Event Information
Remarks by U.S. Global Malaria Coordinator Dr. Raj Panjabi

Your excellencies and valued partners. Thank you for inviting me to speak at this important forum today, just ahead of the important meeting between President Biden and Prime Minister Suga.

First, I want to congratulate the Parliamentary Group to End Malaria by 2030 for your inaugural meeting last month. I am grateful for your leadership and for your partnership.

As Secretary Blinken said during his recent visit to Japan, the United States is committed to the US-Japan alliance. Committed to deeper cooperation on the key issues of our time. Malaria is a key issue of our time.

The United States is proud to be working with Japan to stop COVID-19 and other pandemics. Malaria is a pandemic. More than 3 billion people are at risk of this disease. There are more than 220 million malaria infections each year. More than 400,000 people die. A child dies every two minutes.

These numbers keep me up at night. Yet it is important to remember that while pandemics are global, their impact is personal. Malaria is deeply personal to me. Growing up in Liberia, I contracted malaria not once, not twice, but three times before my 9th birthday. Each time, my parents were worried sick. I was lucky. I received treatment and survived. For too many other children and their families, we know this is not the case.

While training as a medical doctor, I returned to Liberia. This time, I witnessed the relief on parents’ faces when their children survived this preventable and treatable disease. This relief was thanks to the medicines and health workers supported by programs that the U.S. President’s Malaria Initiative, the Global Fund, and others were helping build.

When President Biden asked me to serve as his Global Malaria Coordinator and oversee the U.S. President’s Malaria Initiative, PMI, I couldn’t refuse. I knew PMI was one of the most effective and efficient development programs in history. It is my honor and my privilege to help continue PMI’s work…To be part of the generation to end malaria.

This goal is within reach. Together, we have the tools to achieve it. We have bed nets. And we have insecticides to stop mosquitoes. We have rapid tests. And we have medicines that cure this deadly disease with a just 3-day treatment. We also have medicines that prevent it, that provide protection for the most vulnerable, when they are most vulnerable. Pregnant women. And young children.

Alongside the Global Fund, PMI has delivered hundreds of millions of these lifesaving medicines and supplies across sub-Saharan Africa and the Mekong Region in Southeast Asia. PMI has also helped train hundreds of thousands of dedicated health workers. Community health workers. Nurses. Midwives. Pharmacists. Epidemiologists. Entomologists. And many more.

When beating this disease seemed impossible, the world came together and sparked hope. Hope for parents who—despite living in the poorest, most remote parts of Africa and Southeast Asia—now have the means to protect their children from this deadly disease. Hope in data that tells us that—with the support of the United States, Japan, the Global Fund, and other donors, and most importantly the efforts of malaria-endemic countries themselves—malaria death rates have fallen 60% where PMI works.

My hope is only strengthened by countries such as El Salvador, which, through consistent and determined efforts—applying the tools we know work—have succeeded in eliminating this deadly disease within their borders. Thailand and Cambodia, both PMI partner countries, are, too, on the cusp of elimination.

These country achievements are global achievements. They protect our shared global health security. As President’ Biden said, ‘When we strengthen health systems in far regions of the world, we reduce the risk of future pandemics that can threaten our people and our economy.’

COVID-19 reminds us: until everyone is safe, no one is safe. A malaria infection anywhere is a health threat everywhere.

Experience shows how easily and rapidly malaria can resurge. In India, disruption to funding caused malaria cases to jump from less than 100,000 in the 1960s to more than 6 million in the 1970s. Venezuela’s humanitarian crisis has quadrupled malaria cases and imperiled progress made by its neighbors. And in Asia, the pending China-Laos railway could help malaria spread across the Mekong Region.

Drug and insecticide resistance is also a growing threat. We are in a race against highly evolved mosquitoes and parasites that have existed for millennia. We must not lose this race. We must end malaria. And we must end it faster.

But if we are to end malaria within our generation, we need bold action now. Bold action against two key threats: one — COVID-19, and two — climate change.

