IV 111th CONGRESS 1st Session S. CON. RES. 18 IN THE HOUSE OF REPRESENTATIVES April 23, 2009 Referred to the Committee on Foreign Affairs CONCURRENT RESOLUTION Supporting the goals and ideals of World Malaria Day, and reaffirming United States leadership and support for efforts to combat malaria.

Whereas April 25 of each year is recognized internationally as World Malaria Day and in the United States as Malaria Awareness Day; Whereas despite malaria being completely preventable and treatable and the fact that malaria was eliminated in the United States over 50 years ago, more than 40 percent of the world’s population is still at risk of contracting malaria; Whereas according to the World Health Organization, nearly 1,000,000 people die from malaria each year, the vast majority of whom are children under the age of 5 in Africa; Whereas malaria greatly affects child health, with a child dying from malaria roughly every 30 seconds and nearly 3,000 children dying from malaria every day; Whereas malaria poses great risks to maternal health, causing complications during delivery, anemia, and low birth weights, with estimates by the Center for Disease Control and Prevention that malaria infection causes 400,000 cases of severe maternal anemia and from 75,000 to 200,000 infant deaths annually in sub-Saharan Africa; Whereas HIV infection increases the risk and severity of malarial illness, and malaria increases the viral load in HIV-positive people, which can lead to increased transmission of HIV and more rapid disease progression, with substantial public health implications; Whereas in malarial regions, many people are co-infected with malaria and one or more of the neglected tropical diseases (NTDs) such as hookworm and schistosomiasis, which causes a pronounced exacerbation of anemia and several adverse health consequences; Whereas the malnutrition and chronic illness that result from childhood malaria leads to increased absenteeism in school and perpetuates cycles of poverty; Whereas an estimated 90 percent of deaths from malaria occur in Africa, and the Roll Back Malaria Partnership estimates that malaria costs countries in Africa $12,000,000,000 in lost economic productivity each year; Whereas the World Health Organization estimates that malaria accounts for 40 percent of healthcare expenditures in high-burden countries, demonstrating that effective, long-term malaria control is inextricably linked to the strength of health systems; Whereas heightened efforts over recent years to prevent and treat malaria are currently saving lives; Whereas the progress and funding to control malaria has increased ten-fold since 2000, in large part due to funding under the President’s Malaria Initiative (a United States Government initiative designed to cut malaria deaths in half in target countries in sub-Saharan Africa), the Global Fund to Fight AIDS, Tuberculosis and Malaria, the World Bank, and new financing by other donors; Whereas the President’s Malaria Initiative has purchased almost 13,000,000 artemisinin-based combination therapies (ACT), protected over 17,000,000 people through spraying campaigns, and distributed over 6,000,000 insecticide-treated bed nets, the Global Fund to Fight AIDS, Tuberculosis and Malaria has distributed 70,000,000 bed nets to protect families from malaria and provided 74,000,000 malaria patients with ACTs, and the World Bank’s Booster Program is scheduled to commit approximately $500,000,000 in International Development Association funds for malaria control in Africa; Whereas public and private partners are developing effective and affordable drugs to treat malaria, with more than 23 types of malaria vaccines in development; Whereas according to the Centers for Disease Control and Prevention, vector control, or the prevention of malaria transmission via anopheles mosquitoes, which includes a combination of methods such as insecticide-treated bed nets, indoor residual spraying, and source reduction (larval control), has been shown to reduce severe morbidity and mortality due to malaria in endemic regions; Whereas the impact of malaria efforts have been documented in numerous regions, such as in Zanzibar, where malaria prevalence among children shrank from 20 percent to less than 1 percent between 2005 and 2007, and in Rwanda, where malaria cases and deaths appeared to decline rapidly after a large-scale distribution of bed nets and malaria treatments in 2006; and Whereas a malaria-free future will rely on consistent international, national, and local leadership and a comprehensive approach addressing the range of health, development, and economic challenges facing developing countries: Now, therefore, be it

That the Senate— (1)supports the goals and ideals of Malaria Awareness Day, including the achievable target of ending malaria deaths by 2015; (2)calls upon the people of the United States to observe Malaria Awareness Day with appropriate programs, ceremonies, and activities to raise awareness and support to save the lives of those affected by malaria; (3)reaffirms the goals and commitments to combat malaria in the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008 (Public Law 110–293); (4)commends the progress made by anti-malaria programs, including the President’s Malaria Initiative and the Global Fund to Fight AIDS, Tuberculosis, and Malaria; (5)reaffirms United States support for and contribution toward the achievement of the targets set by the Roll Back Malaria Partnership Global Malaria Action plan; (6)encourages fellow donor nations to maintain their support and honor their funding commitments for malaria programs worldwide; (7)urges greater integration of United States and international health programs targeting malaria, HIV/AIDS, tuberculosis, neglected tropical diseases, and basic child and maternal health; and (8)commits to continued United States leadership in efforts to reduce global malaria deaths, especially through strengthening health care systems that can deliver effective, safe, high-quality interventions when and where they are needed and assure access to reliable health information and effective disease surveillance.

Passed the Senate April 22, 2009. Nancy Erickson, Secretary