AFRO-NETS> DATELINE HEALTH NIGERIA: Supplement on Roll Back Malaria Summit

[A Odutola <chpss_abo@yahoo.com>]

DATELINE HEALTH NIGERIA: Supplement on Roll Back Malaria Summit
---------------------------------------------------------------

Report on Roll Back Malaria Summit
held in Abuja, Nigeria
April 24 - 25, 2000

In a broad bold initiative to tackle the scourge of malaria epidemic 
in Africa, which experts warned is more devastating than the dreaded 
Acquired Immune Deficiency Syndrome (AIDS), Nigeria organized an Af-
rican Head of State Summit on Roll Back Malaria on April 24 and 25, 
2000 at Abuja.

To underscore their seriousness to tackle the scourge of malaria epi-
demic, the Summit was attended by 21 African Heads of States, Minis-
ters from the Group of 8 countries and the leaders of Organisation of 
Economic Cooperation and Development countries (OECD).

Malaria has indeed been the major cause of death in Africa more than 
anything else (war or famine). The statistics are horrifying. About 
255 million of the 300 million cases in the world are found in Af-
rica. This is 85 percent of the global total. In Nigeria alone, 60 
million experience malaria attack at least twice in a year, with no 
less than 80 percent of the population exposed to the disease. 225 
children in Africa die every two and a half hours, while about 2173 
children under the age of five die daily in the continent from ma-
laria.

Nigeria's President Olusegun Obasanjo put it more clearly in his 
opening address at the Summit when he noted that Africa loses between 
$7 billion and $12 billion yearly to the deadly scourge. Professor 
Jeffrey Sachs, Director of the Harvard Institute of International De-
velopment, and a participant at the Summit argued that the prevalence 
of malaria has continued to be a major cause of the underdevelopment 
of the continent. According to him, until malaria is effectively 
brought under control, other macro-economic and related policies will 
continue to fail in addressing the African Development crisis. The 
link between malaria and development is very clear. Malaria reduces 
productivity of labour and increases the already high mortality rate 
of the African population. It also aggravates the incidence of pov-
erty by reducing the capacity of the poor to earn sustainable liveli-
hood. The poor are more likely to die from malaria attack than the 
rich because of inability to meet the cost of treatment.

With all these in mind, the Summit set out to review strategies for 
reducing by half within 10 years the number of malaria related death. 
Several experts offered suggestions as to how this goal can be 
achieved within the time frame.

Director-General, United Nation Education, Scientific and Cultural 
Organisation (UNESCO), Mr. Koichiro Matsuura, canvassed debt swaps 
for science as a way of reducing the heavy indebtedness of Africa 
thereby making it possible for her to make progress. UNESCO, Matsuura 
explained, has produced a guide to the scourge. He pledged commitment 
to raising African and global awareness about the devastating effects 
of malaria in Africa, especially among women and children.

World Health Organisation (WHO) on its own said that it would spend 
about $10 billion on the Roll-Back-Malaria in Africa programme in the 
next 10 years. According to WHO Director of Roll-Back-Malaria (RBM) 
in Geneva, Dr. David Nabarro: "an estimated cost ranging between $300 
million and $1 billion would be needed to fight the malaria scourge 
yearly for a decade in Africa." Nabarro stated that at the moment, 
$500 million would readily be available through donor agencies as 
their contribution toward combating the devastation caused in the so-
cial economic frontiers on the African continent.

At the end of the two-day Summit, African leaders resolved to sub-
stantially increase funds allocated by their countries for combating 
the dreaded disease in a working document titled "Abuja Declaration 
on RBM in Africa." Participants agreed to reduce or waive taxes and 
tariffs on mosquito nets, insecticides, and anti-malaria drugs. They 
urged international donors to donate $1 billion yearly towards the 
fight against malaria in Africa.

African leaders present at the Summit also called for appropriate and 
sustainable action to be initiated to strengthen health systems in 
the region, and to ensure that by the year 2005 at least 60 percent 
of malaria sufferers would have prompt access to correct, affordable 
and appropriate treatment within 24 hours of the onset of symptom. 
The Abuja Declaration on RBM in Africa document calls for the promo-
tion of community participation in the ownership and control of RBM 
schemes to enhance their sustainability, and in order for diagnosis 
and treatment of the disease to be available and easily accessible to 
the poorest groups in the community. The Declaration urged creditor 
nations to consider canceling African countries' debt in order to re-
lease more funds for Poverty Alleviation Programmes, including Roll-
Back-Malaria Initiatives.

