained capacity to address malaria (and other priority health problems). WHO's partners in RBM will include malaria endemic countries, other UN organisations (on 30 October 1998, the United Nations Development Programme, UNICEF, the World Bank and the World Health Organization announced that the four agencies were launching RBM jointly and that they would cooperate in all aspects of its activities, see press release WHO/77), bilateral development agencies, development banks, non-governmental organisations and the private sector. WHO's role in the global partnership will be to:
The role of UN partner agencies UNICEF will:
UNDP has committed to the following actions, as malaria has important implications for health and poverty. Effective responses will require broad-based support across sectors and the involvement of a range of development partners. At country level, UNDP will:
At regional/sub-regional levels, UNDP will:
At global level, UNDP is:
The World Bank Group strongly supports the Roll Back Malaria global partnership. Malaria has a major impact on social and economic development. Consequently, the Bank has committed to:
Together with Roll Back Malaria partners, the Bank will actively pursue these activities through its country programmes and research agendas. Malaria must be reduced as a negative factor on macro-economic growth. RBM's first focus: Africa The Roll Back Malaria campaign will focus first on Africa. It is aimed at:
At country level, RBM will work towards development of sustained capacity to address malaria (and other priority health problems) that is adapted to local realities, and delivering measurable and properly validated results. RBM will support the building of coalitions for action at regional and country level, and assist with development of clear, evidence based action plans at country and regional levels. RBM will develop a systematic approach to monitor progress and results, and broker financial and technical inputs into countries. RBM will support Resource Networks which will facilitate the implementation of RBM in endemic countries by providing support in specialised areas, e.g.:
Most victims of malaria die simply because they do not have access to health care close to their home, or their cases are not recognized as malaria by health care professionals. In addition, life saving drugs are often not available. In Africa, RBM will create a network of teams to go into villages and analyze treatment and prevention practices at the household and community level, the availability and quality of health care by the public and private sector, and potential local partners. RBM will provide technical and financial support for each analysis through this network at the district level. In African districts with stable, high transmission malaria, RBM will simultaneously seek to significantly improve early diagnosis and appropriate treatment of malaria-related fevers in children, early treatment/prevention in pregnant women, and personal protection for children and pregnant mothers through the use of insecticide impregnated bednets (IIBNs). In many districts, this will require reinforcement of the local public and private health sector, focusing on activities at the community level. RBM will also attempt to upgrade the training of health care providers to ensure quality care after the campaign ends. RBM will set up a resource network throughout Africa to forecast malaria epidemics and their prevention. The network will link surveillance information from countries and regional surveillance systems and establish the means of routine and rapid analysis of this information for forecasting and early detection of epidemics. Regional, sub-regional or country strategies for epidemic preparedness and emergency action will be formulated. The resource network will also be used to track the quality and supply of drugs used to treat malaria. Geographic mapping of malaria and health care For countries participating in RBM, national malaria information will be integrated with regional information to produce a comprehensive national malaria control map, as part of the international mapping of the disease. The information will allow a better estimation of the burden of malaria and the population at risk, and hence a better assessment for RBM. It will also provide more reliable and area-specific information for national and international advocacy for malaria control. Where RBM operations have started, information on the availability and quality of health services and the results of monitoring and evaluation will be added to the data base. The road forward RBM will be in a "roll-out" phase until the end of 1999. By that date, RBM will have:
The general objective of RBM will be to significantly reduce the global burden of malaria through interventions adapted to local needs and by reinforcement of the health sector. Goals are to be set by countries based on situation analyses and assessment of feasibility, and could include: malaria morbidity and mortality goals; financial goals (e.g., significant increase in resources available for community level activities in health care); accessibility goals (e.g., Percentage of population with access to early and adequate treatment); coverage goals (e.g., Proportion of the targeted population with insecticide treated bed nets); health sector reform goals (e.g., New partnerships with private sector health care providers); goals of policy change (eg., Significant changes in policy favouring evidence-based strategy development). Performance indicators will also be used to assess the RBM Project: WHO's link with external partners e.g., capacity of WHO to support the global partnership. WHO's impact on country level operations. WHO's in-house working arrangements. RBM team Roll Back Malaria will be run with a central team of eight to 10 people headquartered in WHO in Geneva. The team will be led by Dr David Nabarro, who until his appointment as RBM project manager was Chief Health Advisor and Strategic Director of the United Kingdom Department for International Development.
For further information, journalists can contact the Office of Public Relations, WHO, Geneva. Telephone (41 22) 791 2584. Fax (41 22) 791 4858. Email: info@who.ch. All WHO Press Releases, Fact Sheets and Features as well as other information
on this subject can be obtained on Internet on the WHO home page http://www.who.ch/
Documents previously distributed in the e-journal are
available on the Africa Action website: To be added to or dropped from the e-journal subscription list, write to e-journal@africaaction.org. For more information about reposted material, please contact directly the source mentioned in the posting.
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Africa Policy E-Journal
