Published: 25 April 2023

World Malaria Day statement by HE President Umaro Sissoco Embaló of Guinea-Bissau and Chair of the African Leaders Malaria Alliance (ALMA):

We can end Malaria in our lifetime if we accelerate efforts to defeat malaria through smart investments, innovation, and implementing last mile solutions against Malaria.

Africa, the continent bearing the heaviest burden of malaria, is at a critical juncture. We are now living in the age of pandemics and the time is now to end malaria. The African Union (AU) Malaria Progress Report 2022, that I presented at the AU summit, in my capacity as the Chair of the African Leaders Malaria Alliance (ALMA), reveals that progress remains stalled, with most member states off-track to achieve the AU’s goal of eliminating malaria by 2030.

The World Health Organization’s World Malaria Report 2022 indicates that in 2021, Africa accounted for 96% of all malaria cases (238 million) and 98% of all malaria deaths (603,877). Nearly 77% of malaria deaths were among children under five, undermining Africa’s collective social and economic development and hindering the achievement of Agenda 2063. Despite strong political will across the continent, efforts must be accelerated to increase domestic resources and foster shared responsibility and global solidarity.

This year’s World Malaria Day theme, “Time to Deliver Zero Malaria: Invest, Innovate, Implement,” underscores the urgent need for action and further investment to achieve zero malaria. The theme highlights enhancing resource commitments, expanding coverage of existing interventions and prioritising the investment in and roll out of transformative tools and promotion of accountability. All this is premised on the continued political commitment of African Heads of State and Government, leaders at various levels and ultimately the communities heavily impacted by malarial.

Significant investments are still required to increase coverage of key interventions and achieve the ambitious goal of eliminating malaria by 2030. In 2022, the global community’s pledge to replenish the Global Fund fell short of the $18 billion target. Coupled with the current economic climate with constrained economies especially in low income countries in Africa and the increased commodity and delivery costs, countries are now facing serious gaps in financing for malaria control and elimination.

Additionally, Africa is facing an unprecedented threat of the malaria parasite becoming resistant to antimalarial medicines and also mutating to evade detection by rapid diagnostic tests. Mosquitoes that transmit malaria are also becoming increasingly resistant to insecticides, reducing the effectiveness of existing tools and increasing costs. The Anopheles stephensi mosquito, which transmits malaria in urban areas, has migrated to Africa, further increasing the risk of malaria resurgence.

We do however have solutions to these biological threats. We need to enhance monitoring and surveillance so that we can respond in the real time. We need to rapidly scale up the roll out of new insecticide treated nets, and next-generation insecticides that effectively address insecticide resistance and new antimalarial medicines to combat drug resistance. As these commodities are more expensive, the global partners need to support market-shaping for new commodities, to help reduce the costs whilst increasing production capacity. Investment in local manufacturing can also enhance regional resilience and growth. We urge our international partners to step up their support to help countries to rid our continent once and for all of this treatable and preventable disease!

Upon assuming the ALMA chairmanship, I prioritised a four-point agenda that emphasizes multisectoral advocacy, action, and resource mobilization to close funding gaps, harnessing of data for accountability and action, engaging a robust continental youth corps, and enhancing regional and cross-border coordination in the fight against malaria.

Mobilizing additional resources, including from the domestic public and private sector, remains crucial for increasing access to essential life saving interventions. For this reason, I have called upon countries to establish End Malaria (and NTD) councils and funds, multisectoral, high level bodies working to keep malaria high on the national development and financing agenda. To date, 12 countries have answered my call, and have launched or announced End Malaria Councils and Funds (EMCs and EMFs), with another 13 in process.  These councils have mobilized approximately US$32 million in support of national malaria programmes to date. At the same time, 27 countries have launched their Zero Malaria Starts With Me campaigns, we hope that the remaining countries impacted by malaria will act urgently to activate their campaigns.

At the same time, investment in new approaches and innovations, such as digital technologies for real-time data collection and analysis to guide evidence-informed decision-making is integral to the fight against malaria in Africa. The continent is utilizing digital technologies and sharing data and best practices through the ALMA Scorecard Hub, promoting accountability and action. Over 40 African countries are implementing malaria, NTD and other health scorecard tools. The continent is also strengthening engagement through regional economic communities to coordinate malaria response efforts and prioritize the disease on the regional development and financing agenda. A continental ‘ALMA Youth Corps’ has been mobilized to increase youth engagement and resource commitments for malaria elimination and Universal Health Coverage.

We are at the cross roads, the time to defeat malaria is now and avoid the consequences of not achieving Africa’s transformative agenda for socio-economic transformation, inclusive growth, and peace and security. Investing in ending malaria has a high return on investment, and these investments will strengthen the capacity and resilience of health systems to respond to future epidemics and pandemics. Now more than ever, it is clear that malaria is a pathfinder for pandemic preparedness and response. By focusing on investment, innovation, and implementation, the global community can unite to eliminate malaria, save lives, and ensure a healthier and more equitable world for all. Zero malaria starts with me!