The decision to hold the African Roll Back Malaria Summit has, no 
doubt, demonstrated African leaders anxiety to find an enduring solu-
tion to the problem. Several of the far-reaching decisions taken at 
the Summit is capable of helping to reduce the high mortality rate 
associated with the Malaria scourge in Africa.

The Guardian in an editorial titled " To the Malaria Summiteers" 
says: "But there are problems with the remedial approach adopted. We 
do not think this is a matter for a Summit of Heads of States and 
Governments; there are enough African specialists on the subject to 
do what the Summiteers gathered for in Abuja. A galaxy of 21 Heads of 
States does give a sense of immediacy and political impact to the 
project, but this is, at best, only in symbolic sense. For a lower 
cost, a more purposeful workshop of African Medical Scientists and 
Ministers could have produced a more detailed programme oriented plan 
of action. For example, we cannot fathom how much relief malaria vic-
tims will get from the resolve by the leaders to initiate appropriate 
and sustainable action to strengthen the health system to ensure that 
by the year 2005 at least 60 percent of affected persons have prompt 
access to use current affordable and appropriate treatment within 24 
hours. But the Summit Declaration does not indicate by how much the 
health budgets of the member states should be raised to achieve these 
set-targets."

The Guardian further queried "the bulk of the preventive and prophy-
lactic drug to be administered is imported from foreign countries 
which do not harbour the malaria parasite. There is an obvious eco-
nomic trap in advising African governments to reduce or waive taxes 
and tariffs for mosquito nets and materials, insecticides, anti-
malaria drugs and other critical areas of development in Africa, the 
malaria programme is already being designed to guarantee an emergency 
commodity market for industrialized nations."

Nigerian Tribune in its own editorial titled "Winning the Anti-
Malaria War" said: "The battle against malaria must not be limited to 
the Summit Declaration alone. African government must allocate a 
fixed proportion of their budgets towards prevention and control of 
malaria. African countries must also fund research in our universi-
ties and health institutes and even traditional curative medicine in 
the spirit of total war against the parasite."

The Punch in an editorial on the Summit also advised: "We suggest, 
finally, that conscious efforts be made to integrate traditional 
medicine into malaria eradication programmes, as one measure of en-
suring active and sustained communal participation in the roll-back 
project. African parliaments should also take a practical interest in 
providing the executive arm of government in their countries with the 
fiscal muscle to implement the laudable objectives of the Roll-Back-
Malaria Programme."

All in all, it is expected that African-governments would pay more 
attention to preventive measures than curative ones in their attempt 
to stem out malaria. Malaria parasite is spread by mosquitoes and 
most African communities are breeding nest for these agents of death. 
In view of the fact that most African nations are still grappling 
with problematic sewage/waste disposal systems, open drainage, grown 
bushes around living areas and general poor sanitation in both urban 
and rural dwelling, strategies to roll back malaria are unlikely to 
achieve much if they do not also address basic developmental prob-
lems. No matter how much African governments pump into rolling back 
malaria, these would largely achieve little if adequate attention is 
not paid to integrating developmental solutions into the various non-
developmental strategies proposed at the summit. There is no better 
way to roll back malaria than keeping a very clean environment.

If about N1.1 billion (approx. US $ 11.0 million) spent in organizing 
the Summit is not to be considered a waste, the gains of the Summit 
must be fully and urgently implemented through preventive remedies 
rather than curative. It is also hoped that African leaders will put 
their purses where there mouth is.

Source:

The Guardian, February 17, 2000. Pg.3 No by line.
The Punch, April 26, 2000. Pg.3 No by line.
The Guardian April 26, 2000. Pg.12 By Seth Akintoye.
The Guardian April 26, 2000. Pg.20 Editorial.
The Punch, May 2, 2000. Pg. 8 Editorial.
Nigerian Tribune May 1, 2000. Pg.10 Editorial.

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A Odutola
mailto:chpss_abo@yahoo.com

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