World Malaria Report 2013

The World Malaria Report 2013 summarizes information received from 102 countries that had on-going malaria transmission during the 2000-2012 period, and other sources, and updates the analyses presented in 2012.

It contains revised estimates of the number of malaria cases and deaths, which integrate new and updated under-5 mortality estimates produced by the United Nations Inter-agency Group for Child Mortality Estimation, as well as new data from the Child Health Epidemiology Reference Group. Besides, it highlights the progress made towards global malaria targets set for 2015, and describes current challenges for global malaria control and elimination.

Some important achievements

Global efforts to control and eliminate malaria have saved an estimated 3.3 million lives since 2000, reducing malaria mortality rates by 45% globally and by 49% in Africa, according to the "World malaria report 2013" published by WHO.

An expansion of prevention and control measures has been mirrored by a consistent decline in malaria deaths and illness, despite an increase in the global population at risk of malaria between 2000 and 2012. Increased political commitment and expanded funding have helped to reduce incidence of malaria by 29% globally, and by 31% in Africa.

The large majority of the 3.3 million lives saved between 2000 and 2012 were in the 10 countries with the highest malaria burden, and among children aged less than 5 years – the group most affected by the disease. Over the same period, malaria mortality rates in children in Africa were reduced by an estimated 54%.

But more needs to be done.

The report shows that despite the progress in the last 12 years, the absolute numbers of malaria cases are nt going down as fast as envisioned and the number of deaths due to this malaria remains still one of the greatest tragedies of the 21^st century.

In 2012, there were an estimated 207 million cases of malaria (uncertainty interval: 135 – 287 million), which caused approximately 627 000 malaria deaths (uncertainty interval 473 000 – 789 000). An estimated 3.4 billion people continue to be at risk of malaria, mostly in Africa and south-east Asia. Around 80% of malaria cases occur in Africa.

For an universal access to prevention and treatment

Malaria prevention suffered a setback after its strong build-up between 2005 and 2010. The new WHO report notes a slowdown in the expansion of interventions to control mosquitoes for the second successive year, particularly in providing access to insecticide-treated bed nets. This has been primarily due to lack of funds to procure bed nets in countries that have ongoing malaria transmission.

In sub-Saharan Africa, the proportion of the population with access to an insecticide-treated bed net remained well under 50% in 2013. Only 70 million new bed nets were delivered to malaria-endemic countries in 2012, below the 150 million minimum needed every year to ensure everyone at risk is protected. However, in 2013, about 136 million nets were delivered, and the pipeline for 2014 looks even stronger (approximately 200 million), suggesting that there is real chance for a turnaround.

There was no such setback for malaria diagnostic testing, which has continued to expand in recent years. Between 2010 and 2012, the proportion of people with suspected malaria who received a diagnostic test in the public sector increased from 44% to 64% globally.

Access to WHO-recommended artemisinin-based combination therapies (ACTs) has also increased, with the number of treatment courses delivered to countries rising from 76 million in 2006 to 331 million in 2012.

Despite this progress, millions of people continue to lack access to diagnosis and quality-assured treatment, particularly in countries with weak health systems. The roll-out of preventive therapies – recommended for infants, children under 5 and pregnant women – has also been slow in recent years.

Bridging the funding gap to sustain the progress

International funding for malaria control increased from less than US$ 100 million in 2000 to almost US$ 2 billion in 2012. Domestic funding stood at around US$ 0.5 billion in the same year, bringing the total international and domestic funding committed to malaria control to US$ 2.5 billion in 2012 – less than half the US$ 5.1 billion needed each year to achieve universal access to interventions.

Without adequate and predictable funding, the progress against malaria may be foiled by emerging parasite resistance to artemisinin, the core component of ACTs, and mosquito resistance to insecticides.

Although significative, the gains against malaria remains fragile and in the coming years, the world will need innovative technologies combined with strategic approaches to contain it.

For more information about this report, see here: http://www.who.int/mediacentre/news/releases/2013/world-malaria-report-20131211/en/

Development Co-operation Report 2013: Ending Poverty

This article by Ousmane Aly DIALLO, is part of Wikiprogress Series on the Post 2015. It highlights the main points of the recent Development Cooperation Report 2013.

The Development Co-operation Report (DCR) is the key annual reference document for analysis and statistics on trends in international development co-operation. This year, the DCR explores what needs to be done to achieve rapid and sustainable progress in the global fight to end poverty. 

The Millennium Development Goals (MDGs) galvanized political support for poverty reduction. The world has probably already met the MDG target of halving the share of the population living in extreme poverty (USD 1.25 per day). Yet progress towards the MDGs across countries, localities, population groups and gender has been uneven, reflecting a fundamental weakness in current approaches. As the United Nations and its partners shape a new global framework to take the place of the MDGs in 2015 , they face the urgent challenge of ending poverty once and for all. As this Development Co-operation Report (DCR) makes clear, this will take more than business as usual.

New goals for ending poverty

To recapture the Millennium Declaration’s vision, the new international development agenda must reflect principles of solidarity, equality, dignity and respect for nature. Its goals must effectively guide core aspirations, targets must be easy to monitor, and must include strategies for economic and social transformation. The report made numerous proposals for developing these elements, including:

Move from poverty to inclusive well-being

Create a new headline indicator to measure progress towards eradicating all forms of poverty, which could complement the current income-poverty indicator

Include targets and indicators to track whether people are becoming newly poor.

Include a goal of reducing income inequality, or a set of indicators of inequality across the various goals.

