Princess-Astrid-with-patient-at-Way-Urung-ClinicDespite best efforts and tremendous progress, malaria continues to infect an estimated 216 million people around the world each year, killing more than 650,000.en under the age of five. In the time it takes you to read this article, roughly three more children will lose their lives to this preventable and treatable disease.

These are precious lives lost for lack of a $1 course of antimalarial treatment or a $7 long-lasting insecticide-treated net.

Malaria disrupts communities and wrecks lives.

It keeps children out of school and parents out of work.

It costs governments and societies billions of dollars in healthcare costs and lost productivity. In Africa alone, malaria costs an estimated minimum of US $12 billion in lost productivity each year.

But there is a glimmer of hope.

In 2008, the United Nations Secretary-General, Ban Ki-moon, appointed his Special Envoy for Malaria, Mr. Ray Chambers, and called on us to end deaths from malaria by ensuring universal access to malaria prevention and treatment by 2010. The world responded tremendously, resulting in an increase in access to life-saving tools and products that have driven a decrease in malaria cases in recent years.   

Under the strong coordination of the Roll Back Malaria (RBM) Partnership, we’ve seen malaria deaths decline by more than 25 percent since 2000. In that same period, 43 malaria endemic countries worldwide reported declines in malaria cases by 50 percent or more, and many have seen decreases in all-cause child mortality.

Thanks to bold leadership and increased funding, global malaria prevention and control efforts have been scaled up, with notable progress in sub-Saharan Africa, where approximately 90 percent of malaria cases occur. Between 2004 and 2010, the number of long-lasting insecticidal nets delivered to malaria-endemic countries in sub-Saharan Africa increased from 5.6 million to 145 million. Programs to spray the interiors of buildings with insecticides were also expanded, with the number of people protected rising by 71 million between 2005 and 2010.

Investments in diagnostics and treatment have also been fruitful. The availability of rapid diagnostic tests has made it possible to improve and expand accurate diagnostic testing for malaria to some of the most remote areas of the world. For example, the rate of testing in the public sector in Africa rose from less than 5 percent in 2000 to 45 percent in 2010. And the number of artemisinin-based combination therapies (ACTs)–the most effective antimalarials available–procured by government health departments increased by 170 million between 2005 and 2010.

It is clear that we have the proven and cost-effective tools to prevent, treat and diagnose malaria. We also have a global plan–the Global Malaria Action Plan (GMAP)–and a solid coordinating mechanism in the Roll Back Malaria Partnership, which together provide both a roadmap for success and evidence that our goals are feasible, given the right resources and commitment.

But we are at a critical juncture.

While global funding for malaria reached unprecedented levels in 2010, challenging economic times have left an estimated US $3.2 billion funding gap in Africa through 2015 that places our progress in great jeopardy.

Additionally, we face the very real threat of resistance to ACTs that stands to unravel the hard-won gains achieved in recent years.

Our programs and policies are working, but if we don’t continue to invest in them, we will lose the fragile advances we’ve made and millions will continue to suffer. Now more than ever, we must find creative ways to work together to maximize the effectiveness of our efforts and identify alternative sources of funding so we can sustain our progress and continue saving lives. Never before has diplomacy and partnership been so important.

Just recently I was in Indonesia, where I participated in the launch of the country’s national RBM Partnership Forum, an initiative that harnesses the unique skills of various sectors to support the malaria-control strategy of the Ministry of Health. I also had wonderful meetings with political leaders and government officials, during which I was encouraged by Indonesia’s commitment to national investment and regional leadership, to ensure appropriate scale-up and coordinated efforts against malaria. I am convinced that this spirit of partnership and diplomatic leadership will be crucial as we work to advance the malaria agenda globally.  

Investments in malaria prevention and control have been among the best investments in global health, resulting in a dramatic decrease in malaria deaths and illness. We know that when we invest in malaria, the return is high and the cost is low. In the case of Africa, for example, a US $3.2 billion investment now stands to not only save an estimated 3 million lives through 2015, but it could also avert US $36 billion in lost productivity over the next three years.

Beyond being morally compelling, investing in malaria is sound economics.

Health is the building block of all development, and when we invest in malaria, we invest in communities. Recognized as one of the UN Millennium Development Goals, we know that investment in malaria also accelerates progress in other health and development areas by reducing school absenteeism, fighting poverty, and improving maternal and child health.

Recently, the UN Secretary-General announced that malaria was among his top priorities for his second mandate. This announcement shows his clear commitment and determination to defeating this leading killer. I only hope we will respond as enthusiastically as we did in 2008 and make malaria one of our priorities as well. To be honest, we can’t afford not to.

As Special Representative to the Roll Back Malaria Partnership, I urge donor countries to make smart investments and fill the US $3.2 billion funding gap in Africa.

The road ahead will be difficult, but if we are able to maintain our commitment, the reward will be substantial. As we work to defeat malaria, let us do so with bold conviction and collaboration, working together to identify creative solutions to overcome the challenges threatening the progress we have made so we can help communities around the world to thrive.