General Assembly Session 58 meeting 41

Mr. Alessandro (Italy)

I have the honour to speak on behalf of the European Union. The acceding countries Cyprus, the Czech Republic, Estonia, Hungary, Latvia, Lithuania, Malta, Poland, Slovakia and Slovenia, the associated countries Bulgaria, Romania and Turkey and the European Free Trade Association country member of the European Economic Area Norway align themselves with this statement.

This important debate is yet another indication of the attention that malaria control and prevention has received throughout the international community, particularly after the World Health Organization, together with UNICEF, the United Nations Development Programme and the World Bank, founded the Roll Back Malaria Partnership and since the holding of the Abuja Summit in 2000. Over the last few years, we have seen a change in attitude that has placed malaria high on the agenda of Governments, international organizations and development programmes. Through the Roll Back Malaria Initiative and the Global Fund to Fight AIDS, Tuberculosis and Malaria, a new form of co-operative partnership has started between low-income countries and the donor community.

The European Union warmly welcomes such developments. We recognize the need for more resources to implement concrete actions, but, at the same time, we must be aware that those resources are limited and should be used primarily to create continuity in awareness and support. That means day-by-day support at the grass-roots level, involving Governments, local communities and aid agencies in a participatory manner, in order to meet the targets agreed upon for the Decade to Roll Back Malaria.

We fully endorse the final declaration of the Second Summit of the African Union, in which Heads of State and Government confirmed that the fight against HIV/AIDS, malaria and tuberculosis is a priority for the continent. The burden of those diseases and their impact on the population are heavy, and they inevitably affect development initiatives planned within the New Partnership for Africa's Development (NEPAD) and the Group of Eight Africa Action Plan.

This year, more than a million people will die from malaria. Many more will contract the disease. Of the 500 million people suffering from malaria, 450 million, representing 90 per cent of the total, are sub-Saharan Africa's poorest citizens. In addition, we are aware that malaria costs Africa from $10 billion to $12 billion annually in its gross domestic product. That includes medical costs, missed schooling, lower productivity, less foreign direct investment and lower tourism revenues. Moreover, malaria claims the lives of many African children every day. The European Union expresses its deepest concern at this situation and its willingness to act to reverse it.

To end this cycle of suffering and poverty, Governments and the private sector are accelerating malaria research. As we pick up the pace on malaria research, we must also greatly expand existing prevention, care and treatment approaches, which are mutually dependent. Global funding to combat malaria will require resources matching the scale of the crisis. Approximately $60 million a year is invested in malaria research, and $200 million is spent annually to treat impoverished patients and distribute mosquito nets and insecticides. In that regard, the European Union is committed to strengthening and increasing financial support for research and development.

Allow me to describe briefly the actions we have undertaken so far. Under the last European framework programme, covering the period 1998 to 2002, we implemented 26 different research projects on malaria at a cost of more than 30 million Euros. Nearly 100 research institutions, based in 15 African countries, 11 European countries and five Asian and South American countries, participated in the project. Through that partnership to tackle malaria, we encourage strengthened cooperation within the framework of international initiatives such as the European Malaria Vaccine Initiative, the African Malaria Vaccine Trial Network and the new European-Developing Countries Clinical Trial Partnership.

Furthermore -- following as well the recommendations made in General Assembly resolution 57/294 on the Decade to Roll Back Malaria -- last July the European Parliament and the European Council adopted a regulation on assistance in fighting poverty-related diseases in developing countries, namely HIV/AIDS, tuberculosis and malaria. In allocating funding and expertise, priority will be given to the least developed countries and the most disadvantaged sections of the population. The financial framework for the implementation of this new regulation for the period 2003 to 2006 is set at 351 million euros.

The European Union has also noted that, in spite of the fact that most of the key pharmaceuticals are off patent, few developing countries have sufficient capacity to manufacture them. Moreover, for the time being, available drugs are not well suited for developing countries, and malaria drugs are becoming less and less effective as a result of increased parasite resistance. We should therefore find new drugs appropriate to Africa's special needs and take into account local distribution problems and cold chain availability.

In that regard, we encourage interested parties, especially the pharmaceutical industry, to promote sustainable local production for national and regional markets, aiming at the transfer of technology. For that reason, the European Union and its member States fully endorse the Doha Declaration on the Agreement on Trade-Related Aspects of Intellectual Property Rights and Public Health.

Many African countries are working to fight malaria, but they cannot do it alone. Like HIV/AIDS and tuberculosis, this disease requires a well coordinated, comprehensive and consistent response, which is beyond the financial and human resources of many developing countries. Because of their magnitude and transitional nature, poverty-related diseases require a systematic response from the international community. In that respect, we commend the proactive role played by the United Nations and the World Health Organization.

