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Africa faces a perfect storm in the fight against malaria

Umaro Sissoco Embaló, Chair of the African Leaders Malaria Alliance (ALMA) announced that Africa is at the centre of a perfect storm that threatens to disrupt essential life-saving malaria services.

Africa faces growing threats that increase the risk of malaria cases and deaths. Critical financial shortfalls for malaria programmes, linked to the ongoing global financial crisis, the impact of climate change, insecticide, and drug resistance, and humanitarian crises are creating unprecedented crises that need to be addressed urgently to prevent malaria upsurges.

“If we do not act now, we could see malaria deaths rise as a result of funding gaps, biological threats, and climate disruptions”, said His Excellency President Embaló, in a speech delivered on his behalf by His Excellency Carlos Pinto Pereira, Minister of Foreign Affairs, International Cooperation and Communities, Republic of Guinea Bissau. “However, malaria offers a viable pathway for a fully integrated approach where every sector contributes to efforts to build sustained and resilient health systems” he added.

In the context of mounting global development challenges including the economic downturn globally which is particularly impacting Africa, achieving the goal of eliminating malaria and addressing other health challenges, including Neglected Tropical Diseases, faces many obstacles. While there is strong political will and a strong tool kit of interventions, progress towards malaria elimination has slowed.

The sixth annual Africa Malaria Progress Report sets the tone for key wins to turn the tide against malaria. The report notes that there is a significant resource gap, with Member States facing a US$1.5 billion budget shortfall by 2026 just to sustain the current, yet inadequate coverage in essential malaria interventions. This shortfall, linked to the global financial crisis and the higher cost of essential commodities to address the threat of resistance, could result in malaria deaths doubling, mirroring worst-case scenarios predicted at the outset of the COVID-19 pandemic. Furthermore, an additional annual funding of $5.2 billion is required for the continent to make progress towards elimination, allowing countries to fully implement their national strategic plans. Member States, in collaboration with national and global multi-sectoral partners, must act quickly to bridge these gaps and fully finance national malaria strategic plans.

The report also highlights the mounting threat of climate change on health, including malaria and Neglected Tropical Diseases. Africa, contributing just 4% of global carbon emissions, faces a disproportionate impact from climate-induced disasters like heatwaves, floods, and droughts, these also threaten to increase malaria and other vector borne diseases on the continent. An integrated agenda is needed to address these growing threats. Malaria is a pathfinder for health systems strengthening, primary health care and pandemic preparedness, and a prime example for the impact of climate change on health. The global community must increase its support for mitigation and adaptation measures while, at the same time, ensuring that Africa takes this challenge hands-on and contributes additional resources needed to end the disease once and for all.

The report acknowledges the long-term investments and heroic efforts made by countries, partners, and community health workers across Africa towards the fight against malaria. Despite this, the African continent still bears a huge burden with 94% of all malaria cases (233 million cases) and 95% of all malaria deaths (580 000 deaths). The most heavily impacted by the disease remain children with about 78% of all malaria deaths in the region being among children under the age of five.

“Existing tools are being impacted by the threat of resistance. To effectively get back on track, we must add new tools in our arsenal against malaria. The good news is, we have highly effective tools able to address these threats,” said Her Excellency Amb. Minata Samate Cessouma, the Commissioner for Health, Humanitarian Affairs, and Social Development at the African Union Commission. “These newer tools work better but cost more. Local manufacturing, and market-shaping efforts by Member States and partners can reduce some of the costs, making them affordable, accessible and thus creating greater impact.” she added.

The 2023 African Union Malaria Progress Report reveals positive strides in malaria control and other health areas including through the strategic use of health scorecard tools. The use of data to drive real-time programming has led to significant action including resource mobilisation, training, mentoring, procurement strategies to address low stocks, and increased community engagement across more than 40 countries in Africa. These real-time data and scorecards for accountability and action tools have enabled countries to more effectively address bottlenecks and drive action.

The report calls for an accelerated launch of national ‘Zero Malaria Starts with Me’ campaigns, with 29 countries already on board. The establishment of country multisectoral End Malaria and NTD Councils and Funds is crucial for advocacy, action, resource mobilization, and accountability. These councils have already mobilized over US$50 million across Africa in just 7 countries to date, whilst 15 countries are working to launch their councils and funds in 2024.

Finally, the Republic of Cabo Verde’s recent WHO certification as a malaria-free nation stands as a testament to what can be achieved in Africa with unwavering commitment and collective action. This key milestone, positions Cabo Verde alongside 43 other countries and territories that have eliminated this life-threatening disease. The elimination of malaria in Cabo Verde illustrates the art of the possible, embodying the spirit of ‘Zero Malaria Starts with Me’.

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