General Assembly Session 57 meeting 43

Mr. Atta (Egypt)

Malaria, AIDS and tuberculosis have become major public health challenges; they impede development efforts in many countries. The United Nations, by its resolution 55/284 declared this the Decade to Roll Back Malaria in Developing Countries, particularly in Africa. To be sure, we support the mobilization of every possible effort to combat AIDS, but we need similar efforts to fight malaria, which a World Health Organization (WHO) report indicates is spreading widely and causing severe social and economic damage analogous to that caused by AIDS.

Reports also show that malaria is spreading in more than 100 countries, with 40 per cent of the world's population, over a wide area that extends through Africa, Central and South America, South-East Asia, the Indian subcontinent, the Middle East, some European countries and the western Pacific. Among the 300 to 500 million cases, 90 per cent are in Central, East and West Africa. Of the more than 1 million who die annually of malaria, most are children, due to their weak immune systems. It is indeed sad and painful that one child dies of malaria every 30 seconds.

That is painful not just because of the high incidence of malaria among the elderly and children but also because malaria is a disease that can easily be treated if diagnosed early. Providing medicine for treatment to those who cannot afford to buy it, especially in African countries, should be more important than commercial interests. In many African countries malaria is an economic and social problem, not just a health problem. It affects the productivity of individuals and their ability to earn enough to support their families. Studies have shown that some African countries lose 22 per cent of their working hours because of malaria. In some cases, malaria has stricken 25 per cent of the population.

Malaria also prevents children from going to school and thus limits their ability to build their future. It is thus undermining the future as well as the present. Statistics prove that malaria is both a result and a cause of poverty. There is a huge gap between the resources needed to deal with the causes of the disease in developing countries and the material wealth and human resources those countries possess.

WHO estimates that $1 billion should be spent, in addition to what is being spent now, to attain the objectives of the Decade. It is not expected that the gap can be bridged without a sustained increase in official development assistance in the field of health, and without easing the burden of servicing. That would enable countries to free more resources to deal with the diseases that threaten their communities, especially malaria.

I would like to refer here to the important recommendations included in the report of the Secretary-General on this item (A/57/123). The delegation of Egypt supports the Secretary-General's call for increased support for the Global Fund to Fight AIDS, Tuberculosis and Malaria and for increased bilateral assistance in combating malaria.

If one child dies of malaria every 30 seconds, I call on all Governments, especially the donor community, to do some simple arithmetic and calculate how many died while I was delivering my statement, how many will die as we deliberate on this item and how many will have to die before the international community moves to eradicate this easily treated disease by providing the necessary medicine. All we need is a small fraction of what the world spends every day on armaments and on building up arsenals that will eventually be used -- when and against whom no one knows.

Mr. Menan (Togo)

During its fifty-fifth session, the General Assembly proclaimed the period 2001-2010, as the Decade to Roll Back Malaria in Developing Countries, particularly in Africa. In many respects, this was a very important decision taken by the international community with a view to seriously addressing one of the crucial health problems that developing countries, unfortunately, continue to face.

In order to achieve this goal, the General Assembly, in resolution 55/284, inter alia, called upon the international community to help those countries where malaria is endemic to improve their national health systems, in order to attain by 2005 a certain number of specific targets, including prompt access to treatment; a more widespread use of insecticide-treated mosquito nets (ITNs); the prevention of malaria; and an effective combat against that illness, particularly for those most at risk, including pregnant women and children. The fight against the pandemic of malaria is of great urgency in order to reduce people's vulnerability to that sickness.

In his report to the General Assembly on the implementation of the goals of the Decade to Roll Back Malaria, the Secretary-General, after assessing the situation and taking note of the specific actions that have been taken, emphasizes in particular certain priority areas that must be focused on in order to strategically pursue the desired objectives.

While reiterating its appreciation to the Secretary-General for the high quality of his report, the delegation of Togo would like to particularly emphasize the following areas, which we deem of great importance with regard to the strategy that needs to be adopted: awareness-raising among, and the dissemination of information to, the peoples of regions where malaria is endemic; the promotion of partnership at all levels, particularly between the countries of the North and the South; improved procedures and methods for combating malaria; and the mobilization of the necessary financial resources.

