The White House
President George W. Bush
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For Immediate Release
Office of the First Lady
December 12, 2006

Briefing on the White House Summit on Malaria
Room 450
Eisenhower Executive Office Building

      The White House Summit on Malaria

PARTICIPANTS
Anita McBride, Chief of Staff to the First Lady
Admiral Timothy Ziemer, President's Malaria Initiative Coordinator
John Bridgeland, Chief Executive Officer, Malaria No More

11:10 A.M. EST

MS. McBRIDE: Good morning, everybody. Thank you for coming to join us this morning. I'm Anita McBride, Mrs. Bush's Chief of Staff. I'm joined here today by Admiral Timothy Ziemer, who is the Coordinator for the President's Malaria Initiative; and then also by John Bridgeland, who is the CEO of Malaria No More, our private partner in this White House Summit on Malaria.

I wanted to take an opportunity to give you a bit of a brief overview about the summit, which we're very excited about, on Thursday, December 14th, at the National Geographic.

The summit is aimed to bring together international experts, corporations, private foundations, and individuals, faith-based organizations, to raise the awareness of the issue of malaria, and to mobilize extraordinary efforts on the part of large organizations, as well as elementary schools around the country, a wide variety of grassroots efforts that raise the awareness of this issue and what we can do as Americans, as a nation, to help in this treatable and preventable disease.

The purpose of the summit, again, is to jump-start the effort, to educate the American public about malaria -- as I said, is a preventable and treatable disease -- and to send a message globally to governments around the world that we need to join together to control malaria. And again, I think one of the most exciting things about the summit -- and you'll hear this when Admiral Ziemer and when John talk to you -- is it runs the gamut of mega-philanthropies to individual contributors, and the role that every one of these individuals -- single, individual entities to groups large and small can contribute.

One of the things I wanted to explain to you, and I think you saw this year, Mrs. Bush hosted a very successful global literacy summit in New York. She has a personal commitment to global health, to education, especially for women and children. And we are delighted that Mrs. Bush's office was asked to lead the organizing of this summit.

I think one of the things, too, that we'd like you to know about Mrs. Bush's involvement in this -- and she just thinks it's extraordinarily important for Americans to know that their compassion and their generosity is helping to save lives around the world. And she knows that in order to make a difference, we have to come together collectively as governments and private individuals. So I think one of the things that she feels strongly about, as an educator, she also knows that children play a special role in learning about this disease and what they can do to help. Again, as a teacher, she understands and recognizes the compassion of very small children that want to help other kids around the world that they may never know, but if they learn about and understand some of the challenges and difficulties that they face, that they would want to be there to be helpful.

So with that, I wanted to introduce Admiral Ziemer, who is coordinating the President's Malaria Initiative. He will give you a bit of a background on -- I think all of you know -- you'll see in the packets that were distributed to you -- you know the history of this $1.2 billion that was committed by our government in 2005, in June of 2005. And over a five-year period we seek to target 15 countries to help to cut in half the malaria-related deaths in those countries.

And after Admiral Ziemer concludes his remarks, John Bridgeland, from Malaria No More -- which has been an extraordinary private partner in the development of this summit and has really been the leading and driving force, and have met the President's challenge of bringing outside groups together to meet the government commitment -- Malaria No More has really led this effort to bring collectively together some extraordinary groups that will be at the summit.

We've provided you with a package which shows the program so you can look and see who some of the presenters are -- again, ranging from mega-philanthropies like Melinda Gates at the Bill and Melinda Gates Foundation, to an elementary school in the District of Columbia -- every single one of these entities involved is making a commitment, and is making a difference.

So with that I'm going to turn it on to Admiral Ziemer. And I appreciate your attention and time.

ADMIRAL ZIEMER: Thanks, Anita. And good morning to all of you. Hopefully, you've read the fact sheets that have been distributed. They're really quite good and comprehensive. So what I'd like to do is give you an overview and then respond to any questions that you might have.

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.

With the announcement, it recognizes awareness. It recognizes the willingness to take the lead, but not alone. There is not one silver bullet out there that will take on this very complex problem. It will take the partnership of all the interagencies working together with host countries in order to bring malaria under control.

So the PMI is one major tool in the fight against malaria, and it's a significant one, because when you leverage the additional resources, the technical capacity, the support that we're providing to our partners to basically build upon their malaria control plans, it is making a difference.

When you add in our inter-multilateral partners, the Global Fund, the World Bank, Roll Back Malaria, as major partners in this, we're seeing a number of factors -- excitement, enthusiasm, hope -- and more significantly, just in six months of actual program investment, we're able to give you specific figures, like 6 million people have been beneficiaries of a four-pronged strategic approach to controlling malaria. We're interested in preventing malaria, and we're interested in treating those who catch it.

