By Deborah L. Birx, M.D., and Rear Admiral (RET.) R. Tim Ziemer
The World Health Organization (WHO) estimates that the scale-up of malaria control efforts between 2001 and 2013 resulted in some 4.3 million fewer malaria deaths than would otherwise have occurred. The impressive results are due in large part to programs like the U.S. President’s Malaria Initiative (PMI) that are focused on decreasing the malaria burden.
PMI was launched in 2005 and dedicated $1.2 billion in funding over five years to cutting malaria deaths in half in 15 African countries. The 2008 Tom Lantos and Henry J. Hyde Global Leadership against HIV/AIDS, Tuberculosis, and Malaria Act, authorized further funding for the U.S. President’s Emergency Plan for AIDS Relief and for PMI through FY 2013, with continued support to the original 15 PMI-supported countries and an expansion to other endemic countries. This USAID-led initiative, co-implemented with the U.S. Centers for Disease Control and Prevention, has since expanded to 19 African countries, including Nigeria and the Democratic Republic of Congo, as well as the Greater Mekong Subregion.
Since that launch, PMI’s technical and financial support has assisted countries to make significant strides in the global effort to control malaria. The contributions of PMI, together with those of other partners, have dramatically improved coverage of key malaria control interventions including use of insecticide-treated mosquito nets, indoor residual spraying, accurate diagnosis and prompt treatment, and intermittent preventive treatment of pregnant women. As a result, child mortality has declined significantly in the 17 PMI-supported countries in Africa for which baseline and follow-up survey data are available.
According to the WHO since 2001, malaria mortality has decreased by 47 percent globally and by 54 percent in Africa alone. It is estimated that more than 4 million malaria-related deaths have been averted worldwide since in this time period – 95 percent of these are estimated to be children under 5 in Africa. The majority of this progress has occurred since 2007 and the U.S. government has been an important catalyst enabling these impressive results.
While progress has been substantial, significant work remains. The WHO indicates that malaria was responsible for as many as 198 million illnesses and 584,000 deaths worldwide in 2013. More than 90 percent of all malaria deaths occur in sub-Saharan Africa and malaria continues to be a leading cause of child mortality.
Last month, the Obama administration launched an updated strategy to guide PMI through 2020. The U.S. government has embraced the global long-term vision of a world without malaria and will work with PMI-supported countries and partners to further reduce malaria deaths and substantially decrease malaria morbidity.
By 2020, PMI will work with partners to accomplish three objectives:
- Reduce malaria mortality by one-third from 2015 levels in PMI-supported countries, achieving a greater than 80 percent reduction from PMI’s original 2000 baseline levels;
- Reduce malaria morbidity in PMI-supported countries by 40 percent from 2015 levels; and
- Assist at least five PMI-supported countries to meet the WHO criteria for national or sub-national pre-elimination.
The new President’s Malaria Initiative Strategy for 2015–2020 builds on and reinforces the successful approach that resulted in significant reductions in malaria burden since the start of the Initiative, PMI-supported countries and anticipates further reductions in malaria-related child mortality moving forward.
In a 2012 Washington Post article, Michael Gerson wrote, “In much of sub-Saharan Africa, the American image is now defined by, by PMI and by PEPFAR, the American AIDS relief plan. It is a form of influence that is hard to measure or weigh. But people remember when you help to save their children.”
It is true — and there is no greater joy than knowing children, mothers, and communities are thriving because malaria and HIV/AIDS no longer ravage villages. America’s results-driven global health assistance saves and improves lives, reduces long-term health costs, and lays the foundation for sustainable development in the world’s poorest countries.
U.S. global health programs, including for HIV/AIDS, malaria, child and maternal survival, and a broad range of programs that tackle neglected tropical diseases, including Ebola, represent about one-quarter of one percent of the federal budget. Polls show that the American public believes that 25 percent of the U.S. federal budget is spent on foreign aid. When people learn it is less than 1 percent they say it should be 10 percent.
That is why it is so important that we tell our story and we champion our landmark initiatives –from PEPFAR and PMI, to Feed the Future and the Ebola response — expressions of American values and reflective of the commitment and determination of the United States government to ensure impact with all of its investments — realizing an AIDS-free generation, ending deaths from malaria, and ending extreme poverty.
About the Authors: Ambassador-at-Large Deborah L. Birx, M.D., serves as U.S. Global AIDS Coordinator and U.S. Special Representative for Global Health Diplomacy, and Rear Admiral (RET.) R. Tim Ziemer serves as the U.S. Global Malaria Coordinator.