28 April 2014
Guest Contributor

The Battle to End Malaria: Senegal Leads by Example

Authors:
Awa Marie Coll-Seck – Minister of Health, Government of Senegal
Mark Dybul – Executive Director, The Global Fund to Fight AIDS, Tuberculosis and Malaria

On the occasion of World Malaria Day, we would like to take you on a journey to a town in northern Senegal, along the western coast of Africa, that looks like many other thriving communities around the world: the children are happy and healthy, many of their parents are employed at a large sugar company, and the local economy is growing. But there is something important that sets this town, called Richard Toll, apart from other communities: its battle with a devastating disease.

Transmitted by the bite of a mosquito, malaria kills hundreds of thousands of people each year – most of them young children in Africa. Although the disease is endemic in Senegal, and the irrigated sugar cane fields (where many of Richard Toll’s residents work) are ideal breeding grounds for mosquitoes, the area has only recorded a handful of cases of locally transmitted malaria in over a year. Thanks to coordinated efforts by the Ministry of Health and the sugar company itself, proven tools recommended by the World Health Organization have been used to roll back the disease. This includes ensuring the availability of effective treatments in health facilities, along with the introduction of handheld rapid diagnostic tests and the mass distribution of free mosquito nets. Now, malaria has been nearly eliminated in the area.

After years of investment and an incredible effort, Senegal now has committed to eliminating the disease across the entire country. It’s an audacious, long-term goal, and one that is being made possible with a strong partnership between the leadership and funding of the Senegalese government in coordination with faith- and community-based organizations, and support from major external funders like the U.S. President’s Malaria Initiative, the Gates Foundation and the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Although Senegal has significantly increased resources to combat malaria, eliminating the disease requires partnership.  The story of Richard Toll illustrates how Global Fund funding has helped “jump start” successful national malaria programs – and how investing in the development of durable health programs can rapidly bring down malaria cases and deaths. Coupled with the use of innovative new tools and strategies, Senegal has everything it needs to eliminate the disease. Well – almost everything.

Certainly, World Malaria Day is a time to consider the great progress we have made globally against the disease. But it is also an opportunity to consider what remains to be done to truly defeat it once and for all. Though malaria mortality has decreased by 26 percent globally over the past decade, there are some sobering facts to consider: In countries that have reduced malaria transmission in the last century, 75 resurgences have been recorded since 1930 and nearly all are linked to decreases in resources and the scaling back of malaria programs, according to an assessment published in the Malaria Journal. In addition, a recent report titled Cost of Inaction calculated that, if global funding for malaria were to decrease, the disease could kill up to 196,000 more people and sicken an additional 430 million each year – illnesses and deaths that otherwise could have been prevented. The evidence is clear: A well-funded Global Fund is imperative to be able to finish the work on malaria that we’ve started, and to support countries like Senegal as they chart new strategies to end the disease.

The alternative – trying to maintain high levels of malaria control and prevention measures with no end in sight – is like attempting to put out a wildfire by only extinguishing part of the flames. Experience shows us that if we pull back in our efforts even a little, we can see a resurgence in malaria cases in just a few months. Challenges like the parasite’s growing resistance to our best treatments and the mosquito’s increasing resistance to insecticides make elimination an even more urgent goal. Thus, we are at a pivotal moment in time: If the world was to decrease its commitments to fighting malaria now, it would put at risk everything we have invested — and the progress we have made — over the last decade.

So what is life like in Richard Toll, now that the region is nearly free from malaria? Fewer children are getting sick or missing school, there is increased productivity at work, money is being saved or reallocated that would otherwise have been spent on malaria-related costs, health systems are freed up to focus on other concerns, and the overall standard of living is on the rise. It’s wonderful progress, but we aren’t done yet.

The Global Fund launched its Fourth Replenishment in December 2013, the beginning of a rolling, three-year resource mobilization effort. The United States is matching pledges from other donors worldwide – $1 for every $2 donated by other countries, until September 2014. With every dollar absolutely critical to the fight, we must not leave any money on the table.

In the years ahead, the Global Fund will deepen its work with governments and encourage increased private sector investments and domestic co-financing. On this World Malaria Day, will you join us in mobilizing the resources needed to seize the opportunity to defeat malaria once and for all — and give all communities the chance to be malaria-free like Richard Toll?