We believe public health is a public responsibility. Actions targeting the poverty-related disease must be carried out within the larger context of improving health care systems in developing countries and making those systems accessible to all. Improving health care is a precondition for and a key element of sustainable development. The European Union is committed to providing partner countries with assistance consistent with their own development plans, thus taking into account the overall objectives of improving the population's health and reducing poverty.

If the international community is capable of building a true global partnership with effective tools, and if developed and developing countries and the public and private sectors are able to work together towards this common goal, we strongly believe that malaria can be definitively rolled back throughout the world, as it has been in Europe.

Mr. Andjaba (Namibia)

In his report contained in document A/58/136 the Secretary-General reveals that, in 2005 -- when we review the implementation of the Millennium Development Goals -- he, in close collaboration with the Director General of the World Health Organization (WHO), will present to the august Assembly a progress report on the targets of the Decade to Roll Back Malaria in Developing Countries, particularly in Africa.

The importance of that submission to the sixtieth session of the General Assembly is underlined by the fact that, in Africa, an increasing number of deaths is being caused by malaria. It is in that context that heads of State or Government of the African Union, meeting in July at the Second Ordinary Session of the Assembly in Maputo, Mozambique, reaffirmed their commitment, enshrined in the Abuja Declaration and the plan of action adopted for the Roll Back Malaria Initiative. It is for that reason that my delegation thanks the Secretary-General for his report and welcomes this debate.

Mr. Andjaba (Namibia)

Malaria continues to be a major public health problem in Namibia, and thus warrants special attention in terms of monitoring trends and formulating control strategies and prevention at all levels of the health care system and the community. According to health service statistics, an average of 450,000 malaria cases and 800 deaths from malaria are reported countrywide annually. This amounts to an incidence rate of 248 per 1,000 population and a mortality rate of 45 per 100,000 population per year. As one can expect, children under the age of five years and pregnant women are at higher risk of getting malaria and suffering its consequences. Our efforts to combat this disease are impeded by the problem of inadequate resources, compounded by the shortage of trained personnel.

In addressing this problem, in 1991 the Government launched a comprehensive programme to control malaria and other vector-borne diseases. Through this programme a number of activities have been undertaken to improve disease management, including the training of health workers, intensification of house spraying and improved reporting through the health information system.

While challenges remain, we have indeed made progress. At the national level, the Government has demonstrated its firm commitment to tackling the problem of malaria by establishing a national malaria control programme, appointing malaria control staff and allocating regular budgetary and logistical support.

The national policy and strategy on malaria was launched in 1995. That policy document describes the goals, malaria control strategies and activities at all levels of the health care system. It is also intended to inform both health workers and the general public about the role they can play in reducing malaria morbidity and mortality to the lowest possible level.

To date, 2000 health workers have been trained in malaria case management and microscopic diagnosis, which is believed to have markedly improved the quality of malaria diagnosis and treatment. It was possible to significantly improve the coverage and quality of spraying in the affected areas following a major input from the Government and our Roll Back Malaria partners.

To reduce the impact of malaria among the vulnerable population groups, about 20,000 children under the age of five years and pregnant women have been provided with insecticide-treated nets in selected highly affected areas. In order to mitigate the dreadful effects of malaria epidemics among affected communities, weekly malaria surveillance has been put in place. This has facilitated the detection of malaria epidemics at a relatively early stage. To facilitate the implementation of malaria control in the country, a five-year Roll Back Malaria strategic plan has been finalized.

On 22 September 2003, high-level meetings of the General Assembly were convened to mobilize efforts to address the HIV/AIDS pandemic. Today, we meet to discuss yet another killer disease, which in many African countries is claiming more lives than HIV/AIDS. This is a fact that needs to be emphasized as a rallying tool in the process of raising awareness and resource mobilization.

Malaria is preventable, treatable and curable, as stated clearly in the report of the Secretary-General. One can die from malaria only if and when not treated promptly and effectively. The challenge, then, is to assist the affected countries. The use of anti-malaria tools is widespread and common. Unlike the case of the AIDS virus, many African countries have access to anti-malarial drugs. However, the growing resistance to current drugs compounds the problem. This is a challenge that needs to be addressed now, together with the question of affordability. We can achieve the Abuja target of 60 per cent coverage only when the new and improved drugs are affordable.

Efforts at the community level are crucial, and, as pointed out in the Secretary-General's report, home treatment supported by public information and pre-packaging can assist substantially in reducing child mortality. Malaria affects the areas surrounding affected communities and their efforts towards sustainable development. In this context, research on environmental management for malaria control in development should be supported.

