Mr. Chairman and members of the subcommittee, I appreciate the opportunity to submit testimony again in support of the Malaria Vaccine Initiative (MVI). I am appearing today to request that you provide, through the U.S. Agency for International Development (USAID), $3.5 million in fiscal year 2005 funds for MVI. I also request that you increase overall fiscal year 2005 funds for malaria.
I also want to acknowledge your strong support and ongoing commitment to developing new tools to protect against malaria. Specifically, I thank you for the funding recommendation of $3 million for MVI in the FY 2004 Foreign Operations conference bill. This funding is an important contribution to existing efforts to develop a preventive vaccine that can save children’s lives.
MALARIA’S IMPACT ON FAMILY AND SOCIETY
The National Institute of Health’s (NIH) National Institute of Allergy and Infectious Disease (NIAID) estimates that malaria kills between two and three million people in the world’s poorest countries every year. In fact, most people do not know this, but malaria kills more children in sub-Saharan Africa than any other infectious disease.
And many more people suffer short and long-term effects from this terrible disease. Three hundred to five hundred million people fall ill with malaria each year. The average child in Africa suffers several episodes of malaria annually. Indeed, malaria, along with HIV and tuberculosis, is one of the three biggest threats to global public health.
Dikembe Mutombo, New York Knicks Center, founder of the Dikembe Mutombo Foundation, and MVI proponent, knows all too well how much Africa suffers from malaria. He has recently made a point of drawing attention to what can and must be done to eliminate malaria as a public health problem.
As a healthy adult, Mr. Mutombo contracted malaria during a visit to his homeland, the Democratic Republic of the Congo, where malaria is the number one cause of death. It’s hard to imagine that a tiny mosquito bite infected with a parasite could slow down a man who is seven feet, two inches tall. But it did.
In 2000, he traveled to the Congo on behalf of the Dikembe Mutombo Foundation, which is building a new hospital in Kinshasa. When he returned to the U.S. infected with malaria, even with access to the world’s best medical care, he still had to sit on the bench for six weeks during the NBA season while he recovered.
If Mr. Mutombo were a subsistence farmer in rural Africa, those weeks of
recovery would have been crippling for his family. Malaria drives poor families
further into poverty by preventing them from working and forcing children
to stay home from school. It also requires that limited resources be spent
on medication. In this way, malaria perpetuates poverty and slows economic
development. It is estimated that malaria costs African governments $12
billion dollars annually in GDP.
Malaria also contributes to political instability in poor countries. The
2000 CIA report, Global Infectious Disease Threat and its Implications for
the United States, suggests that this kind of persistent threat from infectious
disease likely contributes to economic and social decay by eroding opportunities
for sustainable growth, which can lead to long-term instability.
MEETING THE MALARIA CRISIS
I applaud the United States and other governments for increasing attention to malaria in recent years. The United States’ commitment to halve malaria deaths through Roll Back Malaria and to reduce child mortality and combat malaria through the Millennium Development Goals and the Global Fund for AIDS, TB, and Malaria are praiseworthy. The U.S. Congress has backed these pledges with increased resources for malaria activities and programs over the past four years.
Even so, resources to control malaria are still funded at a relatively low level. As described in a recently published USAID white paper, US Foreign Aid: Meeting the Challenges of the Twenty-First Century, global issues—including infectious diseases—must be addressed with funding levels that are commensurate with the specific need. The U.S. government deserves credit for responding to the global HIV/AIDS crisis by funding programs in the billions of dollars. Surely malaria, the number one killer of children in Africa deserves comparable attention. U.S. funding needs to be increased further to meet the challenges posed by this crisis.
At current funding levels, the world cannot expect to see the kind of dramatic reduction in the malaria disease burden that global commitments call for. On the contrary, current funding levels are barely holding back a rise in deaths and illnesses caused by malaria. The malaria parasite is gradually developing resistance to existing tools such as drugs that treat sick patients and insecticides that control mosquitoes.
Drugs, insecticides, and bednets play an important role in malaria treatment and control. Without them, the disease burden from malaria would be even worse. Experts suggest, however, that even if fully applied over the course of a decade, these interventions could only prevent half of malaria deaths. Today malaria kills more than 3,000 children every day. Reducing this number by half will not end the suffering.
MALARIA VACCINE
The world needs a malaria vaccine to prevent severe disease and death.
In addition to increasing support for short-term treatment and control efforts
now, we must also invest in research and development of malaria vaccines
that promise a long-term solution to malaria. Vaccines, known as the world’s
most cost-effective health investments, provide protection from illness
by preventing suffering before it starts.
MVI is driving forward the innovation required to develop a malaria vaccine. A neutral, non-profit program, MVI partners with governments, companies and universities to support a portfolio of the most promising malaria vaccine candidates in the world. Building and sharing knowledge from each of its ten vaccine development projects, MVI increases the efficiency of the field and seeks to deliver a vaccine sooner rather than later, through its collaborative approach.
While a malaria vaccine is still several years away, MVI and partners are making impressive progress. In the last year, they initiated the largest malaria vaccine clinical trial of the most advanced candidate in the field. Results from this trial in Mozambique—where malaria kills more children under five than any other single disease—will be available by the end of this year. Most recently, MVI launched a dynamic partnership to assess whether five proteins from different stages of the malaria parasite’s complicated life cycle can generate strong immune responses alone or in combination.
Malaria vaccines are a global public good. Because the likely market for malaria vaccines is poor people in developing countries, industry has little economic incentive to get involved. Before MVI was created in 1999, industry had all but abandoned previous efforts to develop a malaria vaccine. History has shown that only significant public funding and partnership strategies will drive the development of a malaria vaccine. MVI has designed an effective model of leadership and leveraging to accelerate progress, but requires public and philanthropic funding to carry out its mission.
Developing a vaccine against a complex parasite will require energy and focus, as it has never been done before. But the longer we delay in pursuing this goal with appropriate funding and attention, the longer malaria-endemic countries will have to wait. While today’s children may not be protected with a malaria vaccine, we hope that their children’s children will be. We cannot afford to delay. For each year we do, another two to three million lives are lost.
I urge the Committee to recommend that $3.5 million be provided in fiscal year 2005 for MVI. I also encourage the Committee to increase funding in fiscal year 2005 in the Child Survival and Health account. Increased funding for Child Survival and Health in general, and for malaria programs, specifically, will save children’s lives around the world.
I thank you for your consideration.
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