Speech of Dr Shin Young-soo, WHO Regional Director for the Western Pacific at the Malaria 2012: Saving Lives in the Asia Pacific

Sydney, Australia
2 November 2012

The Honourable Senator Bob Carr;

Minister of Foreign Affairs, Mr Ray Chambers;

United Nations Secretary-General’s Special Envoy for Malaria,

Mr Peter Baxter;

Distinguished participants and guests,

Ladies and gentlemen:

It is my great honour to stand before you today at this pioneering event, and to stand with you in the fight against malaria and the destruction it causes in our societies.

We are all grateful to Australia for their commitment and expertise in bringing together all parties – from doctors and health-care workers to international agencies and high-level political leaders – to solve Region's malaria crisis.

I spoke yesterday with WHO Director-General Dr Margaret Chan. She regrets not being here today – but shares your vision, commitment and enthusiasm. That's why she sent her best man!

At WHO, we understand that the people of the Region are counting on all of us to work together to end the suffering caused by malaria.

In the Asia-Pacific Region, there are 30 million cases of malaria a year, killing more than 42 000 people. Women and children — especially those living in remote areas – are hit especially hard by the disease.

Malaria also hurts development by lowering the productivity of tens of millions of people in the Region. Economic losses from malaria are estimated at four billion US dollars a year.

Those numbers are scary. And the figures – the economic as well as the human toll – could triple in the future if we do not tackle drug-resistant malaria now.

Many people rightfully wonder: if we have the know-how to defeat malaria, why do so many continue to die from the disease?

The answer explains the painful history of malaria and shows Australia's wisdom in picking a fight we can and must win together.

WHO has been engaged in battling malaria since just after World War II. As far back as 1955, WHO Member States endorsed the first World Health Assembly resolution regarding malaria eradication.

Over the decades, we have seen the number of malaria victims drop dramatically on various occasions as campaigns against the disease enjoyed success.

Inevitably, however, those gains led to complacency. And that complacency led to resurgences in malaria cases.

Today, the Government of Australia's sharp focus on malaria at a time when cases and mortality are dropping dramatically could be seen as counterintuitive. But history tells us that now is precisely when we must press our advantage against malaria.

Now more than ever, we cannot fail because artemisinin resistance could prove more devastating than anything we have seen in the history of malaria.

Indeed, Australia’s high-level attention has already been a boost in the fight against malaria.

The past two days have been a veritable Who's Who in the war against malaria. We have heard from distinguished leaders from many agencies, the private sector, communities and civil society.

Top malaria experts have shared the latest science. Economists have spelled out the disease's toll in development terms. Many others have contributed to fascinating discussions overall.

The greatest accomplishment – and another reason to applaud Australia's management of this event – is that we have come to a consensus on how to fight malaria.

I am proud to present the five themes of the consensus statement.

First and foremost, we must have political leadership and collaboration, as well as a commitment to close the financing gap on malaria programmes.

Then we must guarantee access to quality medicines and technologies with universal coverage of key malaria interventions.

And finally, we must accelerate priority research, especially involving drug-resistant strains of malaria.

Optional list below…
To recap (if you want to use a slide etc.):
1. Political leadership and collaboration
2. Closing the financing gap
3. Access to quality medicines and technologies
4. Universal coverage of key malaria interventions
5. Accelerating highest priority research

These themes represent the powerful combination of technical skill and political will that has come together for this conference.

Indeed, the consensus statement is a strong start as we define the steps to eventually create an Asia Pacific Region free of malaria.

Bringing together leaders from global, regional and country levels from different disciplines here demonstrates how leadership and political commitment with a broader base will enhance our success in the future.

In yesterday’s discussion, for example, there was broad agreement for creating a mechanism that will allow leaders to continue the dialogue beyond this conference. This step will help chart our course to reach our ambitious goals of control and eventually elimination of malaria.

However, as we have discussed over the past few days, leadership and political commitment alone will not solve the problem. Controlling and ultimately eliminating malaria will require substantial financial resources.

Ironically, funding for malaria work may be reduced over the next two years in several countries where we are planning to scale up effective interventions.

The good news is that the funding gap in the Asia Pacific Region can be filled. Having a concrete financial plan with clear timelines will be critical as we mobilize resources externally and within governments.

There is also broad support for a regional financing system. However, this funding platform will need a governance mechanism, technical oversight and country buy-in.

What's more, some have pointed out that a platform dealing with broader public health threat is more likely to generate political support at the highest levels.

Also critical to the success — not only of malaria programmes but of all our health efforts — is ensuring access to quality medicines and technologies. This includes having regional production capacity for medicines and technologies that meet international standards.

In the consensus document, this involves working to halt the use and production of oral monotherapies and medicines that do not meet international standards.

While there is much talk about the need to strengthen regulatory mechanisms in countries, we have not been able to provide sufficient resources to help authorities to ensure they have enough human and systems capacity to fulfil their mission.

There is strong consensus around universal coverage of key malaria interventions in priority areas, particularly in addressing the needs of the unreached populations, migrants and mobile populations at higher risk of contracting malaria.

One of the most important factors that brought us all together here is artemisinin resistance. Tackling this threat requires full and immediate scale up of proven interventions.

Containing artemisinin resistance not only is critical for the Greater Mekong Subregion, but also to the Asia Pacific Region and to global malaria efforts.

WHO will launch an emergency response plan for the Greater Mekong Subregion, which is supported by AusAID and the Bill & Melinda Gates Foundation.

This conference has rightly put a lot of emphasis on research. We continue to explore how best to deliver interventions, how to enhance the use of tools and how to protect their effectiveness.

In particular, we need to intensify efforts to develop new tools for tomorrow’s fight against malaria. There was an overall agreement in yesterday’s discussion on the need to secure funding and prioritize the long list of pending research projects.

Indeed, we still have many details to define as we fine tune our consultations. As I listened to the discussions, several issues within the five themes seemed worthy of emphasis:

First, managing and using information more strategically is critical to our success, especially information that allows us to make more efficient use of limited resources. Information could also be a powerful tool for accountability for donors.

Second, while we focus on technology, we have to keep in mind the importance of maintaining strong technical capacity and human resources to put these tools in operation on the ground.

And last, many highlighted the importance of investing more in health systems strengthening. A well-functioning health system benefits the fight against malaria, and malaria investments would help strengthen health systems.

I would like to end by again emphasizing the value of the consensus statement. It provides momentum for moving forward in the war on malaria.

WHO supports the consensus and stands ready to take an active role in this initiative to improve the health opportunities for the billions of people we serve across our Member States.

Finally, I would like to thank the Australian Government for hosting this conference and welcoming us all to the beautiful city of Sydney. Your impetus and efforts against malaria in the Asia Pacific will be rewarded handsomely.

Thank you.