While we continue to support ongoing research for a vaccine, we call on the international community to support the efforts of the affected countries by providing the tools, which are already available. In that connection, we welcome and further encourage the transfer of technology for the production of insecticide-treated nets and efforts to increase access to anti-malaria medicines. We view the transfer of this new technology as a firm beginning in effectively tackling malaria in the affected African countries. Making generous contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria is one effective way of assisting the affected countries. We commend the efforts of the World Health Organization (WHO), the United Nations Children's Fund (UNICEF) and other Roll Back Malaria partners in mobilizing the business community to take part in the global campaign against malaria.

We welcome the increase in resources mobilized for the Roll Back Malaria campaign, but more resources are needed to complement those of the affected countries.

In conclusion, the report before us contains recommendations to the affected countries, the international community as a whole, and in particular the private sector, in the fight against malaria. We urge the implementation of those recommendations, so as to assist African countries in implementing the Abuja Declaration.

Mr. Aboul Gheit (Egypt)

The General Assembly today is considering an item of great significance -- the Decade to Roll Back Malaria in Developing Countries.

Malaria's socio-economic impact is not limited to the African continent. Studies have shown that malaria is endemic in more than 100 countries, whose populations represent 40 per cent of the total population of the world. Studies have also shown that 90 per cent of those infected by the disease -- whose number ranges from 300 million to 500 million people -- are Africans.

Regrettably, children represent the majority of the 3 million people who die from the disease every year. This is particularly regrettable given not only the high rate of infection and death among adults and children, but also in view of the painful scientific fact that malaria is curable if diagnosed and treated early. For that reason, we must focus on the humanitarian, not the commercial, aspect of dealing with this disease.

Reports indicate that the African continent requires nearly $1 billion a year to combat malaria effectively. Reports indicate also that the financing available is only about a quarter of what is needed. My delegation therefore agrees with the statement in the report of the Secretary-General that the level of international funding to combat malaria is inadequate. We support his call to bolster governmental expenditures in African countries with greater and more comprehensive international funding.

If malaria, as facts have shown, is both a cause and a consequence of poverty, we cannot expect developing countries to succeed in overcoming the health problems they face without a tangible increase in development assistance, including the alleviation of the debt burden of those countries, to redirect more resources to health services, to promote prevention and treatment programmes, and to improve general health-care services in general.

Every 30 seconds a child dies of malaria. I therefore call on all Governments, in particular the community of donor States, to make some simple calculations: how many children will have died during the delivery of this statement? How many children will die during the discussion of this item? How many children must die before the international community moves to eradicate this disease?

Malaria is not considered incurable. On the contrary, there are means of treatment and prevention. All that is required would be a reasonable percentage of what the world spends daily on armaments and on the building of vast military arsenals.

Ms. Bahemuka (Kenya)

My delegation commends the Secretary-General and the Secretariat for the documentation provided for this agenda item.

Malaria is the second most deadly disease in Africa, after the HIV/AIDS pandemic. Recognizing the magnitude of the problem, the General Assembly, at its fifty-first session, appealed to the international community and to non-governmental organizations to allocate substantial resources -- especially through the Global Fund to Fight AIDS, Tuberculosis and Malaria -- for developing countries, particularly in Africa. The goal was to enable African countries fully to implement the plan of action adopted at Abuja for the Roll Back Malaria initiative.

We are grateful indeed to the World Health Organization and to the United Nations Children's Fund (UNICEF) for their joint efforts to compile a report on malaria in Africa, which was released on Africa Malaria Day, observed on 25 April last in a coordinated launch in Nairobi; Washington, D.C.; and London. We also appreciate the efforts of the World Bank and of other partners in resource mobilization and in financing the campaign against malaria.

At the national level, Kenya recognizes that good health is a prerequisite for the socio-economic development of any country. We are a signatory to the Abuja Declaration on Roll Back Malaria. We have responded to the Abuja Declaration through the removal of taxes and tariffs associated with insecticide-treated net products. A National Malaria Strategy has been put in place and focuses on improving malaria case management at all levels of the health sector; reducing the risks of malaria during pregnancy; increasing the use of insecticide-treated nets and other vector-control technologies; and responding to malaria epidemics.

The National Malaria Control Council (NMCC) has since been reconstructed to become the Inter-Agency Coordinating Committee. That Committee will be a more effective political and financial management tool for soliciting and directing investment aimed at rolling back malaria in Kenya. The objective is to reduce morbidity and mortality caused by malaria by 30 per cent among Kenya's population by the year 2006 and to sustain that improved level of control through 2010.

