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Advocacy &Policy Bill Brieger | 20 Sep 2009 08:47 am

Does ALMA spell Political Will?

Almost 10 years after the Abuja Declaration, are African leaders reasserting their political will to eliminate malaria? What will be different this time?

Coming on the heels of a visit to see African malaria success stories, “Ray Chambers, the Secretary-General’s Special Envoy for Malaria, has briefed Mr. Ban (UN Secretary General) on his recent high-level visit to Tanzania and Uganda, where he and UN World Health Organization Director-General Margaret Chan reviewed the progress being made in those two countries against the disease.”  Now leaders from these and other countries are coming to UN Headquarters to continue the discussions.

The Sunday Vision website pictures Ugandan President Yoweri Museveni at a stopover in London on his was to a scheduled meeting with other African leaders at the UN General Assembly in New York to form the African Leaders’ Malaria Alliance (ALMA) this week. UGPulse also comments that. “Twelve African countries will on September 23rd launch the African Leaders Malaria Alliance in New York City.”

According to the website of the UN’s Special Envoy for Malaria, “ALMA will provide a forum in which Heads of State can exchange ideas and articulate policy preferences, as well as anticipate, prevent and overcome obstacles on the path toward the achievement of the December-2010 goal of universal coverage.  ALMA will serve to strengthen the position of member nations in relation to global partners and in the implementation of in-country strategies.”

Apparently now is the time when “African countries promise to expand dramatically in dimension, depth and intensity.”

ALMA is associated with the word ‘bold.’ As UN spokespeople say, ALMA is to be “one of the boldest actions taken against malaria in the modern era… First, the leaders intend to have disease-prevention functions completely under control in Africa by the end of 2010. Additionally, the leaders will announce the even bolder initiative of ‘near zero deaths by malaria by 2015,'” in keeping with the Millennium Development Goals.

Compared to Abuja of 2000, the formation of ALMA 2009 is taking place in much different times. We now have major malaria funding from the Global Fund, the US President’s Malaria Initiative, the World Bank Malaria Booster Program, DfID, UNICEF and other partners.  We have numerous NGOs in both northern countries and endemic countries increasing awareness and action.

We certainly have progress on many indicators generally (though few countries reach RBM’s 80% goals for 2010), and hopes of success in places like Rwanda, parts of Ethiopia, Equatorial Guinea and Zanzibar, though these successes may not translate easily to high burden countries like Nigeria and DRC.

What we still do not have in 2009 are strong, integrated and accountable health systems that will ensure that malaria interventions are scaled up to reach all and are also sustained so that elimination efforts have a chance to succeed.

RBM was launched in 1998 on a platform of health systems reform and strengthening – that is an acknowledgment that malaria interventions cannot succeed on campaigns alone and in isolation from the health system. Unless ALMA addresses addresses health system strengthening for the sustained delivery of malaria interventions, it will simply become a faint echo of Abuja 2000.

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