I applaud the debut of Global Health and Diplomacy with enthusiasm. With a prominent readership that includes Heads of State, ministers of health, policy experts, and opinion leaders, this publication promises to strengthen the political resolve to improve the lives of women all over the world.Throughout my career as a doctor, public health advocate, researcher, and director in international health agencies, I have worked to promote the health of disenfranchised populations in an effort to reduce suffering and injustice. Diplomacy has been my means of predilection for accomplishing this goal. My professional experiences have demonstrated to me that fostering dialogue among all stakeholders and convincing cooperation towards united objectives can go a long way in making a difference. A Swahili proverb states: "a boat doesn't go forward if each one is rowing his own way" in contrast, unified, collective action amplifies the impact of individual effort, which can result in tremendous social benefits.
This year has been a year of crises, both political and financial. Leaders have been required to strike a difficult balance between competing demands and priorities, and some of their decisions have led to gains for some and equivalent losses for others.
On the other hand, there is nothing controversial or difficult about the decision to spend on health—everyone wins. Not only is it a morally appropriate to reduce suffering and death. It is also a smart investment. Vibrant economies and stable, secure societies first require healthy people. Women are essential in this regard. Ensuring the good health of women—as givers of life, caretakers of children, and primary transmitters of knowledge—is the first step towards improving the quality of life of families and societies.
In many countries, women face an unacceptable gap in access to health services and have a lower quality of life than men have. The World Health Organization (WHO) reports that a number of biological and social factors place women at higher risk of physical and sexual violence, sexually transmitted infections, malaria, and pulmonary disease. Less than half of women receive skilled health care when giving birth in parts of the developing world and mortality rates during pregnancy and childbirth remain high. The international community must and can do more to improve women's health. In this regard, I commend the UN Secretary General's Every Woman Every Child Initiative, which promises to improve the health of hundreds of millions of women and children across the globe.
I would like to make the case for malaria control, a package of cost-effective health interventions that will have a positive impact on the lives of women and children, as well as far-reaching benefits. Malaria's main victims are children under five in Africa. Furthermore, malaria can lead to complications during pregnancy and delivery. Also, pregnant women are four times more vulnerable to the disease than adults of the same age. Last year, malaria caused approximately 800,000 deaths and 225 episodes of illness. This triggered a cascade of negative effects across a wide range of sectors: malaria impairs school attendance and learning, accounts for 30% to 40% of all hospital consultations in high-transmission countries, and costs Africa at least $12 billion every year.
There are at least three good reasons to invest in malaria control.
1) Money invested in malaria control rapidly translates into results on the ground.
In 1998, the Roll Back Malaria Partnership (RBM) was launched. A unique alliance between donor and malaria endemic countries, funds and foundations, multilateral organizations and civil society, private companies and research consortia, RBM was created to give new momentum to the malaria response. With better coordination and consensus, donor confidence increased, and the money began to flow. Thanks to the Global Fund to fight AIDS, Tuberculosis, and Malaria, the U.S. President's Malaria Initiative, the World Bank, UNITAID, DFID and other bilateral donors, more than $1.5 billion dollars was disbursed in 2010 for countries to fight malaria.
Coverage with malaria control interventions increased rapidly. Between 2008 and 2010, 290 million long lasting insecticide-treated nets were distributed—enough to cover nearly 80% of the population at risk in Africa. WHO reported more than 73 million people in sub-Saharan Africa were protected by indoor residual spraying in 2009—up from 10 million in 2005. While a considerable effort is required to achieve universal coverage with malaria diagnosis and treatment, the proportion of children treated for malaria who received effective malaria drugs has increased significantly in recent years.
2) Malaria control interventions work.
As a result of improved malaria prevention coverage, the lives of 1.1 million children under the age of five were saved in sub-Saharan Africa since 2001, and there was a 38% reduction in global malaria deaths. With malaria control, you get far more than what you pay for.
3) For the price of mosquito nets, indoor residual spraying, and effective diagnostics and antimalarial drugs, you can save millions of lives—particularly of pregnant women and children under five. Additionally, malaria control generates multiple development gains: it allows boys, girls, and their teachers to stay in school; it saves parents from impoverishment; and, it spurs economic development.
However, we are now facing a financial gap that could slow down this progress and reverse our gains. The Global Fund to fight HIV, TB and malaria, the major financier of malaria control, has recently announced that it may have to freeze or scale down its funding for HIV, tuberculosis, and malaria programs. This could have devastating consequences for the poor whose lives depend most on these resources.
I urge all stakeholders to do their utmost to ensure the continuation of these programs that are working effectively. Let us remember to put people at the center of our decision-making. Let us find creative solutions to maximize the impact of available funding and secure new resources. Promoting the well-being of mothers and their children is morally imperative; it also leads to social and economic progress. Now more than ever, the world needs our strong commitment, our creative ideas and our deliberate action.
