This is an archived USAID document retained on this web site as a matter of public record.
Administrator J. Brian Atwood
Town Hall Meeting
Bucharest, Romania, October 28, 1997
U.S. Agency for International Development
The U.S. Agency for International Development -- as the lead U.S. government
agency in the fight against infectious diseases in the developing world -- works with
many partners in this effort, including approximately 20 U.S. government entities, 50
host country governments, an array of non-governmental organizations, universities
and the private sector.
USAID's approach to infectious diseases consists of four interrelated elements. First,
we are working to change the social and economic conditions -- such as poverty, lack
of sanitation, rapid population growth and environmental degradation -- that allow
infectious diseases to flourish. Second, we are working to improve health systems so
developing countries themselves can better control infectious diseases. Third, we are
carrying out specific targeted programs to address priority diseases. Lastly, we are
continuing to enhance our capability to respond to emergency disease situations.
The ultimate goal of USAID is to support sustained social and economic development
as measured by ........
USAID's health programs focus on the major killers of children under the age of five
-- pneumonia, diarrhea, measles, malaria -- and HIV/AIDS. In 1996, USAID devoted
an estimated $320 million to the prevention, surveillance and treatment of these
diseases, and the development of simple and affordable technologies to ameliorate
their effects.
Malaria stands as a major impediment towards achieving this goal - especially within
the Africa region. The statistics surrounding malaria are astounding: more than 2
million deaths a year, principally among children and infants - 90% of which occur in
sub-Saharan Africa; as a result 1 out of every 20 children born in Africa will die from
malaria before reaching the age of five year. Even as malaria already extracts a heavy
toll on Africa, over the coming years it is estimated the region can expect a 7-20%
annual increase in malaria related deaths and cases of severe illness.
Underlying, in part, the increasing threat posed by malaria is the emergence and
spread of strains of malaria that are increasingly resistant to available treatments.
In addition to the public health impact malaria we have only recently begun to
appreciate that malaria is a major constraint to economic development. The direct
economic cost of malaria to the Africa region including lost wages, the cost of
treatment, and the expense of traveling to a clinic or a hospital was estimated to have
been $1.7 billion 1995 and is expected to double over the next five years to $3.5
million. A t the household level approximately 20% of disposable income of low-income African households is spent on (mostly ineffective) malaria treatment. And, in
many African countries out-patient treatment for malaria accounts for up to 40% of all
public health expenditures.
Given this startling picture the USAID's malaria control efforts in recent years have
focused on the development of new approaches and technologies for its prevention and
control, including support for the development of a malaria vaccine, and in the Africa
region field testing options for practical and sustainable control of the disease, as well
as working with WHO to strengthen the capacity of national malaria programs.
The lessons learned from these programs have significantly increased our
understanding of malaria impact and options for its prevention and control. As a result we, along with many of you, have reassessed the options for malaria control, added
new interventions and strategies for a more targeted application of existing control
measures have emerged.
USAID's approach is a package of maternal and child health interventions for malaria
control that emphasizes improved management of the disease and its prevention.
One of the major constraints we face in trying to reduce the burden of malaria,
especially in its association with the emerging drug resistant strains of malaria, is the
lack of simple and effective tools for the prevention of malaria infection.
The success of the recent "bednet" trials in East and West Africa in dramatically
reducing child mortality has given us all new hope.
Realizing the full potential of bednets, however, will require developing new models
for achieving sustained public demand for, access to, and appropriate use of affordable
nets and insecticides.
It is against this backdrop of need and opportunity that the deliberations of the past
two days will be measured. Ultimately, whether we are able to successfully meet the
challenge of protecting those at risk from malaria will require a concerted and well
coordinated effort of not simply the donor community working with national
programs, but will also need to involve an active partnership with the commercial
private sector - who manufacture critically needed nets and insecticides.
As a measure of the importance we place on the prevention and control of malaria I
can assure you that USAID will be a steady partner in these efforts. In 1998 we plan
on supporting an expanded application of recently proven interventions for the
prevention and control of malaria, including:
- scale-up from earlier USAID field trials in Africa, within the context of existing
maternal and child health programming and
- an Africa regional initiative for the promotion of insecticide-treated mosquito
nets
We look forward to the opportunity of working with you over the years to explore
how best to apply the findings and recommendations you have arrived through this
conference.
Thank you.
This is an archived USAID document retained on this web site as a matter of public record.
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Last Updated on: July 18, 2001
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