Significant resources to Kenya districts are now being mobilized though health sector reform. That reform will provide the framework and financing mechanisms for improved district-led support for curative and preventive services. The Division of Malaria Control will support planning of district-led strategies in concert with the national malaria strategy.

In order to enhance those efforts, the Government of Kenya, in collaboration with other stakeholders, intends to strengthen preventive and promotive health care through malaria control, an expanded immunization programme, integrated control of childhood illness and the prevention of environmentally related communicable diseases. We are also trying to strengthen curative health services so as to manage the top 10 killer diseases through the provision of health personnel, drugs and equipment. In addition, Kenya would like to expand health insurance coverage and access for all its citizens.

National efforts in the fight against malaria require international support through funding, capacity-building and equipment. Kenya has drawn up a strategic plan that has enabled us to benefit from the Global Fund. Such funds will be utilized to strengthen malaria early-warning systems and studies in order to improve detection of outbreaks and response to them.

In conclusion, we must work together with the international community to strengthen national interventions in the fight against the major killer diseases in developing countries. It is very urgent that our development partners honour their commitments by contributing to the Global Fund to fight the three maladies that continue to afflict developing countries.

Mr. Menan (Togo)

Last year, when the General Assembly was considering the item that is before it today, the Togolese delegation strongly urged the international community to make every effort to attain the objectives set out in the framework of the Decade to Roll Back Malaria in Developing Countries, particularly in Africa. From that perspective, and in keeping with the views that we initially expressed, Togo believes that the Decade's objectives should be a genuine challenge for countries where malaria is endemic and for the international community to meet at all costs.

It is paradoxical that malaria, which everyone agrees is a disease that can be cheaply controlled and cured, remains one of the primary causes of death in African countries, as indicated by statistics set out in the report on malaria in Africa in 2003, published jointly by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF). According to those statistics, more than 3,000 children in Africa die from the disease every day.

The Secretary-General addresses that state of affairs in his report on implementation of the Millennium Declaration (A/58/323), when he notes with bitterness that, despite the progress achieved with regard to children's health in developing countries in the 1990s, nearly 11 million children die each year before their fifth birthday, primarily from diseases that can be easily prevented or treated, malaria among them.

However, it is encouraging to note that, because of the proclamation in 2001 of the Decade to Roll Back Malaria and the launching of the Roll Back Malaria initiative three years earlier by WHO, UNICEF, the United Nations Development Programme (UNDP) and the World Bank, preventing and fighting the disease are again becoming top priorities at the national and international levels. That is also made clear in the report of the Secretary-General (A/58/136), submitted to the General Assembly in keeping with the recommendations contained in resolution 57/294, which the Assembly adopted at its last session. As the report recalls, administering medicines and using insecticide-treated mosquito nets are still the only effective ways to fight the disease.

However, access to treated mosquito nets remains relatively limited in Africa -- despite notable recent efforts to bring mosquito nets into general use -- because of their high cost, which is an obstacle to their widespread use. That is why Togo commends the Secretary-General for his proposal to persuade companies that extract petroleum products on the African continent to contribute to the Roll Back Malaria initiative in Africa by providing at greatly reduced cost the polymers used in manufacturing mosquito nets. We fervently hope to see the General Assembly endorse that recommendation as well as the others contained in the aforementioned report.

To attest to Togo's commitment to pursuing efforts aimed at promoting the health of the Togolese people, despite the financial difficulties the country has faced for more than 10 years, since the suspension of the aid that it had received from its main development partners, the head of the Togolese State announced to UNICEF authorities in June the Togolese Government's decision to lower customs tariffs on insecticide-treated mosquito nets.

Here, we should stress that, despite the scarcity of their resources and the problems of every kind that they face, African countries are attempting to various degrees to initiate health programmes that place priority on fighting malaria. Those countries are mindful of the need to increase national investments in the health sector and to improve its management, particularly through greater integration of anti-malaria activities into their development efforts in the health sector, in conformity with their commitments under the Declaration and Plan of Action on the Roll Back Malaria in Africa initiative, adopted in Abuja, Nigeria, in 2000. However, they cannot succeed in that endeavour unless they receive adequate assistance from the international community, as the report of the Secretary-General opportunely recalls.

With regard to pharmaceutical products, according to a study by the Pasteur Institute in France, researchers in areas where malaria is endemic have not been able to develop a viable remedy for all forms of the parasites that are responsible for the disease. The study also states that one of the major difficulties confronting researchers is fighting the great ability of mosquitoes -- vectors of the parasite -- to adapt to treatments and that the parasites deposited by mosquitoes into the human organism are resistant to medicines, whereas mosquitoes themselves develop resistance to insecticides.

