African Union Heads of State and Government, global health leaders and development partners have issued a joint call for urgent action to address the looming malaria emergency. They warned that failure to act now will put at risk both the African Union’s target of eliminating malaria in Africa by 2030, and the UN target of ending malaria epidemics by 2030.
At a press briefing, on the sidelines of the United Nations General Assembly in New York on Friday 22 September 2023, leaders warned that the world is facing the biggest malaria emergency of the last two decades, due to a perfect storm of climate change, growing resistance impacting the efficacy of insecticides, antimalarials and rapid diagnostic tests as well as inadequate funding linked to the global financial crisis.
His Excellency President Umaro Sissoco Embaló, President of the Republic of Guinea-Bissau and Chair of the African Leaders Malaria Alliance painted an alarming picture: “We are at a critical juncture. There are currently insufficient resources to even maintain existing lifesaving malaria programmes, posing the most serious threat to malaria elimination in the last 20 years. If we don’t act swiftly to address the immediate gap of $1.5 billion and mobilise the necessary resources, we will undoubtedly see malaria upsurges and epidemics.”
Examples were shared of how the ongoing global financial crisis has led to significant increases in the cost of delivering essential malaria interventions. Countries are now facing increasing levels of insecticide and drug resistance requiring newer, more expensive tools and approaches to be effectively addressed. Leaders also shared how the impacts of climate change, including a rise in extreme weather events such as temperature increases, flooding and cyclones, and the resulting humanitarian emergencies, are expanding the areas impacted by malaria and the costs of delivering programmes. These higher costs are leading to the reversal of previously hard-won gains against malaria.
“Defeating Malaria across the continent is a priority. Without defeating this age-old disease, we will miss the targets that we have set for ourselves for healthy citizens and socio-economic transformation. We must meet the ambitious targets set out in the Catalytic Framework to End AIDS, TB and Eliminate Malaria in Africa by 2030, Africa Health Strategy and Africa’s Agenda 2063, the Africa that we want. We need to ensure that we sustain our political commitment and continue to translate these commitments into concrete action. With most AU Member States off-track to achieve the goal of eliminating malaria by 2030, much still needs to be done” said Professor Julio Rakotonirina, Director Health, and Humanitarian Affairs at the African Union Commission.
During the press briefing, leaders addressed accelerating the launch of multisectoral high level National End Malaria and Neglected Tropical Disease councils and funds to maintain malaria high on the national development and resource mobilization agenda as well as to increase public and private sector domestic funding. Examples were shared of increasing public sector budget allocation to health and malaria. They addressed prioritization of health and malaria financing in the country allocations of World Bank International Development Association (IDA) funding; and the use of debt swaps. The World Bank was urged to commit to a new Malaria Booster Programme to facilitate the additional financing needed to close immediate gaps, with additional commitments from regional development banks. Increased international financing from traditional donors and new donor markets remains critical.
Dr Michael Charles, CEO of the RBM Partnership to End Malaria, said: “The malaria situation is extremely precarious. While we saw good progress against the disease in the early 2000s thanks to the immense support received for malaria programmes, in recent years we have seen funding overall plateau due to other health pressures like the COVID pandemic and the global economic downturn. As a result, we are now facing the biggest malaria emergency in decades. Already, this disease claims around 600,000 lives annually and kills a child every minute. If we do not take more action urgently, we will see this worsen and a regression of the gains we have made. We face a multitude of challenges, from climate change to insecticide resistance, but we also have an opportunity to get this right, and even use our response to malaria as an entry point to strengthen health systems more broadly. To do this, we need to integrate, innovate, accelerate and get the needed finances to take us over the line of elimination and eradication.”
HE President Embaló called on fellow Heads of State, Government and partners to act: “Now is the time to fully finance the malaria fight to ensure that we eliminate the disease once and for all. This can be achieved through integrated approaches, with malaria as an essential pathfinder when strengthening health systems for UHC and pandemic preparedness; as well as for mitigating and adapting to the impact of climate change”.
The fight against malaria is at a crossroads. It is up to countries, regions and the global community to protect the gains made over the past two decades, and to achieve the 2030 target of putting an end to malaria epidemics and delivering an Africa free of malaria.