101447

Partnership to Fight Malaria’s Huge Cost to Economic Development




by
James D. Wolfensohn
President
The World Bank Group

April 18, 2001

Introduction by Eduardo Doryan, Special Representative of the World Bank
to The United Nations.


Good morning, everyone. Please be seated. Your Excellencies, ladies and
gentlemen, on behalf of the, I warmly welcome all of you to this, the
Fourth Global Partnership Meeting to Roll Back Malaria. As a founding
partner, the World Bank is pleased to host this meeting three years after
the inception of the Partnership and exactly one year after the African
Summit on Roll Back Malaria that was held in Abuja, Nigeria, and which I
had the privilege to attend.

The goal of Roll Back Malaria is to halve the death toll of malaria-
affected persons, young and old, from productive laborers to mothers and
children living in the poorest communities of the world, by the year
2010. To achieve this goal, RBM has made a commitment to work together
with a wide range of partners across different sectors.

In testament to this commitment, I am pleased to see here that the
Partnership is very well represented today. We are joined here by
delegations from at least 21 malaria-affected countries from around the
world and 51 organizations representing multilateral and bilateral
agencies, NGOs, the private sector, industry, research institutions,
foundations, and the media.

I would like to extend now a very warm welcome to the Director-General of
the World Health Organization, Dr. Gro Harlem Brundtland; to the Deputy
Executive Director of UNICEF, Andre Roberfroid; and, indeed, to President
James D. Wolfensohn from the World Bank.

As host of this year's Global Partnership Meeting, I would like to invite
President James D. Wolfensohn to share with us his perspective on the
Partnership and where we stand today.

MR. WOLFENSOHN: Well, Mr. Doryan, Mr. Minister, distinguished colleagues
on the panel, particularly Dr. Brundtland, Your Excellencies, ladies and
gentlemen. We are very happy to have the opportunity of hosting this
fourth meeting of the Roll Back Malaria campaign. I am particularly proud
that we have all of you here with us and representatives of our partner
organizations in UNDP and UNICEF and, indeed, so many of you who have
made a tremendous contribution to this Roll Back Malaria campaign.

As Mr. Alnwick said, today is an opportunity for us not just to reflect
on the progress that we've made in the last several years, but most
particularly to talk about the action phase, to move from the discussions
of the Partnership to implementation, and to learn from each other what
we are doing and what we have been doing, and, more significantly, what
we can do in terms of this really dramatic development and human problem.

Over 3,000 people are dying every day, mainly children, and with economic
costs that in Africa alone are estimated at $12 billion a year, we have a
problem that is not only immense in human scale, but immense also as a
development challenge. It is said to set back GDP in African countries
that are affected by more than 1 percent per annum, and this in a
continent which is struggling to build the levels of GDP growth so that
we can attack the questions of poverty. This is a large and important
issue.

Indeed, at the meeting of the African leaders which was held, at which
you, President Rawlings, made a very stirring speech, this recognition of
the crucial importance of this campaign was made evident. And, in fact,
the representation at that meeting was such that we were given confidence
that African leadership was very much behind the approach that we're
taking.

Now, what is it that is significant about this work? It's clear that it's
not just the money, though money is important. We ourselves in the
institution have now got about $450 million out in various forms of anti-
malaria programs in 46 countries over 56 projects. But we're ready to
roll out additional funding, mainly IDA funding, for this work, really at
the call of you, your Ministers, and for those that are Health Ministers,
your Finance Ministers, whom not doubt you can influence in this effort.

But we also recognize that even if we get the monetary resources which
can come not just from us but with Jeff Sachs' help, all the grants that
he's going to organize from around the world from all the people that he
knows who are ready to give you money, if we can link the grants, the
lending, and the funding in whatever form it comes, we know very well
that that alone is not sufficient.

The fight against malaria is not just a   program to try and deal with the
mosquitoes or the bed nets or the drugs   that are required. That is, of
course, important. The medical aspects,   the focus on the disease, and
prevention is crucial. But it has to go   beyond that in two very important
respects.