However, it is reassuring that research continues to make appreciable progress, as attested by a British pharmaceutical group's recent launching of a new product, called Lapdap, designed to fight the most deadly form of malaria, which is the most widespread form in sub-Saharan Africa. Yet it seems that, if the political will prevails and if pharmaceutical companies are not too much bent on the frenetic quest for high profits, the current efforts could sooner or later be successful, both in discovering a treatment for all types of the parasites that cause the disease and in developing a vaccine.

In this campaign against malaria, Togo, like other African States, very much hopes that the international community will not cease to support seriously affected countries so that lives can continue to be saved and so that the Decade to Roll Back Malaria will be able to reverse the trend of the disease.

In that way, the international community would respond to one of the specific needs of Africa: promoting the health and well-being of our peoples. And above all, it could help to spare families in distant Africa the tragic, wrenching scenes, often marked by the death of a child simply because the parents did not have enough money -- which in many cases would be less than $1 -- to buy the necessary drugs.

In conclusion, I wish to reiterate the gratitude of my Government to the United Nations agencies, particularly the World Health Organization and the United Nations Children's Fund, as well as to the various foundations for their positive contribution in the struggle to combat malaria. The Government of Togo urges donors to provide further support for the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Mr. Tekle (Eritrea)

The Eritrean delegation takes this opportunity to thank the Secretary-General for his informative report (A/58/136) on agenda item 51, entitled "2001-2010: Decade to Roll Back Malaria in Developing Countries, Particularly in Africa".

My delegation participates in this debate anticipating that the review of the first three years of the 10-year programme will enable us to identify the obstacles that confronted us and the various means by which we can get rid of, or attempt to get rid of, those obstacles. It hopes that this exchange of views will enable us, if necessary, to readjust our programmes and to reorganize our priorities and approaches.

Unlike HIV/AIDS, malaria is not a new pestilence. Humanity has known and lived with it for millennia. Although, fortunately, it has been completely eradicated in most parts of the world for at least several decades, in some unfortunate areas it continues to kill or debilitate large sections of the population. Even worse, it has recurred in areas from which it had successfully been eradicated. Among the worst hit is the Horn of Africa, even though previously it had made progress, owing to several national eradication programmes.

The statistical data are grim. In most of the countries of the Horn of Africa, including Eritrea, almost 30 per cent of the population is victim to malaria. Worse, almost 70 per cent of the population lives in malaria-endemic areas. In Eritrea, the death rate among children hospitalized with malaria is about 7.4 per cent.

The causes of the continued existence of malaria may differ from area to area. In the Horn of Africa, the primary reason for this calamity has been war -- never-ending war. Malaria has had at least as much impact as HIV/AIDS on our economies, and in some cases it has had a more negative one, not only because of its debilitating effects on a much greater workforce, particularly among the peasantry, but also because the malaria-endemic areas are largely unavailable for cultivation. Indeed, in Eritrea malaria is the greater threat.

Thus, malaria is as much an economic threat as it is a health problem and has influenced socio-economic development programming in African countries. It is for this reason that the Eritrean Government has, since 1991, addressed the problem with the seriousness it deserves, has given it high priority and is determined to wage an unremitting struggle against the plague.

The Government of Eritrea has, inter alia, taken the following concrete measures in its war against malaria.

First, in addition to earlier efforts, the Ministry of Health inaugurated a five-year malaria reduction programme for the period 2001 to 2005. The major goal of this holistic programme adopted by the Ministry was to significantly control the further spread of the disease while, at the same time, preventing more infection among vulnerable groups by the strengthening of epidemiological surveillance. Its ambition was to minimize the effects of malaria on the capacities of the population by reducing mortality, morbidity and the incidence of malaria by 80 per cent, and to reduce malaria epidemics by 90 per cent by the end of 2005. The programme is largely on course.

Second, it established the national malaria control programme, which is responsible for the formulation of malaria control policies, plans and guidelines; coordination and control of programmes; monitoring and evaluation of programme activities; and coordination of technical assistance and research.

Third, it has trained village health agents and assigned them to provide malaria control services at the grass-roots level. These agents diagnose and treat simple cases of malaria, disseminate awareness information, mobilize communities for environmental management and identify vector-breeding sites close to communities. This is made possible through village meetings and periodic seminars given by the village agents, and through the coordination of community participation in weekly environmental management activities, including the draining and filling of breeding sites.

Fourth, through its regional and local offices, the Government provides insecticide-impregnated bed nets to the needy population. It is hoped that, by the end of 2005, every household will have at least two such bednets.

