Worldwide, malaria kills an estimated 660,000 people each year.With almost 90 percent of these deaths occurring in Africa,malaria kills an African child every minute.The economic loss caused by malaria in Africa is estimated to be $12 billion dollars each year.
Fortunately African leaders have responded. By creating the African Leaders Malaria Alliance (ALMA), African Heads of State and Government are working to utilize their individual and collective power across country and regional borders to end malaria deaths conclusively. With the support of the WHO, the Roll Back Malaria Partnership and donor governments, we have made tremendous progress with deaths caused by malaria decreasing 33 percent over the last decade. It is estimated that this concerted effort has averted 274 million additional cases of malaria per year, and that 1.1 million more people (mostly poor children) would have died.
However, there is still much to be done. In these tough fiscal times, ALMA is working to expand its advocacy to ensure robust funding for malaria programs and continues to push for accountability and transparency to ensure existing funds are used as effectively and efficiently as possible. In 2011, ALMA Heads of State and Government tasked the ALMA Secretariat with establishing an accountability and transparency framework to track progress and facilitate a rapid response to emerging issues and bottlenecks and allow for the sharing of lessons learned. In response, in September 2011 ALMA launched the Scorecard for Accountability and Action, which helps track progress across key indicators covering malaria policy, financing, intervention coverage, impact and includes tracer maternal and child health metrics. This is an important step in ensuring transparency and accountability of malaria programs.
To complement these efforts, African countries - working with partners such as ALMA and under the auspices of RBM - completed a comprehensive gap analysis exercise to help inform our plan to sustain universal coverage of malaria control interventions through the end of 2015. This analysis found a financing shortfall of US$36 billion. During the United Nation’s Secretary General’s Every Woman Every Child Financing Summit — as the 2012 ALMA Chair — I announced a comprehensive plan to support the acceleration of Africa’s progress towards near zero malaria deaths and to address this financing shortfall.
Our “Big Push” is a multipoint plan, which will be critical in helping African nations, and their global community achieve our ambitious goals by 2015. Our plan focuses on three key areas: sustaining existing commitments, promoting efficiencies to maximize impact of current funding and securing additional funding to meet financing gaps. Taken together, these three objectives combined with a transparency and accountability framework will be critical for ALMA and its partners to achieve our goals.
The first focus of the Big Push is sustaining investments that have been made to support Africa’s malaria control efforts. African countries along with their partners — bilateral agencies, NGOs, private sector, CBO, Foundations and development banks — must not allow their malaria control efforts to slip and must keep their commitments to supporting these important health efforts. ALMA will continue to focus its efforts on high-level advocacy in support of these goals and will help provide our partners with the transparency and accountability necessary to build support for these programs worldwide. It is imperative that we demonstrate the value for the money of these malaria control programs and make the case that they offer a huge return on investment in terms of lives saved, economic productivity gained and achievement of important health and development objectives such as the Millennium Development Goals (MDGs).
A key part of sustaining investments in malaria control is demonstrating the various efforts that ALMA and African leaders are using to improve efficiency and effectiveness of our investment in malaria control. We are working with African leaders and ministries of health to focus on improving efficiency, effectiveness and economic use of resources across the health sector and to encourage full transparency of these programs so that proper evaluation and adjustments can take place. For example, malaria programs have identified a number of efficiencies such as improving HMIS, promoting procurement and supply chain management efficiencies such as the use of pooled procurement and standardizing commodities such as net specifications to help reduce costs and improve the use of current dollars. In addition, we have been working on building capacity of local manufacturers to produce anti-malaria commodities in order to save on transportation and logistical costs while also building up local industry and creating jobs. We are committed to these efforts and ensuring that all of this is done within a well structured accountability framework that focuses on results and impact.
ALMA is also working to address continued challenges with procurement of commodities. It is heartening that the need to move collectively towards bulk purchasing has been embraced by the African Union, and the current Chair of SADC, His Excellency President Armando Guebuza, has committed to ensuring that bulk purchasing is pursued by the SADC secretariat, working with member countries in procuring some key antimalarial commodities.
The success and longterm sustainability of our malaria control efforts will hinge on the ability of African governments and their partners in the private sector to sustain and increase domestic resources to battle malaria. Highlighting and holding African leaders accountable to their pledges to allocate 15 percent of public sector recurrent budgets to health will be a critical aspect of ALMA’s efforts. Further, boosting private sector engagement across Africa will help provide additional human and capital resources for health and development.
The second focus of our plan to address the $3.6 billion shortfall is to promote new ideas and methods for securing additional financing. New funding streams must be created if we are to meet our goals of universal coverage by 2015. Innovative financing offers us some unique models and promising options that ALMA leaders will continue to advocate for. These include enrolling more countries in financing initiatives such as UNITAID’s airline tax. The ALMA Secretariat is in funding working with UNITAID which has mobilized close to $2 billion over the last five years to support HIV/AIDS, TB and malaria through a small levy on airline tickets. Several African countries have already implemented this mechanism including Cameroon, Congo, Madagascar, Mali and Mauritius, while others are in the processes of introducing the tax. The ALMA Secretariat plans to arrange technical assistance from UNITAID for countries ready to implement the mechanism and will work with them to ensure accountability and transparency as they receive and use the funds raised through the airline tax.
Additionally, implementing a taxon financial transactions will help fund health interventions in ALMA countries. During the United Nations General Assembly, His Excellency President Francois Hollande announced that France had introduced a financial transactions tax (FTT), which will create a new funding source for, among other causes, health and development nationally and internationally. Led by His Excellency President Mahamadou Issoufou of Niger, ALMA countries are taking up the call and will explore the possibility of introducing an FTT in some ALMA member countries to support health and development. The ALMA Secretariat has committed itself to ensuring that technical support for the implementation of FTTs is available for any country that is ready. ALMA is working with other key partners such as the UN Special Envoy for Malaria, RBM, the private sector and academia, on an innovative financing instrument that could tap more resources from the global markets.
Finally, ALMA is focused on working together with our various partners and stakeholders to build sustainable funding plans and ensure quality financial management, including priority setting. Together with partners — among them, the African Development Bank, the Global Fund, the United Nations Economic Commission for Africa, the World Bank, Department for International Development (DFID), France and the President’s Malaria Initiative (PMI) — ALMA has worked with African leaders and ministries of health to lead this effort. ALMA countries are urged to work to ensure that they are ready to absorb resources through the Global Fund’s new funding modality, which is being rolled out in 2013.
It is imperative that ALMA countries lead the Big Push to fill the US$3.6 billion dollar gap in order to sustain malaria control interventions in Africa. We have developed a comprehensive plan aimed at attracting the additional financial support needed to reach our goals. At the same time, we have increased our efforts to ensure that current funding is generating the important results and health outcomes that we all expect. Our commitment to creating the appropriate accountability and transparency framework to guide our efforts will help translate our goals into action. Together with our partners, ALMA is dedicated to achieving our goal of universal coverage by 2015 and to begin to realize our collective goal of endingmalaria deaths once and for all.