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U.S. Department of State

Diplomacy in Action

World Malaria Day

Susan E. Rice
Permanent Representative to the United Nations 
New York City
April 24, 2009



Keynote Address by Ambassador Susan E. Rice, U.S. Permanent Representative to the United Nations, For World Malaria Day, April 24, 2009

Thank you all so much for having me. It’s an honor to join you.

This is an extraordinary group of people, and if we could bottle the energy and expertise in this room, we would surely have malaria on the run. I’m particularly pleased to be here with Ray Chambers, the UN Special Envoy for the fight against malaria; we have already begun working together, and I look forward to deepening our partnership in the coming months. I would be remiss if I did not single out one of our co-hosts, the great Quincy Jones, whose work to advance religious harmony and solve global problems may prove to be the highest note of his amazing career.

It’s also a real pleasure to be here with my valued colleagues from the U.S. government, including Admiral Tim Ziemer of the President’s Malaria Initiative and Joshua Dubois of the White House Office of Faith-Based and Neighborhood Partnerships.

I’m moved by the presence of so many dedicated leaders of international organizations and NGOs who do crucial work to fight this disease day in and day out, including Margaret Chan of the WHO, Ann Veneman of UNICEF, Ngozi Okono-Iweala of the World Bank, Ed Scott and Tim Shriver of the Center for Interfaith Action on Global Poverty, Rajat Gupta of the Global Fund, and Awa Marie Coll-Seck of Roll Back Malaria.

And we are honored to be joined by so many friends and partners from overseas, including a wise and distinguished group of Muslim and Christian religious leaders from Africa, the First Ladies of Mozambique and Cape Verde, the Nigerian Minister of Health, and the Ambassador of Benin. We are privileged to welcome NGO and religious leaders from across the U.S., including imams, reverends, and rabbis brought together by this urgent and inspiring cause. To all of you, our deep thanks.

In public life, we often face issues of baffling complexity. We face problems that seem hopelessly intractable. There are no easy answers, for example, to the challenges of civil conflict and ethnic strife; there are no easy fixes for poverty, corruption, or repression.

But sometimes we confront serious problems that have clear solutions. Sometimes we confront problems that challenge us mainly to summon the will to follow a path we all can see.

Malaria is one of those problems. Malaria, simply put, is something we can end. And I am here today to say that malaria is a scourge that we will end.

Let us remember that polio was once a global menace. Now it is on the run. Smallpox was once a commonplace killer. Now it is invoked largely as a doomsday bio-terror scenario. Even measles has been cut down to size; through UNICEF and the World Health Organization, the UN has slashed global deaths from measles by 74 percent over the past seven years.

My friends, it is time to add malaria to that list. It is time to band together to bring another unnecessary plague to its necessary end.

We now think of malaria as a curse of the developing world, but before the discovery of quinine, it haunted Europe and North America. Malaria shook the Roman Empire to its foundations. It was known as ague in 16th-century England, when it was so widespread that Shakespeare’s plays shudder with fearful references to it. And during the Civil War, both Union and Confederate troops who had survived America’s bloodiest war succumbed to malaria.

But now, the whine of a mosquito on a midsummer’s night in Washington is an annoyance to slap away, not a mortal threat. Malaria stalks the pages of history. But together, we must now make malaria history.

This will not be easy. For about half the world’s population, malaria remains one of the greatest threats to public health—a disease that plunges families into poverty, rattles shaky public health systems, and steals Africa’s children away from her.

Let us assume that today is an ordinary day in tropical Africa; that means it is also a day when nearly 3,000 people die of malaria. And to make that toll even harder to bear, nearly 90 percent of malaria’s victims are children under the age of 5. This is a human cost that we will never be able to fully tally. We will never be able to know whether an infant who died of malaria might have grown up to be the next Nelson Mandela, Wole Soyinka, Youssou N’Dour, or Ellen Johnson-Sirleaf.

The economic losses caused by malaria are staggering—an estimated annual toll of $12 billion. This puts a terrible burden on the most fragile economies and public health services. In Rwanda, for example, malaria is responsible for up to half of all outpatient visits to health facilities—and more than half of those visits are for children under 5.

This is a serious fight. But we have seen significant progress. And we have the tools to do even more.

We now have effective and increasingly affordable drugs to treat malaria and related illnesses. We now have reliable ways to prevent malaria—especially bed nets treated with insecticides, indoor spraying, and safe, inexpensive drugs that can be provided to ante-natal pregnant women.

Governments are working together with nonprofit groups, businesses, community leaders, priests, and imams. Community groups are teaching pregnant women to take anti-malarial drugs and helping mothers to get sick children the care they need.

We applaud this new spirit, and we are part of it. On World Malaria Day, the United States pledges to continue working with this extraordinary coalition—with all of you—to further spur grass-roots, governmental, and private-sector efforts to defeat this beatable, treatable disease. We are guided by the need to craft a comprehensive approach to global health, by the need to innovate, and by the need to work closely with partners at home and abroad.

In Fiscal 2009, the United States will commit some $527 million to fighting malaria. And we have contributed more than $3.3 billion to the Global Fund to Fight AIDS, Tuberculosis, and Malaria.

In particular, let me highlight the tremendous work being done by Admiral Ziemer and his colleagues at the President’s Malaria Initiative, which represents a historic $1.2 billion, five-year expansion of U.S. government resources to fight malaria in Africa. The results are striking. During its third year of implementation, the Initiative’s work has reached more than 32 million people. In 2008, the U.S. procured more than 6.4 million long-lasting mosquito nets to be distributed free to pregnant women and young children, and we procured 15.6 million doses of anti-malarial drug treatments. The U.S. government also sponsored indoor residual spraying that covered 6 million houses and protected nearly 25 million people.