Fifth, it employs combination therapy for the treatment of the disease at all levels and has evolved a detailed treatment regimen known as the Eritrean standard treatment guidelines.

Sixth, it carries out indoor house-spraying activities, albeit selectively, on the basis of a previous history of malaria in a given area and/or evidence of a sudden increase in other areas. This may, in some cases, include total coverage of villages in affected areas.

Seventh, it routinely conducts tests of insecticide spraying to determine the susceptibility or resistance of the vector to insecticides selected for vector control.

Eighth, it has developed and widely disseminated educational and awareness material in several Eritrean languages, including Arabic, Tigre and Tigrigna, and has effectively used radio and television programmes, as well as village meetings, to that end.

Ninth, the Malaria Control Programme has also established a close collaborative relationship with relevant Eritrean ministries including, in particular, the Ministries of Agriculture and Environment, and Land and Water, as well as the Meteorological Department, to ensure appropriate surveillance and to develop sensitive forecasting methods.

In its effort to control the scourge, the Government of Eritrea has been cooperating with, and has received assistance from the United States Agency for International Development, for its entomological research programme, an Italian cooperation project, the World Health Organization (WHO) for the Roll Back Malaria programme, the United Nations Children's Fund (UNICEF) for the protection of children and those countries which are supporting the HAMSET Disease Control Project, which deals with HIV/AIDS, malaria, sexually transmitted diseases and tuberculosis.

However, Eritrea recognizes that if the campaign against malaria is to succeed, it must transcend national boundaries and benefit from the creation of effective cooperative regional mechanisms, strategies and programmes. These are not yet in place.

Needless to say, the Eritrean Government will steadfastly pursue the goals it has set for itself in its five-year plan, which ends in 2005. The mission is great and the challenges and obstacles are many. Yet, they would not be insurmountable if there were to be peace with justice, peace based on the rule of law, peace respecting good neighbourliness and peace anchored in good faith and trust. Unfortunately, the chances of achieving these ideals, too, seems to be remote.

Mr. Rajalingam (Fiji)

Fiji commends the Secretary-General for the excellent report contained in document A/58/136, entitled "2001-2010: Decade to Roll Back Malaria in Developing Countries, Particularly in Africa", and supports its recommendations.

The HIV/AIDS pandemic has touched all corners of the globe. Its effects have devastated families, economies and Governments. Whole generations may be lost before we totally recover. Likewise, development strides gained in recent decades have been rolled back. Less mentioned but no less intense in its devastation is malaria.

Malaria continues to plague parts of our region. Although our statistics seem relatively less alarming than other regions, they have attracted global attention and resources. We do not believe this statistical indicator to be cause for complacency in taking preventative measures to ensure it does not reach pandemic proportions. Nor indeed should a complacent attitude cause malaria to revisit those countries in the region, such as Fiji, that have successfully rid its citizens of this disease. Sadly, tuberculosis is one such ravaging disease that has returned.

We acknowledge the intensive efforts of the World Health Organization (WHO) in controlling this disease as well as member Governments' initiatives to fight the scourge. The WHO report contained in document A/58/136 is meticulous in its detail and statistics. We are encouraged to see that the plan of action to roll back malaria is global in perspective and embraces all countries and regions, irrespective of size or extent of the endemic malaria. In our region, we feel confident that the malaria project allocation of the Global Fund to fight AIDS, Tuberculosis and Malaria will make a significant difference towards reaching the objectives of the global programme.

Developing countries are particularly vulnerable to the onset of any epidemic. They lack the industrial base for pharmaceutical production to meet demands and lack readily available financial resources to buy the necessary pharmaceutical products from manufacturers. Typically, when a disease reaches epidemic proportions, it is also accompanied by opportunistic, often deadly, companion infections or diseases which are equally potent in impact.

The WHO report has allowed us to reflect on the grim picture of the malaria pandemic in Africa. Alongside the plaguing effects of HIV/AIDS in Africa, clearly the eradication, or at least alleviation of such pandemics depends on development. The Global Fund to fight AIDS, Tuberculosis and Malaria is only one avenue -- groundbreaking as it is -- that is making it possible for African countries to access funds for malarial control commensurate with the severity of their needs.

Clearly, the implementation of the New Partnership for Africa's Development could strengthen this fight. Other financing alternatives, such as debt swaps, form a sound basis for consideration by the United Nations and WHO, in partnership with the Bretton Woods institutions. The private sector and industry need to nurture and contribute to this programme.

The contributions of non-governmental organizations are also acknowledged. Assistance provided by non-governmental organizations such as the Sovereign Military Order of Malta, in setting up sleeping sickness clinics in the Southern Sudanese town of Yei, is noteworthy.

