United Nations (New York)
23 December 2008
document
The General Assembly,
Recalling that the period 2001–2010 has been proclaimed the Decade to Roll Back Malaria in Developing Countries, Particularly in Africa, by the General Assembly, and that combating HIV/AIDS, malaria, tuberculosis and other diseases is included in the internationally agreed development goals, including those contained in the United Nations Millennium Declaration,
Recalling also its resolution 62/180 of 19 December 2007 and all previous resolutions concerning the struggle against malaria in developing countries, particularly in Africa,
Recalling resolution 60.18, adopted by the World Health Assembly on 23 May 2007, urging a broad range of national and international actions to scale up malaria control programmes,
Bearing in mind the relevant resolutions of the Economic and Social Council relating to the struggle against malaria and diarrhoeal diseases, in particular resolution 1998/36 of 30 July 1998,
Taking note of the declarations and decisions on health issues adopted by the Organization of African Unity, in particular the declaration and plan of action on the "Roll Back Malaria" initiative adopted at the Extraordinary Summit of Heads of State and Government of the Organization of African Unity, held in Abuja on 24 and 25 April 2000, as well as decision AHG/Dec.155 (XXXVI) concerning the implementation of that declaration and plan of action, adopted by the Assembly of Heads of State and Government of the Organization of African Unity at its thirty-sixth ordinary session, held in Lomé from 10 to 12 July 2000,
Also taking note of the Maputo Declaration on Malaria, HIV/AIDS, Tuberculosis and Other Related Infectious Diseases, adopted by the Assembly of the African Union at its second ordinary session, held in Maputo from 10 to 12 July 2003, and the Abuja call for accelerated action towards universal access to HIV and AIDS, tuberculosis and malaria services in Africa, issued by the Heads of State and Government of the African Union at the special summit of the African Union on HIV and AIDS, tuberculosis and malaria, held in Abuja, from 2 to 4 May 2006,
Recognizing the linkages in efforts being made to reach the targets set at the Abuja Summit in 2000 as necessary and important for the attainment of the "Roll Back Malaria" goal and the targets of the Millennium Declaration by 2010 and 2015, respectively and welcomes in this regard the commitment of Member States to respond to the specific need of Africa,
Also recognizing that malaria-related ill health and deaths throughout the world can be substantially reduced with political commitment and commensurate resources if the public is educated and sensitized about malaria and appropriate health services are made available, particularly in countries where the disease is endemic,
Expressing concern about the continued morbidity, mortality and debility attributed to malaria and recalling that more efforts are needed if the 2010 malaria targets and 2015 malaria and millennium development goals targets are to be reached on time,
Commending the efforts of the World Health Organization, the United Nations Children's Fund, the Roll Back Malaria Partnership, the Global Fund to fight AIDS, Tuberculosis and Malaria, the World Bank and other partners to fight malaria over the years,
Taking note of the Roll Back Malaria Global Strategic Plan 2005–2015 and the Global Malaria Action Plan developed by the Roll Back Malaria Partnership,
1. Welcomes the report prepared by the World Health Organization, and calls for support for the recommendations contained therein;
2. Also welcomes the Roll Back Malaria Partnership's Global Malaria Action Plan, which for the first time provides a comprehensive plan for combating malaria in the short, medium, and long term, including giving further impetus to internationally agreed targets of universal coverage of malaria interventions to all at risk populations by 2010, of continuing the scale up to achieve near zero preventable deaths from malaria by 2015, and of eliminating and, with additional research and development, ultimately eradicating the disease;
3. Welcomes the theme of "malaria – a disease without borders" that was chosen for the first World Malaria Day as well as activities undertaken by the Member States, relevant organizations of the United Nations system, international institutions, non-governmental organizations, the private sector and civil society to commemorate this day and further encourages them to continue to observe malaria day and to collaborate in the observance of the final two years of the Decade to Roll Back Malaria in order to raise public awareness and knowledge about prevention, control and treatment of malaria as well as the importance of meeting millennium development goals;
4. Also welcomes the designation by the Secretary-General of a Special Envoy for Malaria to raise the issue in collaboration with other UN organizations already working in those issues on the international political and development agendas and to work with national and global leaders to help secure the political will, the partnerships and the funds to drastically reduce malaria deaths by 2010 through increased access to protection and treatment, especially in Africa;
5. Welcomes the adoption by the 61st World Health Assembly of resolution 61.21, which adopted the global strategy and the agreed parts of the plan of action on public health, innovation and intellectual property;
6. Welcomes the increased funding for malaria interventions and for research and development of preventive and control tools from the international community, through funding from multilateral and bilateral sources and from the private sector, as well as by making predictable financing available through appropriate and effective aid modalities and in-country health financing mechanisms aligned with national priorities, which are key to strengthening health systems and promoting universal and equitable access to high-quality malaria prevention and treatment services;
7. Further welcoming recent commitments and initiatives to promote overall malaria prevention, control and treatment, including those announced at the 25th September 2008 High Level Event on the Millennium Development Goals
8. Welcoming also the World Health Assembly resolution 61.18 of 24 May 2008, which initiates annual monitoring by the World Health Assembly of achievements of heath related Millennium Development Goals.