Our joint efforts are bearing fruit. Consider the very different trajectory that malaria is now taking in some African countries. A 2007 health survey in Zambia showed that malaria-related deaths in children under the age of 5 had dropped by 29 percent in five years. In Rwanda, according to the preliminary results of a 2008 survey, the mortality rate for children under the age of 5 dropped by 32 percent between 2005 and 2008—and during those same three years, the percentage of households that owned one or more mosquito nets rose from 13 percent to 57.

In Ethiopia, the government has undertaken one of the most ambitious programs ever to deliver long-lasting, insecticide-treated nets. With $200 million from the Global Fund, the World Bank, and others, and with the help of UNICEF, the Government of Ethiopia delivered nearly 20 million nets between 2005 and 2007—two nets for each of the 10 million households targeted. The result of this extraordinary effort, combined with increased access to ACT medication? A more than 50 percent reduction in in-patient malaria cases and deaths, according to the WHO.

It takes a coalition to get this kind of results. The progress we hail today has been rooted in respectful, effective partnerships with host countries, the Global Fund, the World Bank, the Bill and Melinda Gates Foundation, most of you in this room, and many others. It has been strengthened by public-private partnerships such as one ingenious program in Zanzibar, where a collaboration between a Tanzanian company known as Selcom Wireless, the Zanzibar Malaria Control Program, the President’s Malaria Initiative, and Research Triangle Institute has created an innovative system to use cell phones to funnel together the crucial data that will let authorities spot the earliest signs of a fresh malaria outbreak—and leap to quell it.

Let me also applaud the work being done through another category of successful partnerships, those with faith-based groups and community organizations. My government has supported more than 150 nonprofit organizations in the fight against malaria, and more than 40 of them have been faith-based groups.

We have learned over the past few years that faith-based organizations have some distinct advantages that make them exceptional partners in the struggle to end malaria. They have nearly universal reach: many rural areas lack health clinics, but they almost always have a mosque or a church. Faith-based groups and houses of worship draw from a deep well of community trust. They can mobilize persuasive volunteers who can help educate their neighbors about how to use bed nets and when to seek treatment. And they have also proved to be fine record-keepers, helping governments track the rates of infection and death. Whether these good works are housed in a Presbyterian church in Malawi or a mosque in Nigeria, the results that they produce answer the prayers of children across Africa, Asia, the Middle East, and the Americas.

But our work is not nearly done. According to the WHO, in 2006 and 2007, 66 percent of households across 18 African countries did not own insecticide-treated nets, and 77 percent of the children there went to bed at night without them. We must do more to target programs within a handful of particularly hard-hit countries, including Nigeria, the Democratic Republic of the Congo, Uganda, Ethiopia, and Tanzania, which together account for roughly half the global deaths from malaria. We must do more to deliver nets and drugs to civilians battered by conflict or housed in refugee camps. And we must do more to beat back the specter of drug-resistant strains of malaria and, ultimately, move toward a second-generation vaccine.

We all share the same sense of urgency. Ladies and gentlemen, President Obama is committed to making the United States a global leader in ending deaths from malaria by 2015. This goal is also embraced by UN Secretary-General Ban Ki-moon and the African Union. If we continue to work in the spirit of unity and shared purpose that has already led to such progress, this is a target we can hit.

President Obama is firmly committed to meeting the Millennium Development Goals, including the call to slash mortality rates for children and mothers. As part of the Fiscal 2010 foreign assistance budget, the President plans to request robust investments in life-saving global health programs, including in such areas as maternal and child health, family planning, and other core health programs. We also plan to continue our commitment to combat HIV/ AIDS and tuberculosis through such successful programs as PEPFAR. And we plan to increase funding to combat malaria.

We need comprehensive, innovative, and collaborative approaches to strengthen public health capacities worldwide. We must invest in health systems to ensure that all nations have the infrastructure they need to help their citizens thrive. Improving health systems globally creates virtuous cycles: The doctors and nurses who can beat back the scourge of malaria will also be better equipped to combat TB, HIV/AIDS, pneumonia, and other deadly diseases. For all these reasons, the President’s Malaria Initiative works together with ministries of health to implement national malaria-control plans and help deliver primary health care services. We must not just help deliver doses; we must help build systems.

President Obama’s commitment to boosting the quality of health around the world arises from both American interests and American values. We understand that development, public health, and security are deeply linked. We understand that pandemics can spread around the globe with alarming speed. We understand that widespread illness and poor health care can destabilize whole regions. We understand that such 21st-century challenges as climate change, disease, and extremism pay no heed to borders. And we understand that our common security depends on investing in our common humanity.

So we will not falter. We will continue to work with affected countries, partner nations, faith-based groups, civil society, and the private sector to achieve universal access to the low-cost malaria prevention and treatment measures that we know work.

Here in Washington, a mosquito bite is a fleeting nuisance. But in too many places, a sudden sting and scratch can be a sentence to death. We face a hushed, often overlooked battle of man against microbe and mosquito. Surely we can summon the will and the dedication to ensure that we prevail. Surely malaria is a disease that we can prevent. Surely malaria is a disease that we can end.

Can we save children from dying of malaria? Yes we can.

Thank you all.

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