The 2010 Millennium Development Goals Review Summit - International Development Committee Contents


Written evidence submitted by Malaria No More UK

EXECUTIVE SUMMARY

  1.  Malaria No More UK is pleased to submit evidence to the International Development Committee (IDC) inquiry into the outcomes of the UN MDG Review Summit 2010. We wish to highlight the commitments made by the UK Government to achieving the health related MDG goals at the recent MDG Review Summit in New York: particularly those relating to malaria. We welcome the Government's renewed commitment to increasing spending on malaria from £140 million to up to £500 million pa by 2014; and to using its resources to help halve the number of malaria deaths in at least ten high burden African countries, in line with efforts to achieve the 2015 goal of near zero preventable deaths from malaria. Increased and sustained funding is critical in the global fight to reach the UN goal of ending preventable deaths from malaria by 2015. Looking ahead, we expect DFID to utilise the expertise and insight it has gained through its consultations on the Malaria Business Plan, and both Bilateral and Multilateral Aid Reviews, to translate these pledges into concrete and effective action to help achieve our ultimate goal, to make malaria no more.

BACKGROUND

  2.  Malaria No More UK is an innovative charity committed to ending suffering and death caused by malaria. The charity, founded in 2008, is part of a global movement to end preventable deaths from malaria by 2015, in support of the UN's Millennium Development Goals. There are MNM affiliates in the US, Canada and the Netherlands. MNMUK works to support programmes on the ground in Africa and in the UK to strengthen UK political and financial support and increase the UK public's awareness of the impact of malaria in Africa.

  3.  In September 2008, Malaria No More (US) was one of the organisations that helped organise a malaria side meeting at the UN MDG High Level Event. This meeting, attended by leading supporters of the fight against malaria including the then UK Prime Minister (Gordon Brown M.P.), resulted in commitment by key stakeholders to the Global Malaria Action Plan (GMAP). This plan set out a series of actions required to help reach the UN goals on malaria.

  4.  Two years on, Malaria No More UK attended the UN 2010 MDG Summit meeting and was part of the organising group for the High Level Malaria Event co-hosted by the African Leaders Malaria Alliance (ALMA), UK Mission, United Nations Special Envoy for Malaria and the Government of Tanzania on 22 September 2010. The Malaria Event produced an outcomes document, which we summarise below along with our own analysis of the significance of the Event.

  5.  Rather than repeat our colleagues' analysis, we recommend the Committee also examine the Action for Global Health UK's "Submission to IDC Inquiry on MDG Summit Outcomes 2010" for further information on other key health outcomes of the Summit. In this document there is an important analysis of the historic UN Secretary General's "Global Strategy for Women's and Children's Health" launched at the Summit to fast-track progress on MDGs 4 and 5 (child and maternal health).[30]

KEY MALARIA OUTCOMES FROM THE SUMMIT

  6.  The 2010 Malaria Event was an important opportunity to bring together key stakeholders involved in the fight against malaria. These included donor governments and agencies such as the World Bank and the Global Fund to Fight AIDS, TB and Malaria, along with African governments at the forefront of the effort to end malaria deaths. Malaria No More UK was pleased to support the organisation of the event as an opportunity to motivate key players, gain international recognition of the success so far in the fight against malaria and encourage future commitments to help ensure the achievement of the UN MDG on malaria.

  7.  Speakers at the Event recognised the important role that combating malaria will have in achieving several of the Millennium Development Goals. In addition to being an integral part of MDG 6 on infectious diseases, effective malaria control is also vital to achieving MDG 4, reducing child mortality, and MDG 5, improving maternal health. Malaria also has a significant financial impact on both household and national economies: costing Africa more than 12 billion dollars each year in direct medical costs and countless billions more in indirect costs and lost productivity.[31] Participants therefore recognised that improved malaria control will also accelerate economic development and help contribute towards MDG 1, the elimination of extreme poverty.

  8.  The Malaria Event celebrated recent global achievements in the fight against malaria, particularly towards achieving the 2010 target of "universal coverage" of malaria prevention measures and the 2015 target of near zero preventable deaths from malaria. These achievements include the delivery of more than 300 million Long Lasting Insecticide Treated Nets (LLINs) to communities in Africa since 2007. The Event also highlighted findings from the recent Roll Back Malaria (RBM) Partnership report estimating that, since 2000, coordinated international efforts to combat malaria have resulted in:

    — Nearly three-quarters of a million children's lives saved across 34 malaria-endemic African countries—85% of these since 2006 when international efforts were intensified.

    — Child malaria mortality reduced by 18%; with 485 children saved from malaria related deaths every day in 2010.

