CIRCULATION COPY: PLEASE CHECK AGAINST DELIVERY
Address by
His Excellency President Olusegun Obasanjo
at the Opening of the African Summit on Malaria
Abuja, April 26, 2000
I am most delighted to see you all here today at an event which I very much hope will mark the beginning of the end of malaria in Africa.
Let me begin by welcoming my brother heads of State who have taken time of their tight schedules to be present at this crucial Summit that merits the description of a life-and-death issue for us on the continent of Africa. I sincerely hope that this gathering of political leaders to fight a killer disease will lead to firm decisive action that will have a profound effect on the prospects of improved health for our continent.
I wish to particularly extend a warm welcome to my friend and the Director General of the World Health Organisation Dr Gro Bruntland. This Summit is a direct product of a meeting I had with Dr Bruntland a year ago, during my goodwill tour as president-elect. Dr Bruntland and I instantly connected on the subject of malaria as the priority health concern for the continent of Africa. On behalf of all my fellow African leaders, I wish to express our deep appreciation for Dr Bruntland’s vision and incalculable input - personal as well as that of WHO - into making this summit a reality.
Malaria has always been part of human history for as long as anyone can remember. But it has not always been solely an African problem, as it is today.
Up till about 150 years ago malaria was found practically everywhere in the world. One hundred years ago, it was still a public health problem in southern Italy and Spain to mention just a few countries in Europe. Today, it has been eliminated from North America and practically all of Europe. It is now a problem of the Southern hemisphere, and the tropics in particular. Malaria is now classified as a tropical disease. But we are all aware of the tragic coincidence that the tropics happen to be predominantly inhabited by the poorest people of the world. And a ‘tropical disease’ often assumes the meaning of a disease of poverty, ignorance and squalor, with the disease usually being both cause and effect of these deplorable human conditions. In other words, malaria is a product of underdevelopment and also a cause of underdevelopment.
Thus malaria can rightly - even if not honourably - be called an African disease. It is estimated that every year up to 500 million people worldwide suffer malaria attacks, 90 per cent of these are Africans. There are up to two million deaths each year - again 90 per cent of these are Africans. Malaria kills one African every 15 seconds! In the brief period that I have so far being speaking maybe TEN African have already died of malaria. Your Excellencies, this rate of death among our people, in the 21st century, is avoidable. And I would like this Summit to start on the basis that these deaths are unacceptable.
Malaria has a multi-layered impact on our society and development:
► 1] practically every family has a case of malaria every year;
► 2] in the low-income families medication could cost as much as 25 per cent of their annual income;
► 3] hundreds of millions of working hours are lost due to debilitated malaria sufferers who are unable to work;
► 4] malaria is responsible for a large number of miscarriages and eventual deaths among pregnant women;
► 5] malaria is also responsible for a large proportion of infant mortality and death among children; and
► 6] it is responsible for a large number of children missing school, impeding their educational development.
The overall consequence of malaria on the lives of Africans translates into an annual loss of as much as 1.3 percentage points of growth, as compared with countries without malaria.
There are those who optimistically extrapolate that Africa of today would have been as much as 50 per cent better off in terms of economic prosperity, had it not been for the burden of malaria.
You might not agree with this hypothetical projection, but there is no disputing the fact that African regeneration will remain impaired for as long as the scourge of malaria exists at current levels. Malaria has contributed immensely to our impoverishment and will no doubt continue to keep us poor.
Indeed, the scourge of malaria constitutes a developmental vicious circle which this Summit must resolve to break.
Now the question arises: why is the malaria situation improving in other tropical regions but getting worse in Africa? I am not sure that there is one single answer to this. But one might be the lack of commitment from governments at home and from international healthcare agencies.
The first global fight against malaria began fifty years ago with an attempt at eradication. Regrettably, Africa was deliberately overlooked, because, it was said:
► they didn’t know enough about the malaria situation in Africa at the time, and
► Africa was said to lack the human and material resources needed to carry out the programme.
These reasons were at best lame excuses, and at worst plainly ridiculous.
Unfortunately, this international neglect has persisted until today. In spite of this, Africans have mustered their scant resources to battle malaria in a rare demonstration of unity of purpose.
Africans have consistently put it to the world that malaria is the number one health problem. When recognition of the HIV/AIDS virus came to the fore, Africans continued with their message that malaria was still killing more people. But we went unheeded.
HIV/AIDS had stolen the show and was getting as much as a thousand-fold more recognition and resources allocated to it than malaria. Today there are those who want to debate the statistics of which one kills more, malaria or HIV/AIDS. It is no longer relevant as the two diseases have combined to form a lethal partnership that threatens the very existence of our societies.
The full extent of this lethal partnership is illustrated by the fact that both diseases exploit the weakened physiological state of humans. Malaria, which has been around longer, makes its victims susceptible to HIV infection, and an HIV infected person is more likely to die from malaria. Malaria kills, but with HIV/AIDS it kills even more.
This is not a plea for resources for malaria to match those for HIV/AIDS; instead it should be recognised that given the nexus of malaria and HIV/AIDS, it makes no practical sense to spend so much on one, while leaving the other underfunded.
An already weakened health care delivery system is further burdened by HIV/AIDS. And this lethal partnership with malaria is happening at a time when Africa is on her back, flattened by the steepest economic decline since independence which consists of:
► negative growth,
► a sharp decline in investment,
► low productivity,
► a massive rise in debt obligations, and
► the general pauperization of African societies
We have reached a stage now whereby the small amount we could have allocated to combatting malaria and improving our health care, is having to be used to service our debt. We were made poor by malaria, the debt burden has exacerbated the situation.
