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Malaria is one of humanity’s worst diseases. Each year it kills more than a million people, many of whom need not die. The majority of victims are children under five who die because they are unprotected and are not treated quickly enough to prevent the disease killing them. And yet, this global devastation can be prevented. The world is at a turning point: never before has it had the means to roll back malaria.
Malaria suffering is now a global crisis: one-fifth of the world population is at risk and there are more than 300 million cases of malaria illness each year. Nine out of ten cases occur in Africa south of the Sahara. Malaria in pregnancy is widespread. It endangers the health of women and prospects for the newborn.
The disease continues to spread due to a combination of factors: weak health systems; large-scale population movements; deteriorating sanitation; climatic changes; spreading drug resistance; and in certain cases, uncontrolled development activities. Areas until recently considered malaria-free are now suffering death and social devastation due to an increase in epidemics and outbreaks. In many countries the workforce’s productivity is reduced due to illness while the cost of disease control cripples the economies of poor countries.
Never before have so many agreed to work together to devise effective strategies to combat the effects of the disease, to alleviate malaria-induced poverty and to reduce the suffering of those who are its victims. The movement to fight the disease is backed by a global partnership of governments, development agencies and banks, research groups, the private sector and ordinary men and women around the world. Progress to Roll Back Malaria (RBM) is based on collective strategies and actions that aim to reduce malaria suffering and death and to alleviate poverty made worse by the disease. And RBM's promise is to halve the world's malaria burden by the year 2010.
There is little disagreement that better use of existing tools to fight malaria - such as wider use of insecticide-treated bednets or prompt and effective treatment of people's malaria illness - will lead to a substantial and sustainable progress. The promise to halve the world's malaria burden by 2010 is achievable.
But now, the greatest challenge countries and communities face is the vicious circle that links malaria and poverty. Poverty breeds malaria and malaria impoverishes people and societies. By conducting a well-coordinated battle against malaria, major obstacles to development are removed. Where there are significant improvements in the health of communities and the workforce, economic and social conditions often improve along with economic output. Now is the time for governments, development agencies, the private sector and the research community to join together and help RBM make further progress.
Roll Back Malaria is a partnership working worldwide to halve the burden of malaria by 2010. The challenges are enormous but so are the rewards: saving lives, reducing poverty, boosting school attendance, and making life better for millions of people living in poor countries, especially in Africa.
The Work of of RBM builds on previous experience and existing malaria control efforts in all 105 currently endemic countries and territories. RBM has grown in response to government concerns in more than 30 countries and poorest communities, especially in Africa.
The movement depends on up-to-date technical systems and expertise - for surveillance, for controlling mosquitoes, for using effective medicines, for integrated management of childhood illness (IMCI) and for encouraging the development of new diagnostic, treatment and preventive measures.
Maximum emphasis is given to results and to ensuring that malaria suffering and deaths are reduced. This requires concerted and coordinated action by a broad range of private and public sector organisations at all levels of society. RBM helps countries to develop such actions where they are needed and across a range of sectors, including education, agriculture and environment.
Pepole, especially children and pregnant women, are at the centre of the RBM movement. The movement aims to secure a 30-fold expansion in the proportion of people who acccess effective treatment within 24 hours of the onset on symptoms, and in those who use insecticide treated materials and effective vector control. It also seeks to reinforce links with interventions such as the IMCI initiative to reduce children's deaths from malaria. RBM aims for a 30-fold increase in the proportion of children and pregnant women at risk who receive effective malaria protection.
RBM’s six critial elements work together to help break the cycle of malaria transmission, cure patients and support development. They are:
1. Evidence-based decisions using surveillance, appropriate response and building community awareness
2. Rapid diagnosis and treatment supporting home care, direct access to effective medicines, and wide availability of health services
3. Multiple prevention using insecticide-treated nets, environmental management to control mosquitoes, and intermittent treatment for making pregnancy safer
4. Focussed research to develop new medicines, vaccines and insecticides
5. Well-coordinated action for strengthening existing health services and providing technical support
6. Harmonised action to build a dynamic global movement
Launched in 1998 by the Director-General of WHO, and spearheaded by African leaders, RBM is supported by a broad spectrum of partners, including UNDP, UNICEF and the World Bank as founding partners. Important global and regional commitment has been harnessed, and political commitment has never been higher. The Abuja Summit on Roll Back Malaria, held in Nigeria in April 2000, marked the first meeting of African political leaders to discuss the human and economic consequences of malaria on their continent. They unanimously adopted The Abuja Declaration and Plan of Action. Political support was voiced internationally and heads of development agencies pledged US $750 million in new money and discussed concrete action over the next decade.
A large number of countries have already initiated action to roll back malaria and more countries are coming on board. Significant action has taken place. By early 2001, scaling-up activity could be launched in over 30 malaria-affected countries in line with agreed strategies, plans of work, resource management mechanisms, and monitoring and evaluation systems.
Efforts must be intensified - not only to prevent suffering, but also to enable malaria-affected nations to overcome obstacles to development caused by malaria.
*Adapted from: "Potential for Progress", Roll Back Malaria, April 2000. Thanks to Aafje Rietveld, RBM. For further information, please contact RBM Cabinet Project, World Health Organization, 20 Avenue Appia, CH–1211 Geneva 27, Switzerland, rbm@who.int