25 April 2014
Shawn Clackett

Net Campaign Targets Universal Coverage in Chad

Global Fund News Release – 25 April, 2014

A child receives anti-malarial medication in the Central African Republic, near the Chad border.

A child receives anti-malarial medication in the Central African Republic, near the Chad border – Photo from Unicef.org.nz

KELO, Chad–The Government of Chad, with support from the Global Fund to Fight AIDS, Tuberculosis and Malaria and UNICEF, launched a mass campaign today to distribute nearly 7.3 million long lasting insecticide-treated mosquito nets.

The campaign, which began today, on the occasion of World Malaria Day, will continue over the coming weeks and will move Chad toward universal coverage.

Of the 7.3 million nets to be distributed free of charge, 5.6 million are financed by the Global Fund, 1.7 million by the Government of Chad and 200,000 have been acquired with funding from the Government of Japan, as well as 65,000 with UN Foundation funding, both through UNICEF. Nearly 10 million people will benefit and will receive protection against malaria for the next three years.

“The fight against malaria, both in its preventive and curative aspect, requires a long-time consistent investment and a strong political commitment. The investment made by the Chadian Government and its partners will make available to the population millions of mosquito nets to prevent malaria. The efforts made by the Government will continue and will allow the country to defeat this disease,” said Dr Ngariéra Rimadjita, Minister of Health, Social Action and National Solidarity.

Intended to cover Chad’s entire territory, the campaign will reach 13 high-risk regions, covering 48 health districts and 800 health centers, in the first phase. Supported by a large social mobilization effort, the campaign will run throughout 2014 to achieve universal coverage. The government will provide funding for the remaining 10 regions.

“Chad will be the first country in the sub-region to achieve universal mosquito net coverage,” said Tina Draser, the Global Fund’s Regional Manager for Western Africa. “This will not only help to save more lives, including thousands of women and children under 5 years of age, but also to strengthen health systems in Chad.”

Malaria is endemic in Chad with a high prevalence in the Sudanese region (the South) and the Sahel (Central and Eastern). Children under the age of five and pregnant women are the most affected. Epidemiological analysis of Chad shows that 98 percent of the population lives in areas at risk of malaria. The prevalence of malaria is 29.8 percent in Chad, according to the 2010 Malaria Indicator Survey (MIS), with a prevalence of 35.8 percent among children under 5 years of age.

In 2013, Chad experienced a severe outbreak of malaria, with nearly 1 million suspected cases and 2,614 deaths, compared with 616,000 suspected cases and 1,359 deaths in 2012, according to data from epidemiological surveillance.

“This is a first in this part of Central Africa and brings positive progress in accelerating child survival and development in Chad. More than 8 out of 10 households will be reached and mothers and children will be able to sleep under a mosquito net, safe from the threat of malaria, which is the leading cause of infant mortality in the country,” said Bruno Maes, UNICEF Representative in Chad. “Mosquito nets remain by far the best way of prevention against this disease.”

In August 2013, the Support Fund for Population Activities and Fight against AIDS (FOSAP) signed a financing agreement of more than 20 million euros for UNICEF to organize the campaign distribution in 13 regions of Chad. This agreement is supported by the new funding model of the Global Fund. UNICEF has been selected as a sub-recipient of this funding for the implementation of the program. Overall, Chad has benefited through this mechanism from a Global Fund grant totaling more than €25 million.

In 2011, through funding from the Global Fund and the Islamic Development Bank (IDB), the country – supported by its partners – carried out mass distribution campaigns of long lasting Insecticide-treated bed nets in 9 regions, benefiting more than 3 million people.

22 April 2014
Shawn Clackett

UNICEF and Global Fund Coordinate Efforts to Reach Mothers, Newborns and Children

Sayon Keita with her 8 month old son, Samba. A few days before this photo was taken, Samba was receiving treatment for severe malnutrition at Kangaba Hospital in Mali

Photo from UNICEF

GENEVA/NEW YORK – UNICEF and the Global Fund today reinforced their long-standing partnership through a new agreement to better coordinate efforts aimed at reducing the burden of HIV, tuberculosis and malaria and improving the health of mothers, newborns, and children.