Regarding the question of outreach, the Secretary-General has recalled the fact that Africa Malaria Day, which was launched by the Abuja Declaration on the Roll Back Malaria Initiative, is commemorated on 25 April, with a view to supporting the efforts under way and monitoring the progress achieved in efforts to combat malaria in Africa. This year's commemoration provided an opportunity for certain countries in the continent to carry out broad-based activities aimed at, inter alia, combating malaria at the level of the family and promoting and raising awareness of, the use of ITNs. In addition, certain non-governmental organizations and private-sector partners made use of 25 April to hold their own events to promote efforts to combat malaria. This initiative should be welcomed.

Nevertheless, while such one-off activities are necessary to create a promising environment for efforts to combat this disease, we should not lose sight of the fact that awareness-building should be an ongoing process in order to bring about a mindset that considers malaria as an intolerable burden. The tangible progress that has been achieved in certain African countries in the combat against HIV-AIDS through outreach and prevention should encourage us to persevere along these lines.

As far as promoting partnership is concerned, I hardly need to recall the importance of international cooperation in the context of achieving these goals. The launching in 1998 by the World Health Organization (WHO), the United Nations Development Programme, the United Nations Children's Fund (UNICEF) and the World Bank of the Roll Back Malaria Initiative is a vivid illustration of the viability of such an approach.

It is important, however, that South-South cooperation also be further reinforced. It is essential that the countries of the South that have been successful in the combat against or the eradication of this disease demonstrate greater solidarity vis-à-vis those countries where malaria is still endemic.

Likewise, it is equally important to ensure the participation of the private sector in achieving the goals of the Decade. Partnerships between private companies and Governments could make it possible for Governments to have access, at affordable prices, to new combination anti-malaria therapies that are very effective against drug resistance and also to ITNs, at a lower cost. This type of cooperation could also provide an opportunity for the countries concerned to obtain new technologies for manufacturing ITNs and effective pharmacological products.

Regarding the improvement of ways and means of combating this disease, everything should be done to overcome one of the major difficulties encountered by Africa: drug resistance. Products such as chloroquine, which were very effective and cheap, are no longer so these days because of the resistance developed by disease vectors to these products. It is to be hoped that a new drug called Coartemether, which was recently endorsed by WHO and which is partly derived from Chinese herbs that are particularly effective in the treatment of malaria, will become an alternative solution in future.

As far as mobilizing resources is concerned, the Secretary-General rightly points out in his report that insufficient human and financial resources represent the principal obstacle in the combat against malaria.

In this connection, the delegation of Togo would like to recall that, since the proclamation of the Decade to Roll Back Malaria, the only initiative taken by the international donor community has been the creation of the Global Fund to Fight AIDS, Tuberculosis and Malaria. Because of the broad scope of the Fund, it is to be feared that very few financial resources will be allocated to anti-malaria efforts. Furthermore, according to predictions, only 17 per cent of the contributions sent to the Fund would go to the fight against malaria, whereas 61 per cent and 22 per cent, respectively, would be allocated to HIV/AIDS and tuberculosis.

It is not the intention of my delegation to bemoan the condescending attitude of our development partners, which, I hardly need recall, should assist the efforts of the developing countries themselves to resolve their particular problems.

After the first year of the Decade to Roll Back Malaria, it is somewhat premature to assess the effects of the actions undertaken on morbidity and mortality rates or to calculate the economic impact on the countries affected. Nevertheless, it is important to emphasize that it is the duty of the international community to display more active solidarity towards the African countries in order to harmoniously achieve the Decade's objectives.

In this connection, we should not lose sight of the fact that most of the programmes and plans of action that have recently been drawn up by the international community to help to combat poverty in Africa -- measures that gave rise to great hope and optimism among the African people -- unfortunately have not made it possible to achieve the expected results, as was confirmed by the New Agenda for the Development of Africa in the 1990s, which has been terminated by the General Assembly and replaced by the New Partnership for Africa's Development.

Togo sincerely hopes that the international community will do everything in its power to ensure that the Decade to Roll Back Malaria does not meet with a similar fate, and that, above all, it will create conditions that are conducive to reversing this trend.

Mr. Fall (Senegal)

My colleague from Togo has just given a very detailed, well-documented and edifying statement. I would like to congratulate him and to associate myself fully with all of his incisive comments. During the few minutes it took to make that statement at least 10 African children died from malaria. That fact demonstrates the importance of the item that we are considering, and which is of particular concern to us.

