Director-General

Closing session of the 5th Global Forum of the Roll Back Malaria Partnership

Yaounde, Cameroon
19 November 2005

Monsieur le Premier Ministre Mesdames et Messieurs les Ministres, Mesdames et Messieurs,

C'est un grand plaisir d'être avec vous à Yaoundé aujourd'hui. Je vous félicite de votre détermination à lutter ensemble contre le paludisme. L'appel de Yaoundé est une importante déclaration d'intention. Mais le plus important sera de donner une suite concrète à cet engagement. Nous devons rapidement appliquer plus largement les interventions qui sauvent des vies.

I would like to make just five points.

1. There is no excuse for continued low coverage of these interventions. There must be no further missed opportunities. The disease burden demands rapid and aggressive response. One million people dying each year from a preventable and treatable disease like malaria is simply not acceptable. The losses are mounting, in human, social and economic terms.

2. This is the time for a realistic assessment of how far we have come since 2000, and where we still have to go. Ambitious targets were set in Abuja. They are far from being met. This is an understatement.

3. We are in a much stronger position to address this problem than we were five years ago. Technical and financial resources have increased since 2000 when the goals were set. There is increasing political will to put an end to the problem.

The World Bank, the Global Fund, the US President's Malaria Initiative, and several bilateral donors have transformed the financial resources available to malaria control and raised its profile. The Gates Foundation has pledged $250 million to intensify malaria research.

Efficient technical tools are available and we are finding new ways of delivering them. The new, combination drug therapies including artemisinin are highly effective. But price and availability are still limiting factors. Safe, rapid diagnostic tests are supporting efficient treatment. Treated bednets can prevent disease and death. But only about 3% of children under five in malaria-endemic countries use insecticide treated nets. And only 15% of pregnant African women sleep under any kind of bednet.

Innovation in technical tools and delivery mechanisms has brought benefits. There are promising developments in the field of research, for example vaccines and preventive therapy to protect infants from both malaria and severe anaemia. However, further research is urgently needed to develop new tools, new drugs, new insecticides and support programme implementation.

4. An effective response demands a long-term national commitment. There are worrying signs that, in some countries, international funds are replacing national investment, instead of supplementing it. This is a time for increasing commitment, not reducing it. Malaria control is a long-term prospect. We need to face that and fund it accordingly. That means corresponding commitments from malaria-endemic countries. It also means accountability, transparency and good governance, which all play a vital role in sustainable funding.

5. There are critical surveillance, supply and staffing issues to resolve at country level. We must improve our monitoring of the disease and our response. Accurate numbers to assess disease burden, programme coverage, outcomes, and drug and insecticide resistance are essential. But good data are not available. It is still not clear how many people have access to effective treatment, nor how many people sleep under treated nets. These are fundamental requirements.

We must improve our supply mechanisms to ensure that effective tools reach the poor, in a reliable way. Efficient prevention and treatment is utterly dependent on this. Long-lasting treated bednets and effective modern drugs are available - they have to be delivered.

We must strengthen our health care infrastructure. Without enough skilled health workers, primary health care cannot function. Recruitment, training and retention are all critical - and not just for malaria.

The situation of HIV/AIDS in Africa is no less challenging than that of malaria. Yet the "3 by 5" initiative has demonstrated that it is possible to scale up a complex but life-saving intervention, even in resource-poor settings.

The G8 and others have committed to put resources behind the political will they have expressed, to achieve universal access to antiretroviral treatment for all those who need it.

We have an equally remarkable achievement in polio eradication. The polio epidemic in ten countries in west and central Africa has been successfully stopped. Polio eradication efforts are intensifying in Nigeria, where extensive disease transmission continues, as part of a mass polio campaign across 28 African countries.

These examples give us hope and encouragement that we can do the same for malaria.

Fighting malaria is not just about preventing deaths and relieving human suffering. It is also about giving the world's poorest a chance to improve their social and economic situation.

Thank you.

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