  The RBM report also predicted that, if universal prevention coverage is achieved and sustained, a further three million children's lives could be saved by 2015.[32]

  9.  Gains over the last few years in scaling interventions and reducing the impact of malaria are cause for celebration and hope that we can achieve the malaria MDG targets by 2015. However, the Event also recognised the scale of the challenge remaining, with malaria still causing the death of a child in Africa every 45 seconds. It's estimated that between US$ 5 billion and US$ 6.2 billion per year is needed to achieve the 2015 goals, however, currently commitments up to 2011 account for just 25% of the estimated need to meet the Global Malaria Action Plan targets. Increased and sustained support is vital in continuing the momentum towards universal coverage and ending deaths from malaria.

  10.  The UN General Assembly MDG Summit outcomes document emphasised the importance of African leadership and the international community's role in supporting and sustaining national efforts and programmes to combat malaria. It also reiterated the value of integrating malaria prevention, diagnosis and treatment interventions.[33] Strategies to address malaria will need to include: increasing coverage and use of long-lasting, safe insecticide-treated bed nets and indoor residual spraying to prevent malaria; availability and accessibility of affordable, quality and effective diagnostic tools—such as rapid diagnostic tests, and treatment—including Artemisinin Combination Therapy; as well as ongoing research into development of malaria vaccines.

DFID'S ROLE IN DELIVERING AGREED STRATEGIES

  11.  We welcome the leadership shown on malaria by the UK, especially the Deputy Prime Minister and the DFID Secretary of State, during the MDG Review Summit and particularly as a co-host of the Malaria Event. At the 22 September Malaria Event, the UK Government committed to using its resources to help halve the number of malaria deaths in at least ten high burden African countries, in line with efforts to achieve the 2015 near zero preventable deaths from malaria goal. The Government also re-iterated its pledge to increase funding for malaria from £150 million to up to £500 million per year by 2014, and to review how malaria interventions could be included across all DFID's programmes. This additional funding will come from the UK continuing to increase its spending on official development assistance (ODA) in order to reach the Government target of 0.7% of GNI by 2013.

  12.  Two specific programme commitments were announced by Secretary of State Andrew Mitchell on behalf of the Malaria Event co-host, Deputy Prime Minister Nick Clegg. These represent the first phase of DFID's increased support for scaling up malaria prevention and treatment:

    (a) "UK aid will save 5,500 children's lives in Zambia by increasing access to malaria prevention, diagnostics and treatment."

    (a) "In Ghana the UK will supply 2.4 million new insecticide-treated bednets, enough to save 13,000 lives a year."[34]

  13.  Given Malaria No More UK's work to support programmes in Africa, particularly in Ghana, we were delighted to hear these commitments confirmed and look forward to seeing the impact of these interventions in the coming months. Meanwhile the exact strategy, mechanism, funding and focus for the bulk of the UK's increased commitment to the global fight against malaria has yet to be decided. This will be informed by the outcomes of DFID's current reviews of multilateral and bilateral aid spending and the development of the malaria business plan. It will also be influenced by the DFID business plan on reproductive, maternal and newborn health, given that most (over 85%) malaria deaths tragically occur in children under five and pregnant women. The results of this work will not, we understand, be released before early next year. We look forward to the outcomes of these reviews, the business plans, and to a clear roadmap of how UK aid will support the push to meet the UN malaria goals by 2015.

  14.  Recommendation: We encourage DFID to incorporate and reflect the expert testimony it has gained through its consultations with a wide range of stakeholders in preparing these business plans. As the majority of the significant gains to date have been made in lower prevalence countries, we urge DFID to continue to support countries with a high malaria burden to scale up their capacity and ability to respond to malaria more effectively.

  15.  The Malaria Event at the MDG Summit highlighted the critical role that the Global Fund to Fight AIDS, Tuberculosis, and Malaria (GFATM) and the World Bank's International Development Association (IDA) play in supporting the international malaria response; jointly representing approximately three quarters of international malaria funding. The announcement of this week's Global Fund replenishment shortfall (following the pledging conference on October 5) is a significant blow to international efforts to meet the MDGs on health. As illustrated in the Roll Back Malaria report, there is a direct correlation between malaria funding and lives saved.[35]

  16.  Recommendation: We ask the IDC to recognise the importance of the UK making its "fair share" contributions to both the GFATM and IDA—assuming they will receive positive assessments of performance in the Multilateral Aid Review.

  17.  As a malaria focused organisation, we welcome the Government's commitment and leadership in the global push to reduce the impact of this devastating disease. However, we recognise the critical interconnectedness of all the MDGs, particularly those relating to health.

  18.  Recommendation: We call on DFID to ensure increased malaria funding compliments rather than detracts from DFID's efforts to support other health priorities, by supporting the strengthening of health systems as a compliment to improving access to vital malaria prevention, diagnosis and treatment tools. It is in this context we also look forward to publication of the DFID business plan on reproductive, maternal and newborn health.

