Zambia Daily Mail - March 17, 2006
Dean Mwaanga

Mrs. Gates was in the slums of Kanyama residential area, on a mission to visit malaria control projects and learn more about Zambia's response to malaria.

"We want to ensure that life serving advances in health are created and shared with those who need them most," she said.

The Bill & Melinda Gates Foundation, of which Mrs. Gates is co-chair together with her husband, has committed more than US$6 billion in global health grants to organizations worldwide.

The Foundation focuses on two primary areas of accelerating access through provision of funding to ensure that existing health interventions and technologies are made widely available to the developing world.

The other area the grants focus on is supporting research by providing funding for basic and clinical research to develop new vaccines, drugs and other health tools to fight diseases that cause greatest illnesses and death in the developing countries.

The Foundation entered into a nine-year partnership with the Zambian government were they have committed US$35 million to help in the fight against malaria.

Mrs. Gates said one of the Foundation's top priorities was to fight malaria saying, "growing resistance to the most inexpensive and widely used malaria drugs in Africa has underscored the urgent need for research."

She said her Foundation's resources were working to speed research and development on new prevention and treatment tools and expand existing malaria control tools such as bed nets.

Despite public health authorities agreeing that new and effective drug treatment, combined with a series of measures to keep mosquitoes away from their human prey, can save lives and reduce illness, effective malaria control has proved a challenge, particularly in Africa, where the disease burden continues to grow.

The burden of the disease is straining health systems across the continent and slowing economic development. In Zambia Malaria has been a major obstacle to Zambia's social and economic development.

The cost on the country has been huge with thousands of pregnant women and infants succumbing to the disease every year. Some studies have shown that malaria has continued to claim more lives annually than HIV/AIDS and TB combined.

Mrs. Gates said she was optimistic that the partnership the foundation has with the government of Zambia will establish the value and scale-up national malaria control in the country so that it could be used as a standard in Africa.

"Through our support to anti-malaria programmes in Zambia, we want to show the world that the incidence of malaria could be reduced significantly until such a time a vaccine is found," she explained.

A major partnership was launched last year to demonstrate the enormous potential to save lives with existing malaria control interventions and identify specific ways that African governments can implement malaria control strategies most effectively.

The partnership was announced during the 58 Th World Health Assembly in Geneva.

With country leadership, MACEPA is providing vital technical support for programme planning, implementation, performance monitoring, and the development of impact evaluation systems that will document, in human and economic terms, the importance of continued investment in malaria control in Zambia and serve as a model for use in other countries.

Former minister of Health, Brian Chituwo, said at the launch of the programme last year that the social and economic impact of the disease - responsible for 40 percent of child deaths in the country - had prompted the government to make malaria control a priority.

"MACEPA is helping partners to be more flexible and to provide what is needed by our national program.

We expect that MACEPA will help us learn from the failures and successes in other disease areas; and what lessons can be learned from thriving special initiatives, such as the copper mines' substantial efforts to protect workers and their families from the health and economic devastation of malaria," Chituwo said.

The Ministry of Health will coordinate efforts to purchase, transport, and distribute hundreds of thousands of insecticide-treated mosquito nets, thousands of doses of an effective drug treatment known as artemisinin combination therapy, and enough insecticide to spray the walls of eligible homes in Zambia.

The Malaria Control and Evaluation Partnership in Africa (MACEPA) is an in-country collaboration between PATH, the Government of Zambia, and the Zambia Roll Back Malaria Partnership to accelerate and document the impact of progress toward meeting Zambia's malaria control targets.

The immediate goals of the partnership are to support coordination of rapid scale-up using proven malaria control strategies-including insecticide-treated bed nets, indoor mosquito control, and effective medication-to reach 80 per cent of Zambia's population and to cut deaths due to malaria by 75 per cent within three years.

The initiative, supported by a new, nine-year US$35 million grant from the Bill & Melinda Gates Foundation, is intended to serve as a model for how other African nations can cut malaria deaths drastically.

Mrs. Gates said she was impressed with the efforts Zambia was making in rolling-out malaria adding that she was also encouraged by the political will from the government.

Mrs. Gates met President Mwanawasa and the first Lady Maureen at State House.

She said Zambia was a natural place for her to visit and learn about malaria because of the Malaria Control and Evaluation Partnership in Africa (MACEPA) programme that was launched earlier last year.

"Zambia's fight against malaria is quiet phenomenon and we hope results from this project will serve as a model for how to use tools we have today in an unprecedented assault against this killer disease," she said.

She visited communities in Kafue and saw how people were affected by malaria.

She was happy with government's efforts, through the ministry of Health's programme, against malaria using funds from the Global Fund Against HIV/AIDS, Tuberculosis and Malaria.

She called the malaria programme as ambitious. "It's a very, very ambitious programme, its very needed in the country given the number of incidences of malaria in the country," she said.

She was glad to hear how the ministry of Health had prioritised the resources that government was getting from the Global Fund and how the ministry was forming the private public partnerships to help roll out the programme.

"I am impressed with how they are focusing this on pregnant mothers, they really have that as a target and are doing all the right things to deliver the bed nets and door to door residual spraying were it is needed," she said.

She said pregnant women were a vulnerable group that needed special attention. She said it was important to get them malaria treatment were it was needed and embark on preventive malaria treatment.

The programme has been in the planning phase and will go into the five-year rollout phase and then there will be a monitoring and evaluation phase.

She said the programme team had met a lot of challenges and learnt from them. Mrs. Gates said procurement of bed nets had been a bit slower than had been anticipated and that warehousing bed nets was something to be planned for. She said the delivery of bed nets to recipients also proved to be another challenge.

She called on government to use funds from the Global fund to subsidise prices of bed nets so that even people in rural areas could afford them, adding that the benefits of using bed nets should be explained to the people before giving them.

"We want to see the problem of malaria come down and we expect results. We want to reduce malaria significantly, this programme is to treat and help to prevent malaria,"she said.

Mrs. Gate said the Foundation was also working with biotech industries to come up with a new malaria drug but added that the future lies in having a vaccine for the killer disease.

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