Take a twin-track approach to gender: a goal for gender equality and women’s empowerment coupled with a way of revealing gender gaps in all other goals and targets

Combine national and global goals and responsibilities

Base a new global goal of reducing income poverty on national poverty measures that are internationally co-ordinated and consistent.

Make the new agenda applicable to all countries, but with responsibilities that vary accordingto a country’s starting point, capabilities and resources.

Set targets nationally but within global minimum standards.

Improve data for tracking progress

Adopt a specific goal, target and indicator to increase the availability and quality of data fortracking progress towards these new goals, and invest in national statistical capacity

The report stresses the ambition and the credibility of this goal (ending poverty once for all) and as well as the importance of sound political leadership to achieve it. In Africa, during the last 13 years, the leadership of the late Ethiopian Prime Minister Meles Zenawi and his 

 focus on development results, food security and poverty reduction have been exemplary. The reports highlights also the successes of Ghanaian presidents hailing from different political parties, but who have coincided in championing poverty reduction and food security for the poorest. This has enabled Ghana to implement a successful development strategy focused on building the private sector, developing human resources and implementing good governance. Furthermore

Balancing Poverty and Environmental Sustainability

While it is not always easy to balance poverty reduction with environmental sustainability, important progress is being made. Over the past decade, for instance, Brazil has greatly reduced extreme poverty and inequality while at the same time cutting deforestation by 80%. Ethiopia aims to become a middle-income country without increasing its greenhouse gas emissions and has developed the innovative Climate- Resilient Green Economy strategy to guide it in doing so.

The role of the Global Partnership for Effective Development Co-operation

The Global Partnership for Effective Development Co-operation is just what is needed. This unique coalition of governments, civil society, the private sector and international institutions was launched at the Fourth High-Level Forum on Aid Effectiveness in Busan in 2011. Its aim is to catalyse and co-ordinate global efforts and resources for more effective development. The Global Partnership will play a key role in helping development actors work together, discuss the pros and cons of diverse policies and instruments, share good practice, foster collaboration and promote concrete action – crucial pre-conditions for successfully implementing the post-2015 development agenda. It is up to all of us, now, to make use of this novel, inclusive partnership to improve our development co-operation efforts.

Development Co-operation Report 2013 - Ending Poverty - Highlights

Du microcrédit à la microassurance santé pour rompre le cercle de la pauvreté en Afrique

Cet article de Yamila Castro,experte en communications, fait partie de la série  de Wikiprogress sur la Santé.

Une protection santé à 1€ par mois pour toute la famille ? Non ce n’est pas un rêve mais bien le nouveau système de microassurance maladie que PlaNet Finance est en train de mettre en place en Afrique.

Jacques Attali, président du groupe spécialiste de la microfinance, a présenté deux projets pilotes au Bénin et à Madagascar, lors du Sommet Mondial de la Santé qui s’est récemment tenu à Berlin.

Au royaume du micro, le principe est simple : les clients des institutions de microfinance (IMF), souvent des microentrepreneurs, font des microcrédits pour financer des activités génératrices des revenus et sortir de la pauvreté. Une fois les projets en marche, ils remboursent les IMF, le système fonctionne. Mais que se passe-t-il si l’emprunteur tombe malade, ne peut plus travailler ni rembourser son crédit ?

Dans les pays les plus pauvres, en particulier en Afrique, l’accès aux soins est un vrai casse-tête. Manque d’infrastructures, de médicaments et surtout de moyens. Selon Jacques Attali, avec des systèmes de santé et d’assurance maladie très précaires, voire inexistants, « un foyer peut devoir investir jusqu’à 50% de son revenu quand l’un de ses membres tombe malade », c’est qui veut dire retour à la casse départ de la pauvreté et mise en danger du système de la microfinance.

Rompre le cercle de la pauvreté en Afrique

Pour rompre ce cercle vicieux, PlaNet Finance s’est donc associé au géant de l’industrie pharmaceutique, Sanofi pour fournir une couverture santé aux clients des IMF et à leurs familles, avec un taux de prise en charge des soins de 70%.

Au Benin les microentrepreneurs souscrivent  à cette mini-sécu pour 1€ par mois, par personne, sur une base volontaire, via une association gérée par trois IMF. En mai 2013, 3259 clients des IMF et leurs familles, 3848 personnes au total, bénéficiaient du régime de la microassurance santé.  « Un des challenges de l’opération consiste à vérifier la qualité des services proposés par les centres de santé partenaires et à combler les lacunes du système », affirme Robert Sebbag, vice-président de Sanofi.

A Madagascar le système est obligatoire et coûte 9€ par famille, pour tous les clients qui empruntent une somme égale ou supérieure à 350€. Un an seulement après son lancement, près de 2000 personnes ont souscrit à l’assurance à Antanarivo et PlaNet finance espère couvrir 30000 personnes dans tout le pays d’ici 2016. Un deuxième type d’assurance maladie, pour les producteurs de vanille, a été mis en place, avec prise en charge partielle par l’employeur, la multinationale allemande Symrise. Un système qui s’avère très pratique dans les zones rurales, avec l’avantage non négligeable de fidéliser les agriculteurs et renforcer les liens avec leur employeur.

Conflit d’intérêts?

Un laboratoire pharmaceutique qui finance l’accès à la santé ? A ceux qui se demandent s’il y a conflit d’intérêts pour Sanofi, Robert Sebbag répond par un non catégorique, «rendre les soins et les médicaments accessibles à tous est une cause d’intérêt commun». Jacques Attali quant à lui affirme «l’accès à la santé en Afrique est un procès très long et ce devrait un sujet de haute priorité pour nous tous». 

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