Many other contagious and preventable diseases are affecting developing countries. In Fiji, filariasis, dengue, leprosy and diabetes have ravaging impacts and the incidence of tuberculosis is increasing. Care, treatment and upstream prevention need to be extensively addressed by WHO and other stakeholders.

Mr. Olhaye (Djibouti)

With the advent of information technology and instant communications, our world appears to have gone from a state of information awareness and knowledge, to one of information overload and virtual ignorance. Consequently, many concerns deserving the attention of the international community are driven from public view in the competition for attention being waged by a vast number of issues. The global fight against terrorism in all its various forms, the recent wars in Asia, particularly in Afghanistan and Iraq, and those plaguing the continent of Africa, as well as the spreading scourge of the HIV/AIDS crisis, are but a few of the more pressing issues which have combined to push malaria below the radar of public concern. Not surprisingly therefore, the disease remains a dangerous threat to millions of people.

The effort to combat malaria figures prominently in the Millennium Development Goals, which seek to halt and reverse the incidence of this disease and other major diseases by 2015.

The General Assembly, by its resolution 57/294, declared 2001-2010 as the "Decade to Roll Back Malaria in Developing Countries, Particularly in Africa". The resolution called for support of the Secretary General's recommendations, contained in document A/57/123. What we are seeking in this and other relevant meetings is an update on the status of the implementation of the recommendations in the General Assembly resolution.

Implementing the recommendations would, of course, take place in a real-world situation, and here the actual facts are startling. The latest report of the Secretary-General on implementation of the Millennium Declaration highlights disturbing statistics relating particularly to sub-Saharan Africa. Clearly, Africa represents the major focus of the malaria crisis.

To its credit, Africa has recognized that fact. The Abuja Declaration of 2000 set targets and called on African States and their partners to allocate new resources -- at least $1 billion per year -- for combating the disease. The Africa malaria report of 2003 was released on 25 April 2003, Africa Malaria Day, and took stock of the malaria situation.

Obviously, funds set aside for malaria must increase. A meagre $200 million was spent worldwide in 2002, as against the $1 billion recommended for Africa alone. But perhaps more critical than the sheer provision of funds is the need for Governments in Africa to be engaged and to enhance the capacity of manpower. The international community must transfer new technology to developing countries, particularly for the production of long-lasting insecticide nets, and ways must be found to increase the availability of combination drugs for multi-drug-resistant malaria.

As with HIV/AIDS, the roles of both prevention and treatment loom large for malaria. It appears that thousands of lives can be saved, particularly children, simply through the effective use of insecticide-treated bed nets. Usage is restricted, however, due to the high cost of those nets. Those costs could be lowered by a reduction in the high tariffs and taxes levied on them within Africa. With the resulting lower prices, more people would be able to afford the nets, which would stimulate market potential for commercial production. The result would be a low cost but highly effective method for reducing the incidence of malaria among users.

The report of the Secretary-General is quite positive about the potential of long-lasting insecticidal nets, which are factory pre-treated and require no further treatment during a projected four to five years of usage. While the nets are considered to be a major breakthrough in the prevention of malaria, global production is inadequate. The report recommends that an additional five to ten factories be constructed in Africa at strategic locations in the next few years. Even more promising, the long-lasting insecticide nets are made from polymers derived from petroleum. Oil companies in Africa could therefore be encouraged to make those polymers available either free or at a low cost.

The importance of long-lasting insecticide nets rises considerably when we examine the growing immunity and resistance of malaria parasites, particularly to the major malaria drug, chloroquine. Developing new treatments are therefore critical. The World Health Organization recommends the use of artemisinin-based combination therapy (ACT), which appears very promising aside from its relatively high cost and limited operational experience in Africa. One pharmaceutical company is said to be making ACT available at cost. Others must follow, along with donor Governments, to explore strategies for making ACT available at the lowest cost.

For many reasons, people in sub-Saharan Africa cover the cost of malaria prevention and treatment out of their own pockets. More important though, is the fact that, given the inevitably low level of knowledge, awareness and information -- all tied to poor communications and public education -- there is little guidance on quality, safety or appropriateness. Public education is critical.

Perhaps the essential fact to note is the conclusion of the Secretary General's report that malaria is treatable, preventable and curable. That can be seen by the zero- to low-level incidence in many areas of the world where malaria has been eradicated. Major advances are possible in many countries simply by utilizing existing tools. Developing new tools, such as a vaccine, deserves continued support, although they may be years away. While progress is being made, measured against our targets and recommendations, it is too slow. The creation of the Global Fund to Fight AIDS, Tuberculosis and Malaria is a major breakthrough and holds the potential of access to funds for malaria control commensurate with needs. Such funds would be well spent given that macro-economic analysis indicates that the net return on investment in malaria control is substantial and far exceeds the initial investment in terms of improved economic performance and reduced poverty.