9. Urges the international community to deliver on the programmes and activities at the country level in order to achieve internationally agreed targets on malaria;
10. Calls upon the international community to continue to support the "Roll Back Malaria" Partnership Secretariat and the RBM partner organizations, including the World Health Organization, the World Bank and the United Nations Children's Fund, as vital complementary sources of support for the efforts of malaria-endemic countries to combat the disease;
11. Appeals to the international community to work in a spirit of cooperation towards effective, increased, harmonized and sustained bilateral and multilateral assistance to combat malaria, including support for the Global Fund to Fight AIDS, Tuberculosis and Malaria, in order to assist States, in particular malaria-endemic countries, to implement sound national plans, in particular health plans and sanitation plans, including malaria control strategies and integrated management of childhood illnesses, in a sustained and equitable way that, inter alia, contributes to health system development;
12. Further appeals to the malaria partners to resolve the financial and delivery bottlenecks that are responsible for stock-outs of long-lasting insecticide-treated nets, artemisinin-based combination therapies and rapid diagnostic tests at national levels, whenever they occur, including through the strengthening of the malaria programme management at country level.
13. Welcomes the contribution to the mobilization of additional and predictable resources for development by voluntary innovative financing initiatives taken by groups of Member States, and in this regard notes the International Drug Purchase Facility, UNITAID, the International Finance Facility for Immunization, IFFI, the Affordable Medicines Facility – Malaria, AMFM, the Global Alliance for Vaccines Initiative, GAVI, and the advance market commitment initiatives;
14. Urges malaria-endemic countries to work towards financial sustainability, to increase, to the extent possible, domestic resource allocation to malaria control and to create favourable conditions for working with the private sector in order to improve access to good-quality malaria services;
15. Urges Member States to assess and respond to the needs for integrated human resources at all levels of the health system, in order to achieve the targets of the Abuja Declaration on Roll Back Malaria in Africa and the internationally agreed development goals of the United Nations Millennium Declaration,2 to take actions, as appropriate, to effectively govern the recruitment, training and retention of skilled health personnel, and to give particular focus to the availability of skilled personnel at all levels to meet technical and operational needs as increased funding for malaria control programmes becomes available;
16. Calls upon the international community, inter alia, by helping to meet the financial needs of the Global Fund to Fight AIDS, Tuberculosis and Malaria and through country-led initiatives with adequate international support, to intensify access to affordable, safe and effective antimalarial combination treatments, intermittent preventive treatment in pregnancies, long-lasting insecticide-treated mosquito nets, including where appropriate through the free distribution of such nets and where appropriate, to insecticides for indoor residual spraying for malaria control, taking into account relevant international rules, including the Stockholm Convention on Persistent Organic Pollutants (POPs) standards and guidelines;
17. Requests relevant international organizations, in particular the World Health Organization and the United Nations Children's Fund, to assist efforts of national Governments to provide universal access to malaria control interventions to at risk young children and pregnant women, in malaria endemic countries, particularly in Africa, as rapidly as possible, with due regard to ensuring proper use of those interventions, including long-lasting insecticide nets and sustainability through full community participation and implementation through the health system;
18. Calls upon Member States, in particular malaria-endemic countries, to establish and/or strengthen national policies and operational plans, aspiring to ensure the achievement of 2010 and 2015 targets, in accordance with the technical recommendations of the World Health Organization, so as to ensure the achievement of targets set out in the Global Malaria Action Plan and to promote the achievement of the malaria related MDGs;
19. Encourages all African countries that have not yet done so to implement the recommendations of the Abuja Summit in 20003 to reduce or waive taxes and tariffs for nets and other products needed for malaria control, both to reduce the price of the products to consumers and to stimulate free trade in those products;
20. Invites all malaria endemic countries with the support of the international community to scale up their efforts to meet the 2010 and 2015 internationally agreed targets on malaria;
21. Calls upon the United Nations agencies and their partners to continue to provide technical support necessary to build and enhance Member States' planning and implementation capacity to meet the internationally agreed goals;
22. Expresses its concern about the increase in resistant strains of malaria in several regions of the world, and calls upon Member States, with support from the World Health Organization and other partners, to strengthen surveillance systems for drug and insecticide resistance and for the World Health Organization to coordinate a global network for the monitoring of drug and insecticide resistance and to ensure that drug and insecticide testing is fully operational in order to enhance the use the use of current insecticide and artemisinin-based combination therapies;
23. Urges all Member States experiencing resistance to conventional monotherapies to replace them with combination therapies, as recommended by the World Health Organization, and to develop the necessary financial, legislative and regulatory mechanisms in order to introduce artemisinin combination therapies at affordable prices and to prohibit the marketing of oral artemisinin monotherapies, in a timely manner;
24. Recognizes the importance of the development of safe and cost-effective vaccines and new medicines to prevent and treat malaria and the need for further and accelerated research, including into safe, effective and high-quality traditional therapies, using rigorous standards, including by providing support to the Special Programme for Research and Training in Tropical Diseases9 and through effective global partnerships, such as the various malaria vaccine initiatives and the Medicines for Malaria Venture, where necessary stimulated by new incentives to secure their development and through effective and timely support towards pre-qualification of new antimalarials and their combinations;
