[Congressional Record (Bound Edition), Volume 159 (2013), Part 5]
[Extensions of Remarks]
[Pages 7379-7380]
[From the U.S. Government Publishing Office, www.gpo.gov]




           THE U.S. CONTRIBUTION TO THE FIGHT AGAINST MALARIA

                                 ______
                                 

                       HON. CHRISTOPHER H. SMITH

                             of new jersey

                    in the house of representatives

                         Tuesday, May 21, 2013

  Mr. SMITH of New Jersey. Mr. Speaker, last week, I chaired a hearing 
of the Subcommittee on Africa, Global Health, Global Human Rights, and 
International Organizations that examined the United States' 
contribution to the global fight against malaria.
  Leadership matters. In 2005, President George W. Bush established the 
President's Malaria Initiative (PMI) and targeted several African 
malaria endemic countries to receive over a billion dollars to mitigate 
and someday eradicate this killer disease. The positive consequences of 
that bold and compassionate initiative include over a million lives 
saved over the last decade.
  The global impact of this disease is severe--yet we are making 
progress. The World Health Organization estimates that in 2010 there 
were 219 million malaria cases and 660,000 deaths. While still 
unconscionably high--every life is absolutely precious and of 
extraordinary importance--loss of life has declined from approximately 
985,000 deaths in 2000.
  Not surprisingly, malaria has a particularly devastating impact on 
the most vulnerable. Nearly 86% of those who die are children under 
five years of age living in Sub-Saharan Africa. Dr. Mark Dybul, 
Executive Director of the Global Fund to Fight AIDS and President 
George W. Bush's extraordinarily effective Global AIDS Coordinator, 
said that in ``Africa alone, Malaria take the life of a child every 
minute'' and pregnant women are also disproportionately afflicted with 
the disease. WHO emphasizes in its World Malaria Report 2012 that 
malaria is strongly associated with poverty. Countries in which a 
larger percentage of the population lives in poverty also have higher 
mortality rates from malaria. Children living in poorer populations and 
in rural areas have the highest parasite prevalence rates.
  It is also important to note the extent to which the prevalence of 
malaria is concentrated. Eighty percent of malaria deaths occur in just 
14 countries and almost 80% of cases occur in 17 countries. Over 40% of 
malaria deaths occur in two countries--the Democratic Republic of the 
Congo and Nigeria, and 40% of malaria cases are in the DRC, Nigeria, 
and India.
  These high morbidity and mortality rates are not necessary--malaria 
is both preventable and treatable. We heard about the cost effective 
measures that are currently available and already having an impact or 
that are in the development process. And the United States, despite the 
current financial constraints, is making a significant contribution to 
the global fight against malaria. In addition to our contribution to 
the Global Fund to Fight AIDS, Tuberculosis and Malaria, the United 
States provided $871 million in anti-malaria assistance in FY2012, and 
the request for FY2014 is $893 million.
  But these levels, even when combined with contributions from other 
donors, fall short of the global need. So our question last week was: 
what are the major challenges going forward, and how we can best use 
our resources to meet those challenges, to save the most lives and to 
have the greatest impact in controlling, if not eradicating, this 
dreaded disease?
  We also took a close look at several immediate threats to global 
efforts to combat malaria. On April 19th, the subcommittee that I chair 
held a hearing called ``Meeting the Challenge of Drug-Resistant 
Diseases in Developing Countries.'' In his testimony at that hearing, 
Dr. Thomas Frieden, the Director of the Centers for Disease Control and 
Prevention, warned that in recent years, malaria infections in parts of 
Southeast Asia have been showing resistance to artemisinin drugs. These 
drugs are the last remaining class of anti-malarial drugs and form the 
basis of malaria treatment globally. If these resistant parasites 
manage to spread to sub-Saharan Africa, he stated that ``the results 
could be devastating.''
  Insecticide-treated bed nets, which have an average useful life of 
two to three years, are an important, proven malaria prevention tool.

[[Page 7380]]

According to the World Health Organization, 150 million nets are needed 
each year to provide protection to the vulnerable populations in sub-
Saharan Africa. For the past two years however, the supply has been 
considerably lower than this level, resulting in an estimated current 
shortfall of 77 million nets. The consequences, if not urgently 
addressed, could place entire populations, especially children, at risk 
of a dramatic malaria resurgence and death.
  We were fortunate to have with us three distinguished experts who 
provided us with valuable insights into these challenges.

                          ____________________