Last week the leaders of the 18 east Asian nations made an unprecedented commitment to eliminate malaria across the region by 2030. The adoption of this historic goal, made at the 9th east Asia Summit (EAS) held in Myanmar’s capital Naypyidaw, demonstrates the strength of political will to eliminate malaria. The Australian and Vietnamese leaders, as co-chairs of the Asia Pacific Leaders Malaria Alliance (APLMA), will now develop a plan to achieve elimination, to be presented to the 10th EAS in Malaysia in 2015.
“Technical experts and available evidence all suggest this game-changing goal is crucial and achievable,” said Dr Benjamin Rolfe, executive secretary of APLMA. “Reaching it will require an urgent and coordinated regional response, robust and predictable financing, as well as effective programme management in each country.”
The announcement comes at a critical time for regional efforts to defeat malaria. As a result of a significant scale up of resources for malaria control and prevention in the Asia-Pacific region Cambodia, Vietnam, Thailand, Malaysia, Philippines, Bangladesh and Sri Lanka have all reduced malaria by more than 75% since 2000. However, there are still an estimated 32 million cases of malaria each year in the region, and 47,000 deaths. Geographical areas with the highest prevalence are also often the most remote, and their populations poor, migratory and hard to reach.
Furthermore, the spread of malaria parasites resistant to the most effective anti-malarial drug, artemisinin, threatens to undermine the hard-won gains of the last decade. Mirroring the emergence of drug resistant malaria in previous decades, treatment failures were first registered on the Thailand-Cambodia border, but have now been recorded in Myanmar. The fear is that if drug resistant strains of the disease reach India and then Africa, as has happened with previous antimalarial medicines, the impact on malaria control efforts around the world would be devastating.
In this context it is hard to overstate the importance of political will in mobilising resources and coordinating the activities of stakeholders to tackle this problem. As the spread of drug resistant malaria is showing, communicable diseases do not respect borders, and therefore regional cooperation and coordination is crucial.
There is an obvious cost implication to the goal of eliminating malaria in the next 15 years, and at a time when many countries and organisations are scaling down their contributions it will be important for this political will to be maintained to ensure sufficient resources are mobilised.
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