First: I’ve seen incredible resilience in the face of COVID-19. But let me be clear: decades of progress against malaria have never been more under threat.

Malaria progress has been jeopardized by other pathogens before: When Ebola  first erupted in West Africa late in 2013, malaria deaths rose dramatically. In fact, it is estimated that more people died from the increase in malaria than from Ebola itself. Malaria is an acute and deadly disease. If you become infected, you need treatment right away. Ebola left people afraid to seek treatment. It overwhelmed fragile health systems. And hundreds of health workers—health workers who could have provided malaria care—died.

Like Ebola, COVID-19 has left people afraid to seek lifesaving care for malaria. It has overwhelmed health systems. Many health workers have died.

I am incredibly proud of the response PMI and partners have led to maximize protection against malaria during COVID-19. In 2020, PMI, and many others, worked tirelessly to ensure vital malaria prevention campaigns continued with only minor delays. Thanks to PMI’s efforts, more than 250 million people had a mosquito net to sleep under at night.

Yet I am concerned how COVID-19 continues to disrupt supply chains and strain access to malaria testing and treatment—disruptions that the World Health Organization estimates could cause up to 100,000 additional malaria deaths. While COVID-19’s impact is still being determined, there is no question that delays in care could cause malaria deaths to rise significantly. We need to make every effort to sustain the malaria services we know save lives.

I am also concerned that too many nurses, midwives, community health workers and others who deliver malaria services struggle without sufficient training, equipment, and fair pay. As we work toward a sustainable and resilient recovery from the COVID-19 crisis, we must build back better to make global health systems safer, more effective, and within reach of all. I commend Japanese leadership on universal health coverage. Malaria investments are a key part of helping achieve universal health coverage.

I’d like to now pivot to the second threat, important to both the United States and Japan. Climate change.

Symbolic of the urgent need for climate action—and a reminder of the close ties our countries share—this year cherry blossom peak blooms were among the earliest on record in Washington, DC, and in Japan.

Climate change is a problem we can only solve as a global community, working together. We must challenge ourselves and each other to do more.

I am glad this discussion focuses on climate change today because it is one of the greatest global health threats in our lifetime. The World Health Organization estimates climate change could cause an additional quarter million deaths per year between 2030 and 2050 from malnutrition, malaria, diarrhea, and heat stress. By 2030, the direct cost to the health sector is an estimated $2-4 billion per year.

Just as cherry blossoms respond to their environment, so do mosquitoes. Climate crises such as cyclones and floods not only destroy health system infrastructure, they also create prime breeding grounds for mosquitoes. Simply put: More climate crises will mean more malaria in affected areas. We saw this in Mozambique, Malawi, and Zimbabwe in the wake of cyclones Idai, Kenneth, and Eloise.

Further, many malaria programs are strategically timed to the seasons for maximal impact. Growing up in Liberia, I knew exactly when the rains would come – and along with them mosquitoes. Now, the rains are less predictable. Disruptions to usual weather patterns will have knock-on effects for timing, effectiveness, and cost of malaria interventions. Preventive medicine for young children must start just before the rains start so we can prevent children from falling ill. Houses must be sprayed with insecticides just before the rains start to kill mosquitoes most effectively.

Global warming may also play a role. Japan has already seen how global warming has impacted Aedes mosquitoes, which transmit dengue, as these mosquitoes emerge in parts of Japan previously too cold for them. Anopheles mosquitoes – the kind that transmit malaria – may also emerge in areas unprepared to deal with the resulting malaria outbreaks sure to follow. It is important to prepare for, mitigate, and adapt to climate change impacts to maximize the effectiveness of malaria programs.

Malaria. COVID-19. Climate change. These challenges are connected. Global. Shared. Urgent. Science shows we can end malaria in this generation. We have a window of opportunity we must step up to meet. Ending malaria, one of history’s oldest and deadliest pandemics, will inspire hope we can defeat future pandemics. Hope is worth fighting for.