*Africa Malaria Day*

*Dr. Peterson DRAFT remarks*

*April 25, 2003*

*National Press Club*

-   I want to welcome and thank all our distinguished guests and say
    what a privilege it is to be here with you to commemorate Africa
    Malaria Day.

-   I would also like to welcome the Ambassadors other distinguished
    country representatives and our global partners in the Roll Back
    Malaria Partnership today as we gather to recognize expanded and
    coordinated response and recommit our efforts.

-   Malaria can be either an insidious or a dramatic disease. I've
    personally experienced both. We lived for years in Africa and
    learned that not only kills outright but in non- endemic areas where
    people are only intermittently at risk like holidays to coastal
    areas \-- but still **.... I...** got malaria \-- probably when
    getting up at night to feed my baby daughter.

-   It wasn't **so** bad for most "Mzungu" -- foreigners \-- just
    headaches and chills resolved fairly quickly with medication. And
    because of that kind of scenario many have not taken malaria so
    seriously. But my husband did the dramatic version. He went to a
    known choloroquin resistant area, decided to not take his medicine
    since the "old timer missionaries" weren't and as I joking (now) say
    "He tried to die". He ended up in hospital on IVs and quinine with
    resistant malaria. He sometimes claims that he has had 3 sinless
    days in his life -- those worst days of malaria when he was to sick
    to even think any sinful thoughts! It undermines health and
    well-being every day of the lives of vulnerable Africans through the
    effects of anemia and other sequelae of repeated infection and
    reinfection. The disease burden of malaria has a variety of factors,
    including intensified and spreading poorly understood factors.

-   Malaria affects the health and wealth of nations and individuals
    alike. In Africa, it is both a disease of poverty and a disease that
    causes poverty. It is a major constraint to economic development,
    with significant direct and indirect costs. As a result, the
    international community has remobilized in the past few years to
    develop and implement sustainable actions against malaria. Ninety
    percent of malaria deaths occur in Africa, and the disease accounts
    for approximately \$12 billion a year of lost African gross domestic
    product.

-   Malaria's greatest impact is felt by very young children in Africa.
    As much as a quarter of child deaths in endemic areas are
    attributable to malaria. But infection of women during pregnancy
    takes a huge toll: on the health of the mother herself and on the
    development of her unborn child. Placental infection is a
    significant contributor to low birthweight and subsequent neonatal
    death. In areas of unstable or epidemic malaria, all persons are at
    risk of serious illness and death. The drain on the physical and
    financial resources of households and communities of the disease and
    often ineffective attempts to respond to it is well documented.

-   However, we do have proven tools that can greatly reduce malaria
    infection and illness. We can take action against malaria. And that
    is why the Roll Back Malaria partners\--leaders from across Africa,
    African health institutions, WHO, UNICEF, World Bank, bi-lateral
    agencies, international, national and local NGOs, and the private
    sector.

-   No one agency can do it all. We have developed strong partnerships
    with many companies, bringing in private dollar action side by side
    to support public programs. USAID is committed to reaching out
    beyond our traditional partners to find able and creative
    organizations, particularly those that are faith-based and
    community-based.

-   And with so many new partners, the coordination of our efforts
    becomes even more critical. This is as true among the U.S.
    government agencies as it is among our international partners,
    including the new Global Fund. Coordination efforts must occur at
    two levels: at headquarters and in the countries we are assisting.
    private sector\-- have committed to halving Africa\'s malaria
    mortality by 2010.

-   As Paula noted the U.S. government is doing more than ever before.
    The Bush administration has made a significant investment in the
    Global Fund. USAID played a key role in establishing the Secretariat
    of the Global Fund to Fight AIDS, Tuberculosis, and Malaria and in
    creating the Fund's monitoring and evaluation strategy.

-   USAID has played an important role in developing the global
    initiative Roll Back Malaria. At the regional and national level,
    USAID activities have established, strengthened, and expanded
    country programs throughout the world.

-   In collaboration with public and private partners, USAID also
    focuses on developing and testing malaria vaccines through its
    Malaria Vaccine Development Program. In the latest step forward,
    field-testing has begun in Kenya of a single-component malaria
    vaccine.

-   During the past year, USAID has supported activities to Roll Back
    Malaria in Africa through 22 of its missions, and two regional
    programs as well as numerous PVO projects in Africa. Through central
    projects and partnerships USAID provides technical assistance,
    focusing on implementation of key interventions and development of
    new technologies, approaches and partnerships..

    This year USAID's NetMark Project launched insecticide-treated net
    products in Zambia, Senegal, Ghana, and Nigeria. This innovative
    pubic-private partnership to promote ITNs, sold more than 600,000
    nets and 500,000 insecticide re-treatments during its first five
    months of operation. **In the coming year NetMark will launch in at
    least five more countries in Africa.** NetMark has formed
    partnerships with 13 major commercial firms (representing over 80
    percent of the global capacity to produce and distribute ITNs) to
    share the risks of developing ITN markets, to identify and reduce
    barriers to effective engagement of the commercial sector , and to
    create demand, thereby expanding the availability of affordable
    ITNs. This effort, joined with that of the many Roll Back Malaria
    partners to scale-up ITN access and use throughout Africa , can
    reduce malaria deaths by one million annually. We hope that this
    successful cooperation with the commercial sector for
    insecticide-treated netting will serve as a model for future
    cooperation with the commercial sector in other parts of the world
    and with other health related products.

-   USAID is also supporting technical and strategic innovation to
    scale-up effective treatment of malaria illness and interventions in
    pregnancy through its Malaria Action Coalition. Again the watchwords
    are technical excellence, innovation and partnership.

    USAID invests in development of new tools, particularly vaccine
    development and the response to increasing drug resistance. USAID is
    also addressing malaria in humanitarian emergencies which are
    estimated to account for up to 30 percent of Africa's malaria deaths
    in the midst of war, civil strife, food shortages, or large
    population displacements.

-   There is much to do. If we are to meet our goal of halving Malaria
    by 2010, all of us, our esteemed partners from African governments,
    health institutions and our global partners must act together
    through the opportunity offered by the Global Fund and through the
    Roll Back Malaria partnership at all levels, most importantly in
    countries, to deliver the tools we have in hand, to develop new
    tools, and to fulfill the promise of coordinated and concerted
    support to countries.

-   Thank you.