First of all, it has to be national in scope. It has to be rolled out on
more than a project basis. The numbers are too great to think in terms of
a project here and a project there. We simply have to deal with this, as
we do in so many other development issues, with programs that are
replicable, that are communal and that are owned, and that can be rolled
out on a broad scale.
All of us could take a small area and deal with the question of malaria
by delivering nets, by dealing with the problems of getting drugs, and
giving a focus, and we could make an area safe. And that's a project
which works and makes you feel terrific. And we tend to do that a lot in
the Bank in all our work.

But with the population growth anticipated to go from over 600 million to
1.1 billion in the next 25 years in Africa alone, with 2 billion more
people in the next 25 years going into the developing countries, many of
which are affected by malaria, projects alone are not sufficient. We have
to come up with programs that are communal, where there's education,
where it's known, and where we can engage all sectors of society, not
just medical officers. And it starts with the planning of public works,
the dealing with water. With every single project that we're engaged in,
one needs to think in terms of the malarial impact.

We have to scale our projects in terms of communities so that there is a
recognition on the part of communities that they are educated to the
issues of malaria, that they know how to deal with them, and that they
simply will not accept as a fact of life that 3,000 people die per day,
mainly kids under five years old. This is not a necessity. It is a fact,
but it's something that we must join together to fight against.

Here the partnership that we have to build is not an uncommon
partnership. It's a partnership first and foremost with governments.
Governments must give this the priority that it needs and deserves. It
needs to be more than a health priority. It needs to be a priority which
is embedded in government policy at all levels and is perceived, as is
growing in terms of Africa in the case of AIDS, which is maybe more
visible in some ways today, in terms of the public media, that this is a
killer of a million people a year and a costly aspect of the loss of
jobs, the loss of efficiency, the loss of GDP, and the loss of human
contentment and human happiness.

That is where we have to place this issue, so governments have their
role. But governments alone can't do it. It has to be done with
nongovernmental organizations, with civil society in its broadest forms,
and with church groups, who have played such an important role in terms
of health delivery systems and which need to be embraced in a more
coordinated manner, voluntarily, than perhaps has been true up to now.

We have been dealing with the faith-based organizations and with civil
society in many of the countries in Africa, and most notably, I'm happy
to say, in Tanzania, where we recently had a meeting with faith-based
groups on this subject. So we're ready to reach out to all aspects of
civil society and also to the private sector.

For the private sector, it is not just a charity. It's self-interest. You
need to keep the families healthy. You need to create an environment in
which the lost jobs are diminished and where you have a healthy society
in which you can operate. It's good business as well as good societal
behavior.
What we need to do and what we're going to learn from each other in the
course of these next few days is to learn of the initiatives that have
been taken to see how from each other in the presentations that will be
made we can understand what are the types of programs that work, that can
be replicated, that can be owned and can be developed in scale.

Keep in mind the replicability and scale and ownership. We're not
interested in the programs that can solve the problems of 1,000 well-
placed, well-financed families. When I say I'm not interested, I am
interested but it's not the issue that we're facing today. You can deal
with 1,000 families if they've got enough money and you've got a wall
around them and you stop the mosquitoes and you have bed nets. The more
significant thing is how to deal with the sort of people that we saw in
this short feature that we've had before us today.

We need to engage academia, and we need to engage the drug companies and
the vaccine companies, and we need to give a focus to this war in which
we're engaged. This is like, if I may say so, so many of the problematic
wars and conflicts in Africa. They do not get the appropriate attention
in the press. They do not get the sense of priority. They do not get the
impetus that they deserve, as though life is cheaper and human suffering
is less because it's in Africa and poorer countries.

Suffering is the same in whatever family and in whatever economic strata.
And we have today the responsibility and the opportunity to lift the
level of awareness and to create the momentum and build on that momentum,
because this is truly a fight, it is truly a war.

We have to work with governments on taxes and tariffs. We have to work on
it in terms of priorities. We have to look at the debt relief issues
which were already mentioned by Mr. Alnwick and in which I believe we've
already made significant progress. And we need, in fact, to use today as
another starting point, no longer for analysis but for implementation.

I want to say to you that, so far as   the Bank is concerned, we're ready
for that challenge. We're anxious to   be part of it. We respect greatly
the leadership of Dr. Brundtland and   WHO and those that are setting the
course for us. We're anxious to be a   good partner, and we welcome you to
this meeting.

Thank you very much.