By proclaiming, through resolution 55/284 of 7 September 2001, the period 2001-2010 as the Decade to Roll Back Malaria in Developing Countries, particularly in Africa, the General Assembly fully acknowledged the true scope of the threat posed by that disease to the development of the countries of the South, particularly those in Africa. Malaria is, in fact, by far the chief cause of mortality in many African countries. Together with tuberculosis and AIDS, it is dangerously compromising the development of our countries, as the very alarming statistics show.

Some 300 million people are affected by malaria every year. As was pointed out earlier, malaria kills one African child every 30 seconds, and 90 per cent of deaths from malaria occur in Africa. In my country, Senegal, malaria is the reason for 30 per cent of all medical consultations and is responsible for a loss of earnings equivalent to 1.3 per cent of our gross domestic product. Malaria is thus an enormous challenge for African countries, which, as the Assembly is aware, are trying to deal with other urgent and important challenges at the same time.

A little more than two weeks ago, researchers from West Africa met in Dakar, Senegal, to define a regional approach to policies to combat malaria and to take stock of the effectiveness of anti-malaria pharmaceuticals in the subregion. That gathering followed a meeting of all the French-speaking African countries to discuss the disease. This demonstrates once again the importance that Senegal attaches to the fight against malaria and to the implementation of the objectives of the Decade, as well as to the Roll Back Malaria Initiative.

We believe that the fight against malaria must not be trivialized or relegated to a second place after the fight against HIV/AIDS. On the contrary, the challenge of rolling back malaria must be met head on, together with that of fighting AIDS.

The absence or inadequacy of infrastructure and resources, the resistance of vectors to pharmaceuticals and insecticides, the inefficacy of prevention strategies, and poverty -- the mother of all these ills -- are serious obstacles that must be overcome if we wish to achieve the objectives of the Decade, first and foremost to eradicate malaria. To that we can add the meagre progress achieved in the quest for a vaccine.

The Extraordinary Summit of the Organization of African Unity -- now the African Union -- held at Abuja, Nigeria, in April 2001, on the fight against AIDS, malaria, tuberculosis and other endemic diseases in Africa, resulted in the launch of a number of initiatives which deserve further support from the international community. By declaring 25 April to be Africa Malaria Day, and by committing themselves to devoting 15 per cent of their national budgets to health-related expenditure, African countries once again demonstrated their collective political will to meet the crucial challenges of health and development.

The Abuja Declaration emphasized the need to

"Reduce or waive taxes and tariffs for mosquito nets and materials, insecticides, anti-malarial drugs and other recommended goods and services that are needed for malaria control strategies".

As can be seen from the report of the Secretary-General (A/57/123), Senegal is among the 10 African countries that have taken bold measures to implement that recommendation, with a view to facilitating access to medicine, treatment and preventive care. We therefore believe that it is essential to strongly and solemnly reiterate here the recommendation to undertake the necessary fiscal and customs reforms, with a view in particular to making more widespread the now inadequate use of insecticide-treated mosquito nets, in particular by children and pregnant women.

The partnerships established within the framework of the Roll Back Malaria Initiative have enabled us to make considerable progress in the international fight against malaria. We must consolidate and strengthen it by further involving the private sector, local communities, families, non-governmental organizations, the media and other sectors of society in order to attain the goals of the Decade.

Last but not least, I would like once again to underscore the great importance and urgency of strengthening worldwide campaigns to mobilize resources for the Global Fund to Fight AIDS, Tuberculosis and Malaria.

To this end, Senegal totally subscribes to the five recommendations included in the Secretary-General's report (document A/57/123), and my country requests its endorsement by the Assembly.

Thank you, Mr. President, for your compassion, because by the time I reach the end of my statement, malaria which has affected tens of millions of people, will have mortally terminated the possibilities of dozens of African children who will have succumbed to an affliction that has also stricken their families, their land, their continent. These are children who will not enjoy the presence or affection of their families. The loss of these children will, in turn, be a loss to their country and their continent.

The Acting President

We have heard the last speaker in the debate on agenda item 29.

We have thus concluded this stage of our consideration of agenda item 29.