In recent years, the global community seems to be turning its focus on the target to reduce malaria cases and deaths by half. This is due to grassroots organizations and celebrity champions who have raised the profile of the disease and have put it back on the agenda of global leaders and development partners.

In spite of the renewed interest, the world does not seem to be on track and has already missed the 2010 targets. Drug resistance, insecticide resistance and poor access to the latest anti-malarial tools and high taxes and tariffs on malaria-fighting commodities constitute a major barrier to controlling a disease that continues to kill people needlessly.

The Director of the Malaria Taxes and Tariffs Advocacy Project (M-TAP), Dr Halima Mwenesi says it is the taxes and tariffs that have increased the cost of the malaria commodities beyond the reach of the poor and the vulnerable.

The Executive Secretary of African Media and Malaria Research Network (AMMREN) Charity Binka had a chat with Dr Mwenesi in Nairobi Kenya during an M-TAP Malaria Policy Advocacy Workshop for stakeholders across Africa.

        Dr Halima Mwenesi, 
          Director of  M-TAP

Q: Why is the removal of taxes and tariffs on malaria commodities a big issue?

Dr Mwenesi: To win the fight against malaria and reduce malaria deaths to zero by 2015, we must make every effort to reduce the cost of life-saving products. Taxes and Tariffs and non-tariff measures can make many life-saving products unaffordable to the poor. The big issue is that taxes and tariffs decrease the availability and access to malaria commodities such as bed nets and medicine to people who really need them. They are the people who cannot pay the market price. That is why it is important to remove the taxes so that the commodities can be cheaper for our people.

Q: Malaria has been with us for so long. Does it mean that we have not actually paid attention to it as a people or a continent?

Dr Mwenesi: As a people and as a continent we appear to be doing a lot of work on malaria both at the national and global levels. However we talk more than we act. One of the easiest things African governments can do is to ensure that trade barriers that make it difficult for our people to access those commodities are removed. When the tax and tariffs are removed, more people will have access to malaria drugs, bed nets and other malaria commodities leading to significant reduction in the malaria burden.

Q: Which malaria commodities are you referring to?

Dr Mwenesi: The commodities we are referring to here are bed nets which have been treated with insecticide to ensure that they kill mosquitoes on contact and they last for a very long time. We are also talking about medicines that are best for treating malaria, medicines that can be used by children and pregnant women who must take sulfadoxine-pyrimethamine at least twice within their pregnancy to ensure that they are safe and their babies are safe. We are also talking about insecticides that are used for indoor residual spraying. We are also talking about the pumps that are used to spray the insecticides.  These key commodities are so critical that we must make sure that they are accessible and available to those that need them.

                   IRS spray pump

Q. Are there any African countries that have removed the taxes?

Dr Mwenesi: We have good examples from Kenya, Uganda, Tanzania and Guinea who have taken the bold step to remove the taxes and tariffs. The result has been significant. Prices of the commodities have dropped. It has to do with political will. The Presidents of Uganda, His Excellency Yoweri Museveni and His Excellency, Jakaya Mrisho Kikwete of Tanzania have even written about this in international media. Since the tariffs and taxes were removed those countries have saved a great number of people’s lives.

Q.  If you want to advocate for removal of tariff on these things, what will be your key message to African leaders given the fact that many African countries get their revenue from taxes?

Dr Mwenesi: The key message here is that we are almost totally dependent on donor funding from outside Africa to control malaria. It is time to take over and find solutions to our own problem. The international community uses their citizen’s tax money to support malaria control in Africa. The least African countries can do is to remove the taxes and work hand in hand with the donor community to remove the barriers to malaria commodities.

In any case there is no justification to put tax on malaria commodities that are bought with money by our funders. What message are we sending back to them? Is it that we probably are not serious about dealing with the malaria menace?

Q: What you are saying in effect is that African countries must show more seriousness towards eliminating this disease from Africa?

Dr Mwenesi: Absolutely. And we must show it by action rather than just talking about it.

Q: We also know that in some countries people have access to these commodities like the bed net but they are not using them. Is that also not a challenge?

           Insecticide-treated nets, ITNs

Dr Mwenesi: The first thing is to make people understand what the disease is and how it can be controlled. We need to step up information, education and communication on the disease and behavior change. People should not only know the cause of malaria but must also know how to prevent it. They must know that they get this disease by a bite every night from mosquitoes. But if you sleep under a net they will be protected. Households must be encouraged to use the nets every single day of the year whether it is warm, cold or hot because mosquitoes do not choose when to bite. Behavior change is the key here and we must focus on that and on all other issues.

Q. There are those who will not use the artemisinin-based combination therapies and those who refuse to have their rooms sprayed. What do we do with such people?

Dr Mwenesi: It still has to do with education. People must be convinced that it is only the Artemisinin-based combination therapies that can completely treat malaria. People must be encouraged to open their doors for indoor residual spraying to ensure that mosquitoes have nowhere to hide in their homes.

Q: So what message should we in a very short sentence give to African leaders?

Dr Mwenesi: The African leaders have done a very good job lately by coming together as the African Leaders’ Malaria Alliance and have taken the issues of removal of taxes and tariffs and malaria control in general very seriously. The message to them is that they should encourage all member countries to remove the taxes and tariffs to reduce prices of the malaria commodities. With improved access to the commodities the malaria burden will reduce significantly leading to productivity. When absenteeism from work is reduced it will lead to growth of our countries and continent. There is no better time than now to push malaria out of Africa.

ABOUT M-TAP

With funding from the Bill & Melinda Gates Foundation and support from the Roll Back Malaria Partnership, the Malaria Taxes and Tariffs Advocacy Project (M-TAP) used evidence gathering and policy advocacy to engage global- and country-level policy advocates, national governments, and regional and global agencies in identifying collaborative ways to eliminate barriers to progress on malaria.

M-TAP is managed by the Academy for Educational Development (AED) which provides technical leadership on evidence gathering, malaria policy expertise, and support for communications with public and private sector stakeholders. AED currently manages over 250 programs in more than 150 countries that address critical social and economic challenges

Research conducted by M-TAP indicated that taxes, tariffs, and NTBs remain a serious challenge to the timely, efficient, and low-cost delivery of life-saving tools to at-risk populations.

The essential anti-malaria commodities identified by the World Health Organization include:

• artemisinin-based combination therapies;
• rapid diagnostic tests;
• long-lasting insecticidal nets;
• insecticides for indoor residual spraying (IRS);
• compression spray pumps for IRS.

In 2010, M-TAP partnered with the African Leaders Malaria Alliance (ALMA) a coalition established during the 2009 United Nations General Assembly that represents 36 African Heads of State on malaria policy issues-to reaffirm the commitment that African leaders made under the Abuja Declaration in 2000 to remove taxes and tariffs on all anti-malaria commodities.