Admiral Timothy Ziemer hosts Ask the White House

Admiral Timothy Ziemer
Thank you for joining today. It is a pleasure to participate in this forum. First of all, you have to understand, I used to fly airplanes for the United States Navy. I am not a malariologist or a scientist, so please bear with me.

The President's Malaria Initiative is very unique in that it is responding to a critical, urgent need -- not just with an announcement, but in action. When you reflect back in history in 1997, USAID spent $1 million on Africa malaria programs. If you fast forward to the completion of this initiative of $1.2 billion, with the support of Congress, that has changed the U.S. commitment in terms of combating this terrible disease.

I am honored to lead the PMI because we are saving lives in Africa now and our goal is to reduce malaria-related mortality by 50 percent in 15 target countries by reaching 85 percent of the most vulnerable groups - children under five years of age and pregnant women - with proven and effective prevention and treatment measures.

President Bush has revitalized the U.S. global malaria strategy fundamentally in scope, size, and structure, ensuring greater effectiveness and accountability, and providing critically-needed global leadership to combat a devastating yet preventable and treatable disease.

Debbie, from Indianapolis writes:
What is the purpose of the Summit? Who will be attending?

Admiral Tim Ziemer
Thank you, Debbie, for your interest. The President And Mrs. Bush will host The White House Summit on Malaria to discuss and highlight measures for controlling malaria. The purpose of the summit is to jumpstart the (public-private) effort, to educate the American public about malaria ... and to send a message globally to governments around the world that we need to join together to control malaria,"

While malaria is under control in the United States, it is an emergency for Africa. Of the over 1 million people who die of the disease each year, 80 to 90 percent are in Africa, and of those 80 to 90 percent are children under five years old. Three thousand children die of malaria every day. Malaria is preventable and treatable and, together, we can save lives.

Zach, from Lenexa, KS writes:
What is the President's Malaria Initiative? Do you work closely with the State Department?

Admiral Tim Ziemer
Thank you for your question, Zach. On June 30, 2005, President Bush announced the President’s Malaria Initiative (PMI), a five-year, $1.2 billion initiative to dramatically reduce by 50 percent malaria related deaths in 15 target countries by reaching 85 percent of the most vulnerable groups —- children under five years of age and pregnant women — with proven and effective prevention and treatment measures.

The PMI is an interagency initiative led by USAID, with the Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) as key partners with the Department of State and other international, non-governmental (NGO), faith-based and local African partners.

Daniel, from Great Barrington, MA writes:
How much does the U.S. spend every year on combating malaria? Thanks.

Admiral Tim Ziemer
Daniel, in 1998 the U.S. spent about $10 million a year on malaria prevention and control efforts around the world. This year, we will spend over $220 million on malaria programs. This amount does not include our contributions to important international systems like the Global Fund for Aids, Tuberculosis and Malaria. The U.S. Government has provided nearly $2 billion to the Global Fund for Aids, Tuberculosis and Malaria over the past three years. More than $450 million of that money has been used to fight malaria.

Cliff, from Brimfield, Ohio writes:
Admiral Ziemer, Sir: When you see the word Malaria, you think of an illness from the past. That is seldom mentioned in the United States So just how big of a problem is Malaria and does it still occur in the United States and if so how many cases have been reported and treated? How big of a problem world wide is Malaria? Thank You

Admiral Tim Ziemer
You are right, Cliff. Now in the United States, malaria is virtually unheard of. With a concentrated and extensive effort, malaria was eradicated in the United States back in the 1950s. The challenge now is to make sure this progress benefits people still at risk of malaria. Worldwide malaria’s toll is terrible – especially in Africa. Each year, more than 500 million people suffer from acute malaria, resulting in more than 1 million deaths. An estimated 85 percent of these deaths are among children in sub-Saharan Africa. Globally an estimated 3,000 children and infants die from malaria every day.

Naser, from NIHNIAID- Rockville MD writes:
I am a malarialogist, and I have deep interest in the initiative. What is the best way to learn more about the initiative? and is the Wed summit opened for people interested in malaria.