So on the prevention side, we're aggressively pursuing spraying as a component of prevention, along with the distribution of nets -- I'd like to say distribution and use of nets.

On the treatment side, we've got some wonderful drugs, the ACTs -- that's the Artemisinin-based Combined Therapies -- that if a child has malaria, a treatment of three doses will bring it under control and keep him or her alive. And then we have the sulfadoxine-pyrimethamine, which is a drug that we are working to purchase and distribute for pregnant women so that when they go into the natal clinics, we can get them on a preemptive treatment so that if and when they are bitten by mosquitoes, the chances of them having a normal pregnancy goes up, and therefore, the health of the baby.

So we have two prevention components to the strategy and two treatment components. And it isn't either/or; we're providing support in all four. And again, I want to emphasize we're not doing this alone, we're doing this with our host countries. And it's important that they own the plan and we become collaborators and partners.

You'll hear a lot of that as we go through this summit in the coming days, because it will take all of us working together -- you, the media, championing an appropriate response from those who read your pieces -- to keep the awareness up, to help us mobilize an appropriate response, and donating through whatever mechanism they feel comfortable to do something about malaria. So with the leadership of this government, which is significant, with your role in keeping the drums beating, and program partnership in the field and through the multilats, we can bring malaria under control. That's what this is all about.

MS. McBRIDE: John.

MR. BRIDGELAND: Thank you, Anita. Thank you, Admiral. To ensure that the private sector entered this space in a way that was constructive and most productive, we've actually done a lot of listening over the past three months, especially to people working on the ground in Africa. I just returned from a week-long trip in Rwanda, where I saw firsthand that malaria is the leading cause of death; 34 percent of children under five who die, die because of malaria. And as Admiral Ziemer mentioned, it's getting worse: cases of malaria in Rwanda have gone from 1.2 million to 1.5 million.

Malaria really is, when you see it on the ground, and you look into the faces of pregnant women who are holding comatose children who have malaria, is a disease of sad contradiction -- preventable and treatable, and yet needlessly killing more than a million people on the African continent, and infecting more than 300 million worldwide. And unlike many diseases, we actually have the tools, the know-how, the technology, and with good people like Admiral Ziemer, I think now a concerted, targeted, focused plan that can help us meet needs where they're the greatest.

I also wanted to note, it's interesting, as we look to this fundamental question of how do we actually awaken the national and global consciousness to care about a disease that was eliminated in the United States in the 1950s and eliminated in many developed countries around the world, how do we actually get people in those countries to care about this disease? Nationally, representative Gallup poll data provided -- just surveyed over the weekend -- tells us that Americans rank malaria last in a question about the seriousness of diseases around the world. Americans do better when they're asked about the seriousness of malaria in Africa, but even then, there's much less awareness about malaria than AIDS and malnutrition.

So part of our job, I think on the private sector, working in partnership with the public sector, is to raise awareness and educate Americans about this disease. I must say that having worked on dozens of issues where we try to awaken the national consciousness, including after 9/11, I have never, ever seen an issue that has greater civic power than malaria. The individual literally can step forward, make a contribution, buy a bed net, and directly save a life. Schools, divisions in workplaces, churches can organize activities and literally directly save the lives of villagers, an entire African village or region. That direct cause and effect, where your investment will make a difference in saving a life, is just extraordinary, and we don't find it every day. And I think it can be the disease that reawakens that national consciousness.

The President came forward with this President's Malaria Initiative and, again, targeted the greatest needs. And the First Lady announced at the end of August, I believe it was, the White House Summit on Malaria. And so in the last few months we have been working to focus in on what are the Africa control plans, what are their priorities, their needs, working in partnership with PMI. And he challenged the private sector to step forward in that context and to play a meaningful and constructive and strong role.

I must say in our listening, the entire field, from villagers on the ground to multilateral institutions like the Global Fund to PMI and others, when we ask the question, what is it that you want the private sector to do, they said, we want you to ignite a grassroots global movement that will support the comprehensive approach -- not just another net campaign, not just an ACT campaign, not just a spray campaign, not just an education campaign -- but a comprehensive approach to control malaria with all of those elements, so people understand that they have to work in tandem, as the Admiral said.

So just very quickly, I must say in the last three months I've been strongly encouraged by what has come forward. Business executives, philanthropists, nonprofit executives, people with huge reach into American civil and private sector society, right, left, center, politically confused, have come forward to establish Malaria No More. These are people like Bonnie Hunter, the Chair of the American Red Cross; Ann Veneman, the head of UNICEF; Tim Shriver, the head of Special Olympics; Jack Valente, Fight for the Global Fund, on and on. But businessmen, philanthropists, nonprofit executives, leaders in the media and others who are coming together through Malaria No More to ignite this grassroots movement.

