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Speech on Malaria by Hilary Benn, Secretary of State for International Development, 15 March 2007.

Thanks Stephen [O’Brian], and to all of you in this All Party Parliamentary Group. You’ve done a great job in raising awareness on malaria, and I’m very pleased to launch this important and timely report. We will be studying the recommendations with great interest.

You are all malaria experts and are passionate about malaria. But I am sure, like me, you must be appalled by the continuing impact of this disease. Malaria kills over 1 million people a year, mostly children in sub-Saharan Africa.

Over 3 billion people are at risk of contracting malaria with up to half a billion cases a year.

And climate change, one of the new challenges is hardest felt by those least responsible for it, will increase the spread of malaria.

And it puts huge pressure on health care services - in sub-Saharan Africa it accounts for around one-third of all outpatient visits and 20-45% of hospital admissions. This is a considerable burden on nurses, doctors, communities and families.

Malaria kills people. It makes people ill. It prevents people working. Economic costs due to malaria in Africa are estimated at US $12 billion a year. It’s a lot of money.

And it affects the poor and vulnerable most. Up to 30% of malaria deaths in Africa occur in the wake of war, local violence or other disaster.

Now, we have a pretty large body of evidence of what works both to prevent and to treat malaria; but we – all of us - have been less successful in ensuring people have access to these interventions.

So I think we need to do three things:

Increase funding,

Do more of what we know works, and

Do more research.

First, funding for malaria has increased substantially in recent years.

The Global Fund to Fight AIDS, TB and Malaria has already committed to spending $2.6 billion on malaria. It now provides 60% of external funding for malaria. And I’m pleased that we’re one of the fund’s largest donors, and have committed £359 million of your money through to 2008.

But there are huge demands on the limited budgets of poor countries, and they need more resources to meet these demands.

In our white paper last year, we committed to allocate at least half of our bilateral aid to basic services – including health.

And we are working to make sure that this aid is longer-term and more predictable. Only then will countries have the confidence to expand their health services, invest in training, recruit additional staff and revitalise their health infrastructure. Predictability is just as important as amount. That’s why I pushed for debt cancellation. This allowed Zambia to provide free health care.

We are also a founder member of UNITAID, which supports the provision of drugs and diagnostics for AIDS, TB and Malaria.

The UK is making a 20-year contribution, starting with £15 million this year, and, subject to the outcome of a joint assessment of the performance of UNITAID, rising to £40 million a year by 2010.

So, while we are seeing progress, we need more money, we also need to ensure that the money we do have is well used and can show improvements in people’s lives.

We need better information. Reporting on malaria is very poor. We don’t have good up to date information on deaths from malaria or the number of cases of malaria and are therefore not well placed to measure the progress made as we ought to be. We must do better.

Second, we know what works and what needs to be done.

More vector control strategies including insecticide treated nets and in-door spraying;

Prompt and effective treatment of malaria – because malaria kills quickly.

Preventive treatment of malaria for pregnant women, and

Quick management of malaria epidemics;

Yet far too few people have access to these proven interventions. The challenges are huge.

Prompt treatment with effective drugs is essential for malaria.

But even if the poor can get to a clinic – staff are often not there, drugs are out of stock or if fees are charged it costs too much. Many buy drugs from a local shop as it is often much more convenient, but treatment may be of poor quality. Its about the lack of choice that poor people have.

So we need to make sure the right drugs and treatment are available and affordable. The malaria parasite is increasingly resistant to chloroquine, which is cheap and widely available. The newer ACTs are highly effective. But they are still much more expensive and less widely available.

Health services must be strengthened to ensure that the right drugs are available at the right time, and in the right place and in ways in which people can afford.

Insecticide treated nets can reduce child deaths significantly yet despite progress - and there is progress - most African children don’t sleep under an insecticide treated net.

But we know progress can be made. The development of long lasting nets that no longer require re-dipping is an important achievement.

In Malawi, delivery of these nets is combined with other services. A nationwide programme has been in operation through ante-natal services since 2002. More than 100,000 nets have been delivered every month since the programme began.

It’s made a real difference, now in some districts, 60% of children sleep under insecticide treated mosquito nets compared to just 8% in 2000. That is progress and we need more of it.

And I recently approved £50 million to improve malaria control in Nigeria, Africa’s most populous country. Malaria is the leading cause of child mortality in Nigeria, causing a quarter of a million deaths a year. It is also a significant factor in maternal mortality.

This program will provide subsidized bed nets for poor and vulnerable people, appropriate ACT treatment for children and preventive treatment of pregnant women. It aims to directly prevent 220,000 deaths and by working with other partners, contribute to averting a further 1 million deaths over 5 years. This shows what can be done when donors and countries come together.

Finally, a vaccine for malaria would truly be a prize but remains some years away. However, after decades of effort we are seeing very encouraging signs.

Rapid diagnostic tests that do not need sophisticated equipment or training can be very useful as they allow a diagnosis of malaria to be made at a remote health facility. But they have limitations and must be improved.

We need new drugs, of course new ACTs, but we also need to look to the future when the malaria parasite becomes resistant them.

So we are supporting research on new drugs for malaria. Funding the Medicines for Malaria Venture with £10 million over 5 years from 2005 to 2010, and the Drugs for Neglected Diseases Initiative with £6.5 million over the next three years.

On the 1st March 2007 the Drugs for Neglected Diseases Initiative along with Sanofi Aventis, announced the production of ASAQ, a new drug for malaria that combines two well known existing drugs. It will cost less than 50 cents for the treatment of a child.

Now, I think there are two very exciting possibilities on the horizon.

First, we know that lowering the price of ACTs is critical to increasing access to treatment, particularly in the informal private sector where much malaria treatment takes place. Kenneth Arrow, a Nobel laureate, has put forward a very innovative concept on a global subsidy for ACTs. We’re actively involved in the discussions, and I hope that we can make progress on this.

Second, we’re supporting the piloting of an advance market commitment – where we help guarantee demand for a vaccine in order to promote private sector investment – it’s for a pneumococcal vaccine. I was at the launch of the pneumococcal APPG yesterday. If this proves successful, we anticipate we’ll move to an advance market commitment for a malaria vaccine – a hugely exciting possibility. We need an AMC to stimulate research for the poor. We got ARVs because people in the rich world had AIDS. We now have 1 million Africans on ARVs. It is not enough but it is progress. We lack paediatric formulations for ARVs as children in the West don’t get AIDS.

So, we are making progress, and there are exciting possibilities ahead. And in part this is thanks to you. We are not going to change things unless we make politics work, and it’s your efforts and those of many others around the world, who keep up the pressure and push for change. Economic development is our story . People in developing countries have the same hopes and aspirations. Push for action so that we end these preventable deaths and suffering, and hand on our world to our children in a better condition than when we found it.