25. Calls upon the international community, including through existing partnerships, to increase investment in and efforts towards the research and development of new, safe and affordable malaria-related medicines, products and technologies, such as vaccines, rapid diagnostic tests, insecticides and delivery modes, to prevent and treat malaria, especially for at-risk children and pregnant women, in order to enhance effectiveness and delay the onset of resistance;
26. Calls upon malaria endemic countries to assure favourable conditions for research institutions, including allocation of adequate resources and development of national policies and legal frameworks, where appropriate, with a view to, inter alia, informing policy formulation and strategic interventions on malaria;
27. Reaffirms the right to use, to the fullest extent, the provisions contained in the World Trade Organization Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS Agreement), the Doha Declaration on the TRIPS Agreement and Public Health, the decision of the World Trade Organization's General Council of 30 August 2003 and amendments to article 31 of the Agreement, which provide flexibilities for the protection of public health, and in particular to promote access to medicines for all, including the production, under compulsory licensing, of generic drugs in the prevention and treatment of malaria and resolves to assist developing countries in this regard;
28. Calls upon the international community to support ways to expand access to and the affordability of key products, such as vector control measures, including indoor residual spraying, long-lasting insecticide-treated nets and artemisinin-based combination therapy for populations at risk of exposure to resistant strains of falciparum malaria in malaria-endemic countries, particularly in Africa, including through additional funds and innovative mechanisms, inter alia, for the financing and scaling up of artemisinin production and procurement, as appropriate, to meet the increased need;
29. Welcomes the increased level of public-private partnerships for malaria control and prevention, including the financial and in kind contributions of private sector partners and companies operating in Africa, as well as the increased engagement of non-governmental service providers;
30. Encourages the producers of long-lasting insecticide-treated nets to accelerate technology transfer to developing countries, and the World Bank and regional development funds to consider supporting malaria-endemic countries to establish factories to scale up production of long-lasting insecticide-treated nets;
31. Calls upon the international community and malaria-endemic countries, in accordance with existing guidelines and recommendations from the World Health Organization and the requirements of the Stockholm Convention on Persistent Organic Pollutants to increase capacity for the safe, effective and judicious use of indoor residual spraying and other forms of vector control;
32. Urges the international community to become fully knowledgeable about World Health Organization technical policies and strategies and the provisions in the Stockholm Convention related to the use of DDT, including for indoor residual spraying, long-lasting insecticide-treated nets and case management, intermittent preventive treatment for pregnant women and monitoring of in vivo resistance studies to artemisinin-based combination therapy treatment, so that projects support those policies, strategies and provisions;
33. Requests the World Health Organization, the United Nations Children's Fund and donor agencies to provide support to those countries which choose to use DDT for indoor residual spraying so as to ensure that it is implemented in accordance with international rules, standards and guidelines, and to provide all possible support to malaria-endemic countries to manage the intervention effectively and prevent the contamination, in particular, of agricultural products with DDT and other insecticides used for indoor residual spraying;
34. Encourages the World Health Organization and its member States, with the support of the parties to the Stockholm Convention, to continue to explore possible alternatives to DDT as a vector control agent;
35. Calls upon malaria-endemic countries to encourage regional and intersectoral collaboration, both public and private, at all levels, especially in education, health, agriculture, economic development and the environment, to advance malaria control objectives;
36. Calls upon the international community to support increased interventions, in line with the Global Malaria Action Plan and the recommendations of the World Health Organization and the Roll Back Malaria Partnership, in order to ensure their rapid, efficient and effective implementation, to strengthen health systems and national pharmaceutical policies, to monitor and fight against the trade in counterfeit antimalarial medicines and prevent the distribution and use of them, and to support coordinated efforts, inter alia, by providing technical assistance to improve surveillance, monitoring and evaluation systems and their alignment with national plans and systems so as to better track and report changes in coverage, the need for scaling up recommended interventions and the subsequent reductions in the burden of malaria;
37. Urges Member States, the international community and all relevant actors, including the private sector, to promote the coordinated implementation and enhance the quality of malaria-related activities, including via the Roll Back Malaria Partnership, in accordance with national policies and operational plans that are consistent with the technical recommendations of the World Health Organization and recent efforts and initiatives, including where appropriate the Paris Declaration on Aid Effectiveness and the Accra Agenda for Action adopted during the Third High Level Forum on Aid Effectiveness;
38. Requests the Secretary-General, in close collaboration with the Director General of the World Health Organization and in consultation with Member States to submit to the General Assembly, during its sixty-fourth session, an evaluation report on progress achieved towards the internationally agreed 2010 targets including funding and implementation of activities necessary to reach those targets.
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