Finally, it would be a travesty to discuss the prevention and treatment of malaria in Africa without noting the remarkable private efforts of the Bill and Melinda Gates Foundation. While it is true that the Foundation is the most highly funded in the world, what stands out is not the size of the largesse of those individuals but the intensity of their personal focus and concern for the lives and well-being of the global poor. As one American newspaper notes, the Gates have placed huge bets on big, difficult scientific problems. They have committed more than $126 million to finding an AIDS vaccine and have put some $150 million into the development of a malaria drug. Recently, they personally trekked to a remote clinic in Mozambique to announce the largest grant in history for malaria research, using the occasion to highlight malaria's toll of more than 1 million children dead each year, mostly in Africa. They recently awarded a $28 million grant for a huge series of tests for a technique which, if successful, could cut malaria deaths by half in Africa.

Understandably, much of the world shares with the Gates a lack of understanding about why other people and their Governments do not share their sense of urgency. We hope more Governments and organizations will join this noble cause to eradicate one of humanity's scourges from the face of the earth.

Mr. Zenna (Ethiopia)

At the outset, I would like to extend my sincere appreciation and thanks to the Secretary-General for his comprehensive report entitled "2001-2010: Decade to Roll Back Malaria in Developing Countries, Particularly in Africa" (A/58/136 and Corr.1). My delegation fully concurs with the recommendations contained therein.

It goes without saying that Africa, the most marginalized region in the world, suffers from various social and economic deprivations which claim the lives of millions of people each year. Also, it has always been the case that dismal economic growth, hunger, famine and disease are customary terms to describe the misery of this continent.

When one speaks of diseases in Africa, it is hardly possible to fail to mention malaria. Although malaria is a global health problem, it remains the disease of the impoverished, mostly in sub-Saharan Africa. The major changes in the eco-epidemiological system that frequently occur in different parts of the continent, the premature termination or unplanned interruption of antimalarial measures in epidemic-prone areas and population movements due to the requirements of seasonal workers, refugees or migration for different reasons are the major causes of the outbreak of this epidemic in the region.

Ethiopia is no different from other African countries that are severely affected by the disease. The epidemic has proved to be a major public health and economic problem in Ethiopia, in which 40 million people are at risk of the disease, with approximately 4 to 5 million cases reported annually. The disease is on the top of the list of the major killer diseases in the country and accounts for a significant number of outpatients. Recurring large-scale drought and subsequent malnutrition seem to create a conducive environment for the onset and spread of the epidemic in various regions of the country. According to a high-level delegation of the World Health Organization that recently visited the drought-affected areas in Ethiopia, the onset of the malaria epidemic will increase during the next couple of months. Furthermore, according to the same report, if the proper measures are not taken, tens of thousands of people will certainly die of the epidemic.

In an effort to combat the spread of this epidemic, the Government, to the best of its resource capability, is trying to take the necessary measures. In addition to having signed on to the global campaign to fight malaria, it has launched its own five-year country strategic plan for malaria control. In collaboration with international organizations such as the World Health Organization, UNICEF and others, efforts are under way to target the most vulnerable section of the population, namely pregnant women and children in rural areas, and launch a wider campaign to fight the spread of the epidemic. The Secretary-General's report states that "the bottlenecks that impede effective resource flows for malaria have now been identified and malaria control is back on the Government agenda" (A/58/136, para.21).

Apart from what I briefly touched on at the beginning of my speech about the difficulties that our continent of Africa is facing, the pain and sacrifice in overcoming the horrific situation in the region is becoming unbearable. Being aware of this menace, the international community, at the dawn of the new millennium, has taken the initiative of alleviating the major challenges that impede the growth of the region by setting various development goals. To that end, diseases that are pervading the African region have been recognized as barriers that hamper prosperity. Accordingly, the international community has stressed the importance of solidarity in tackling the problem. That commitment to mitigate the effects of the epidemic is embodied in the Millennium Development Goals. The establishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria is an important and encouraging endeavour by the international community to support poor countries in their effort to make progress in malaria control. Ethiopia, one of the beneficiaries of the Global Fund, calls on the international community, especially partners among the developed countries, to increase the flow of financial support to the Fund. We believe that such cooperation is in line with the political commitment of our partners to help realize the dream of stopping the global spread of malaria.

The Acting President

We have heard the last speaker on this item. The General Assembly has thus concluded this stage of its consideration of agenda item 51.