This point cannot be over-emphasised: the gravity of the malaria problem, with all its ramifications, provides a strong case for the forgiveness of ALL African debts. It might be argued that debt cancellation may not be an instant panacea, but the stranglehold of debt obligations on our developmental priorities is such that no realistic anti-malaria efforts - or indeed any development strategy - is conceivable or meaningful with these debts hanging around our necks.
The Roll Back Malaria initiative which is the backbone of this Summit is the latest on the short list of global initiatives that have been pursued in the past fifty years. The challenge presented by malaria was taken up by African Heads of State when malaria was, for the first time ever, placed on the agenda of the annual Summit Meeting of the Organization of African Unity held in Harare in 1997. At that meeting African Heads of State passed a resolution committing themselves to an intensified effort to control malaria in the region within the framework of the Global strategy for malaria control and the African Malaria Initiative which was adopted by the World Health Organization African Region the following year.
With the launching of the Roll Back Malaria Initiative, co-sponsored by four of our development partners in 1997, a new window of opportunity has been opened for us to take forward our malaria control effort building on experiences gained from our recent endeavours.
Unlike the Malaria Eradication campaign of the 1950s and 60s which completely ignored Africa, this new initiative has Africa as its central focus and target. The initiative recognizes that malaria is now predominantly an African problem and that attempts to control it must concentrate efforts and resources where the problem mostly lies. The initiative therefore aims to employ strategies that have the highest potential of succeeding in Africa.
It is my hope that this Summit will result in an international movement to deal with the scourge of malaria. I envisage such a movement will rapidly achieve substantial results. For example, we could aim to have every African at risk sleeping under insecticide treated bed-nets within a year. It would be an action similar to the provision of condoms in the fight against HIV/AIDS. This target is realistic if this Summit manages to galvanise support from government, international agencies, our development partners, private sector and all those who share our concerns for substantial improvement in the lives of Africans.
I will go even further. This summit should include in its plan of action the aim to put in every African home anti-malaria first aid kit fitted with equipment for simple diagnostic tests and affordable drugs for early treatment. For it is well-known that early diagnosis and rapid treatment massively reduces death from malaria and limits the spread of the parasite. In this regard, we are hoping to able to count on the support of our international friends in the drug industry. I am confident that if we get this support, we ought to see this anti-malaria first aid kit in every at-risk household within a year. This is a target worthy of this Summit.
Research into malaria has been with us for centuries, ever since Europe made contact with Africa. It is, however, sad to note that in the cases of many other diseases that were subsequently discovered, effective cures were found much sooner, following shorter but more intensive research activities.
The truth is, malaria remains an impoverished Cinderella. The total global expenditure on malaria research stands at 84 million US dollars, compared with 900 million US dollars for HIV/AIDS. Global expenditure per fatal case is 42 US dollars for malaria and almost 800 US dollars per fatal case of asthma.
Research scientists reckon that an effective vaccine for malaria could be ready in ten to fifteen years. This calculation is based on the current pace of research. This pace can - and should - be speeded up. I urge this summit to include in its plan of action the need for a massive and coordinated investment into malaria research, with the aim to achieve effective results within five years.
The thrust of the new initiative is the building of infrastructure for malaria control. Considering that actions to roll back malaria are to be undertaken within the context of an efficient general health service, we have a responsibility to reform and strengthen our healthcare delivery system to provide a solid structure within which malaria control actions can operate. Adequate financing is a must for the provision of good sound health and social infrastructures. Malaria control actions in Africa have long suffered from inadequate financing.
The principal role of our development partners would be in the area of funding. We are well aware that such funding would only be forthcoming when there is visible evidence of both political and significant financial commitment to malaria control on our own part.
The human gains from eliminating malaria in our region are there for everyone to see. Not the least of these would be the 1 – 2 million children’s lives saved. The economic gains are also clear: certainly, we can do with the 50 per cent increase in our Gross Domestic Product (GDP) that is expected to follow malaria control.
Your Excellencies, we may well ask: is malaria control achievable in Africa given our prevailing social and economic circumstances? The answer to that question has to be a resounding “yes”. Several non-African tropical countries with a level of economic development not significantly higher than ours have been steadily reducing their malaria burden in the past few years through committed implementation of well-targeted strategies for malaria control. If they can do it, so can we.
What we need is simple basic and effective treatment, prevention through the use of insecticide treated bed-nets and cheap drugs, vaccination, environmental sanitation and elimination of mosquitoes through technologies that, for instance, can manipulate their life cycles.
Your Excellencies, malaria has for too long had things its own way in Africa. It debilitates children and adults alike for several days each year draining our economic resources and impairing our capacity for economic productivity, development and growth. It turns a normal physiological process like pregnancy into a nightmare. We have no excuse for accepting the inevitability of malaria. Yes, there is a lot we can do to halt its devastating effect on our peoples. The world has once again woken up to the scourge of malaria and there is now a determination to break the back of it once and for all.
I would like at this point to appeal to our development partners and the international organisations here present to please make available adequate resources to deal effectively with the nexus of malaria and HIV/AIDS. This means debt forgiveness and increased Overseas Development Assistant for Africa.
There is enough knowledge to commence our final assault on malaria. A primary aim of this summit must be to unite our efforts, pool our resources and summon the active support of our international friends for the task ahead.
The critical element still remains our determination, our will and our resolve to use available knowledge and resources to achieve our goal of vastly improved health conditions for Africa.
This is not a challenge we can afford to shy away from. Our people expect us to deliver, we owe it to them to deliver, and we must leave this summit with an irrevocable commitment to deliver. As political leaders, we must give the leadership through political will and courage. Let us give ourselves ten years to put malaria under absolute control.
Your Excellencies, it is now my pleasure and honour to declare open this unique Summit with its unique opportunities to brighten the future of Africa.
May God guide our thoughts and deliberations.
I thank you.