Admiral Tim Ziemer
Thank you for your interest and for your work as a malarialogist. To learn more on the President’s Malaria Initiative, you can go to www.fightingmalaria.gov. Also, Kaisernetwork will broadcast the White House summit Thursday, December 14 at 8:45 a.m. ET. on kaisernetwork.org. You can also watch the broadcast of the Summit on www.fightingmalaria.gov. A post Summit briefing will be held Friday at 2:30 p.m. at the American Red Cross.

john, from texas writes:
Will global warming extend the range of the malaria problem?

Admiral Tim Ziemer
The mosquito that transmits malaria is still present in most areas of the world even those where malaria has been eliminated such as the United States. While climate change has the potential to change breeding areas for these mosquitoes, it will not alter the fact that we have highly effective tools to prevent and treat malaria. With these tools, we have all we need to prevent the reintroduction of malaria in areas where it has been eliminated.

Monica, from Washington, DC writes:
What are the chances that Malaria will reach the U.S.?

Admiral Tim Ziemer
Thanks, Monica. Malaria was once a great threat in the U.S. but was eliminated in the 1950s. Remarkably, malaria has been effectively eliminated in much of the world. But it persists tenaciously in Africa. The greatest tragedy is that death from malaria is largely preventable through effective prevention and control measures.

Sally, from Miami, FL writes:
What exactly is Malaria? How is it contracted? Can it kill you? I've heard that it never really leaves your system once you get it.

Admiral Tim Ziemer
Malaria is a life-threatening parasitic disease transmitted by mosquitoes. It is transmitted from person to person through the bite of a female mosquito, which requires blood to nurture her eggs. Typically, malaria produces fever, headache, vomiting and other flu-like symptoms. If drugs are not available for treatment or the parasites are resistant to them, the infection can progress rapidly to become life-threatening. Thankfully, malaria is preventable and treatable. You can usually prevent malaria by taking an antimalarial drug and by avoiding mosquito bites when traveling in areas prone to malaria. When treated with effective antimalarial drugs, the parasites are cleared from the system.

Today approximately 40% of the world's population—mostly those living in the world's poorest countries—is at risk of malaria. The disease was once more widespread but it was successfully eliminated from many countries with temperate climates during the mid 20th century. Today malaria is found throughout the tropical and sub-tropical regions of the world where it is a horrible problem. It kills more than one million people each year – mostly children and pregnant women.

Michael, from Powell, Tn writes:
What are precautions people can do to avoid getting malaria? Merry CHrist-mas

Admiral Tim Ziemer
Merry Christmas Michael. Many travelers are at risk for acquiring malaria, a potentially life-threatening disease, during travel to tropical and subtropical countries. For specific malaria-risk areas, see the CDC Travelers’ Health Web site at www.cdc.gov/travel. Malaria is entirely preventable by taking antimalarial chemoprophylaxis drugs and using personal protective measures. These recommendations are also available on the CDC website.

Antimalarial drugs are available in the United States by prescription only. Your health care provider will prescribe your antimalarial based on your travel itinerary and medical history.

Tyrone, from Florida writes:
The outbreak of Malaria in the British commonwealth, Jamaica over the past couple weeks should alert the Executive Branch to start taking precautions in order to prevent it from happening in the United States or from happening in places where American interest's are high. What has the government done or is the government doing in anticipation?

Admiral Tim Ziemer
Outbreaks of malaria can occur. The U.S. mission in Jamaica reports that 59 cases have been confirmed and 120 suspected cases are awaiting confirmation. Five hundred samples are en route to CDC for analysis. The Government of Jamaica has requested assistance in procuring insecticide and spraying equipment and other supplies to address the outbreak. We are looking into ways to support the Government of Jamaica’s efforts.

Rita, from New Jersey writes:
Hi, Could you tell me how can we increase funding to combat Malaria in third world countries? How much is the current allocation for malaria victims globally? How can we channel government funds to make sure the funds realistically benefit Malaria victims? Do we have an arrangement with non profit organizations to greatly distribute funds to Malaria victims? How is the monitoring? Thanks very much for your time. Rita

The PMI is a multi-agency, U.S. government partnership that works with host countries in coordination with international partners, nongovernmental organizations (NGOs), faith-based and community groups, and the private sector.