Mark Dybul, Executive Director of the Global Fund, and UNICEF Executive Director Anthony Lake signed a new Memorandum of Understanding that emphasizes the importance of coordinating investments in commodities to prevent and treat HIV, tuberculosis and malaria with those designed to improve overall maternal, newborn, and child health.

“The Global Fund has helped expand access for millions of mothers and children to lifesaving commodities that prevent and treat HIV, TB, and malaria,” said Lake.  “This new agreement will help governments integrate these critical investments with health services that support basic maternal, newborn, and child health.  This integration will increase the effectiveness of both efforts and potentially save millions of lives.”

Specifically, the Global Fund and UNICEF agreed to jointly identify countries where HIV and malaria investments for mothers and children could be better aligned with investments in basic maternal, newborn and child health.  As a first step, these commodities could include iron and folic acid, tetanus vaccinations, syphilis screening and treatment for pregnant women, and antibiotics to treat pneumonia and oral rehydration salts and zinc to treat diarrheal disease in children.

Under the new agreement, the Global Fund and UNICEF will encourage governments and Country Coordinating Mechanisms to integrate packages of care and support for mothers and children, and to apply for Global Fund grants that align HIV, TB and malaria programming with broader maternal, newborn and child health efforts.  UNICEF will support governments that wish to review and revise national strategies to strengthen this alignment and will help mobilize additional funding where necessary to purchase supplies and equipment for the care of mothers, newborns and children.

“This partnership between UNICEF and the Global Fund strengthens what is already operating on the ground in many countries,” said Dr. Dybul. “We have much further to go, and by working together we can achieve tremendous progress for women and children around the world.”

7 April 2014
Shawn Clackett

Partners in Eastern and Southern Africa Look at Investment Framework

Global Fund News Flash: 07 April 2014

Photo from Unicef.org

Prof. Sheila Tlou, Director of UNAIDS Regional Support Team in East and Southern Africa

WINDHOEK, Namibia Partners from countries in Eastern and Southern Africa opened a four-day meeting in the Namibian capital this week to examine how to make investments achieve the greatest possible impact in partnership with the Global Fund to Fight AIDS, Tuberculosis and Malaria.

More than 150 people – from governments, civil society, technical partners in 12 countries – came together to discuss the Global Fund’s new funding model and to look at how to optimize use of all available funding. Encouraging each country to prioritize investments and coordinate them with national plans and strategies for health is a central theme of the new funding model.

Dr. Richard Kamwi, Namibia’s Minister of Health and Social Services, opened the meeting by asking participants to champion an increase in domestic investments in health, which he said would strengthen partnerships and safeguard the gains of the past 10 years.

“Speak to your governments,” said Dr. Kamwi. “Unless we sustain these gains, the progress we have made will have been futile.”

In the spirit of partnership, Dr. Kamwi announced that his country’s cabinet had authorized a donation of US$1 million to the Global Fund.

The new funding model was designed to more fully deliver on the promise of partnership that created the Global Fund in 2002. That includes strong country ownership, increased domestic spending on health and a focus on human rights.

Prof. Sheila Tlou, Director of  UNAIDS  Regional Support Team in East and Southern Africa, told the meeting that the region should use the new funding model to ensure that marginalized people not only get prevention and treatment but are also involved in decision-making.

“We need to ensure that key populations are involved in the formulation and implementation of programs under the new funding model,” she said. “We need to ensure that no one is left behind.”

Cynthia Mwase, the Regional Manager of Southern and Eastern Africa at the Global Fund, said that the new funding model integrates human rights and partnership into new grants, and also provides a strategic roadmap on how the region can remove the three diseases as threats to public health. She said the meeting was organized to help Global Fund partners in the region to prepare to attain impact through the US$1.7 billion now available for the funding period.

For more information, please contact:
Ernest Waititu

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Pacific Friends of the Global Fund to Fight AIDS, Tuberculosis and Malaria is a high-level advocacy organisation which seeks to mobilise regional awareness of the serious threat posed by HIV & AIDS, tuberculosis and malaria to societies and economies in the Pacific. In pursuing its goals Pacific Friends has a specific interest in highlighting the need to protect the rights of women and children in the Pacific.

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