THE ROLE OF THE UN, THE WORLD BANK, THE EUROPEAN COMMISSION AND NGOS IN SECURING AND DELIVERING SUMMIT OUTCOMES, AND HOW THESE ORGANISATIONS WILL BE HELD ACCOUNTABLE FOR ACHIEVING THEM AND THE ROLE OF DEVELOPING COUNTRIES IN SECURING AND DELIVERING THE SUMMIT OUTCOMES

  19.  The UN plays a critical role in the fight against malaria and both the UN Secretary General and the UN Special Envoy for Malaria were central to efforts to organise the Malaria Event and to securing future commitments from key partners. We strongly support their efforts to help achieve the UN MDG on malaria and are very grateful for their leadership.

  20.  Recommendation: As a significant donor, we believe the European Commission could take further steps to help financially support efforts to reach the malaria goals. We encourage the UK government to press the Commission for a statement clarifying the Commission's future commitments to this end.

  21.  Recommendation: As noted above, the World Bank's International Development Association (IDA) is a significant source of funding for efforts to tackle malaria. We are pressing the UK government, as the largest funder of IDA, to use the upcoming replenishment to ensure the World Bank continues to prioritise malaria. At the Malaria Event, President Zoellick detailed some key ways in which the World Bank has already contributed significant resources in countries such as Nigeria. We are urging all IDA donors to press for such support to continue, particularly following the initially disappointing results of the GFATM pledging conference.

  22.  Recommendation: To sustain and increase African leadership in the fight against malaria we recommend DFID continue to support the work of the African Leaders Malaria Alliance (ALMA). The importance of ALMA's leadership in helping to achieve the significant advances in coverage of long lasting insecticide treated nets and indoor residual spraying prevention measures in Africa was recognised at the Malaria Event. ALMA now has a critical role in ensuring that the remaining prevention gaps are closed in the push to achieve universal prevention coverage. They will also play an increasingly important role in coordinating and monitoring malaria testing and treatment coverage and surveillance reporting on progress. It was very inspiring to hear a number of African leaders announce significant progress towards achieving the UN 2010 and 2015 malaria goals at the Malaria Event, and outline their work to better regulate use of medicines to treat malaria.

  23.  Developing countries and civil society organisations have the opportunity to help achieve further progress on the UN malaria goals through their submissions to the Global Fund to Fight AIDS, TB and Malaria (GFATM). Thanks to the unique way the Global Fund is constituted the country coordinating mechanisms are able to determine their own funding and programme priorities.

  24.  Recommendation: We urge countries to use the GFATM effectively to continue to push towards their national malaria control or elimination goals and put an end to preventable malaria deaths.

LOOKING AHEAD TO AFTER THE MDG DEADLINE OF 2015

  25.  The critical importance of increasing and sustaining gains made to tackle malaria in order to reach and move beyond the 2015 goals cannot be underestimated. We are determined to help the international community to achieve the goal of near zero preventable deaths from malaria along with universal coverage of effective malaria interventions.

  26.  Recommendation: We encourage the UK Government to adopt the Roll Back Malaria campaign's post-2015 position of sustaining and continuing gains made in achieving the MDG malaria goals by supporting efforts to ensure:

    — Global and national mortality stays near zero for all preventable deaths.

    — Universal coverage (which translates to ~80% utilization) is maintained for all populations at risk until local field research suggests that coverage can gradually be targeted to high-risk areas and seasons only, without risk of a generalised resurgence.

    — Countries currently in the pre-elimination stage achieve elimination.

  27.  In the long term, our hope is that malaria will ultimately be eliminated worldwide with the help of new technologies including an effective vaccine. In the meantime we urge the UK and global partners to continue to invest in researching new technologies and to maximise utilisation of the plethora of effective tools we currently have at our disposal to ensure malaria control and achievement of the 2015 UN malaria goals.











30   http://www.un.org/sg/hf/Global_StategyEN.pdf Back

31   Gallup & Sachs. The economic burden of malaria. American Journal of Tropical Medicine and Hygiene. 2001.64(1,2) S. Back

32   Saving Lives with Malaria Control: Counting Down to the Millennium Development Goals-authored by Tulane University, Johns Hopkins University, WHO and PATH. Published 14 September 2010 by the Roll Back Malaria Partnership (RBM). Back

33   "Keeping the promise: united to achieve the Millennium Development Goals"-UN General Assembly Summit Outcome Report Sept 2010: http://www.un.org/en/mdg/summit2010/pdf/mdg%20outcome%20document.pdf Back

34   http://www.dfid.gov.uk/Media-Room/Press-releases/2010/Clegg-UK-to-lead-global-efforts-to-combat-malaria/ Back

35   Saving Lives with Malaria Control: Counting Down to the Millennium Development Goals-authored by Tulane University, Johns Hopkins University, WHO and PATH. Published 14 September 2010 by the Roll Back Malaria Partnership (RBM). Back


 
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