We are embracing a comprehensive and sustainable approach to saving lives and this includes an emphasis on delivering life-saving commodities like drugs to treat malaria, medicines for prevention of malaria in pregnancy, distribution of long-lasting insecticide-treated bednets to prevent insect bites and to kill mosquitoes, and indoor spraying with insecticides to kill mosquitoes.

The PMI is a very different way of doing business than past practice. The hallmarks of the PMI are first and foremost programming based on clearly defined numerical targets for outcomes. Second is transparency in how the money is being spent. Third is a robust and effective monitoring and evaluation plan. This approach provides assurance that taxpayers' money is being spent effectively.

Lucy, from MO writes:
Mr Ziemer, My boyfriend was stricken with malaria 3 years ago, and luckily is still alive. However, he struggles often to battle of the disease. Is there anything out there to ease his pain and help him live a longer, healthier life? He already gets treatment whenever he has 'attacks', quinine i believe its called. Is there nothing else?

Admiral Tim Ziemer
I am very sorry. In certain cases, people get malaria, seemingly recover and then suffer several additional attacks ("relapses") after months or even years without symptoms. This occurs because some parasites can remain dormant in the liver for several months up to about 4 years after a person is bitten by an infected mosquito. When these parasites come out of hibernation and begin invading red blood cells (“relapse”), the person will become sick. Treatment to reduce the chance of such relapses is available. You should consult a physician. My best wishes to you and especially hoping your boyfriend recovers quickly.

Joseph, from Baltimore writes:
Before I asked a question, I will first like to say that before there can be any effective treatment for malaria, the life cycle of this parasite and the environment in which it breeds should be taken into consideration as a very important aspect for treatment of malaria. Malaria likes ponds of standing water which is very common in africa because of the lack of infrastructure and a poor drainage system. Along with treatment with medications such as maloxine and quinine sulfa, african countries must employ a good sanitation as a preventive measure not only to malaria but to a lot of other diseases.

Question: How is the United States helping in preventing malaria which is so difficult to treat in AIDS patients? Joseph

Admiral Tim Ziemer
We have proven and effective approaches for reducing malaria through: rapid diagnosis and prompt, effective treatment with antimalarial drugs; prevention of malaria infection through appropriate use of insecticide-treated bednets (ITNs) and indoor residual spraying (IRS); and early detection and rapid response to malaria epidemics. We are closely with the Office for Global AIDS Coordinator and the President’s Emergency Plan for AIDS Relief to ensure that malaria prevention and treatment efforts are also targeted to people living with HIV/AIDS.

Gregory, from Torrance, CA writes:
Dear Admiral Ziemer: Many believe that the major drug companies are not Doing enough to provide cheap or generic drugs to Africa to help combat the Various diseases that are running rampant in Africa. What is the Administration doing to change that? Thank you.

Admiral Tim Ziemer
We all have a role to play and drug companies certainly are partners in this effort. We must work with pharmaceutical companies to continue to invest in research, production and distribution of effective malaria medicines and reduce the overall cost. The most effective medicine used to treat malaria is an artemisinin-based combination therapy.

Admiral Timothy Ziemer
We are at a crossroads in our battle against malaria. Global eradication efforts beginning in the 1950s eliminated malaria in the U.S, and brought it under control in much of the tropical world. However, the challenge still remains in many parts of the world, especially Africa. Africans have paid and still pay a heavy price not only with their lives and health, but also economically and socially.

The bottom line here is that for the first time the tools, the political will, and the funding are all aligned so that we can really make a difference.

A campaign against malaria is a broad and challenging undertaking, requiring cooperation among many different countries, agencies and programs. We must leverage and include other international and African partners, nonprofits to build local capacity and fulfill our moral and ethical imperative to defeat this killer. Coordination efforts must occur at the country level and must be led by the countries. These actors are fulfilling unique roles - roles only they can perform due to their expertise, positions and responsibilities.