Interestingly, we have extraordinary new private networks of support. Chapters of large charities in the United States that have never opened their windows into communities on the disease of malaria or anything like it are opening those windows and providing and enabling Malaria No More to reach immediately 15 million Americans. Two hundred and twenty corporations working with the Global Business Coalition, which is a founding partner of Malaria No More, led by Richard Holbrooke, the former U.N. ambassador, are enabling us to reach millions of customers, employees all over the world to buy a bed net, to save a life, to make a difference.

When you think about some of these corporations, and there are millions of people that they reach in their workforce and in the customers that they touch, those networks of support are absolutely vital to make this campaign successful -- not just in the context of a White House summit, but in the context of a decadal effort to end malaria.

Second, more boots on the ground. When I was in Rukara, I saw two villages in Rwanda -- Rukara, where the comprehensive approach was working that the Admiral talked about, and then Mukarange, where there was no comprehensive approach. And you literally saw the kids in Mukarange dying.

And in Rukara, the child mortality rates have been cut significantly because of their comprehensive efforts. And what they needed and what I saw on their faces were 49 community health workers tapped by local villages, elders in their communities, who would literally step forward, go house-by-house three times a week for two hours, and as the Admiral said, not just put nets into communities but train people on their proper use, help to eliminate breeding grounds, ensure that when their child has a fever -- because most fever is managed in the home -- that they actually know what to do so their child doesn't get the symptoms nine to 14 days later and eventually potentially die.

And so these community health workers on the ground are absolutely vital, and so Malaria No More, working in partnership with two hugely powerful partners, will be mobilizing 150,000 new trained volunteers and community health workers in Africa that will reach 12.5 million people over the next two to three years on the prevention and treatment of malaria. And I will just tell you, those are conservative numbers. We wanted to be very careful. These are new announcements and conservative numbers.

Faith-based partnerships, for many villagers you've seen it firsthand. For those of you who have visited, the church is the only formal institution in many of these communities. In Rwanda, 90 percent of people live in rural areas. And so the church has to play a profound role. They have universal distribution into countries, the ability to mobilize volunteers, local credibility, and finally, they're great record keepers -- actually help us monitor and evaluate the child mortality rates, because churches have historically kept good records about life and death.

And so we will be announcing a test case to mobilize faith-based leaders in one country throughout Africa. And Rick Warren's Saddleback Church, through his extraordinary peace plan, it not only reaches into this one country, he's got a network that works in 163 countries worldwide. And when you're on the ground, meeting with these peace plan volunteers who are being led by the church leaders in Africa, it's an extraordinary and hopeful thing. They will be educating and training 2.5 million people on malaria prevention and treatment.

We also -- the White House summit has created the environment where new resources have come forward. This is not insignificant. More than $100 million has been mobilized. If we stay on that pace just for a quarter, the private sector arguably could raise $400 million a year. Working in partnership -- I saw nets in warehouses and ACTs in warehouses and not on shelves. It's not just about new resources, it's about distribution capacity. But working in partnership with our government and multilateral institution partners, we hope the private sector can also be mobilizing significant new resources.

We will be providing bed nets to save lives. They're needed now, providing more than 1 million bed nets to protect 2.5 million people. And again, we'll announce in one African country with PMI and a multilateral institution that we will be doubling the household ownership of bed nets in that country. Again, as you know, bed nets literally save lives.

Another interesting component: how do you create the generation that cares; how do you get young people? When we shared this Malaria No More idea with a local school, it was like lighting the tinder. These young people learned about malaria in their science classes; they learned about the geography of Sub-Saharan Africa in their geography classes; and then, as part of their service commitment, they stepped forward to organize 324 students who have done a read-a-thon. The 7th graders have talked to the 1st graders about malaria, doing bake sales and raising support. Literally, schools all across the country -- remember America's Fund for Afghan Children -- could create America's Fund for African Children and literally be able to say, our school saved a village today, or played a role in saving a village.

And so we will be providing educational materials on malaria to nearly 6 million 1st, 5th and 6th graders, to virtually every public, private and parochial elementary and middle school in the United States to try to educate and make them aware of a disease that they don't know much about and that our survey data tells us that even adults in America don't know much about.

We envision this global grassroots movement. We will announce -- we originally thought it might just be a U.S.-based effort, but Admiral Ziemer and others encouraged us to think globally, and so we will actually be announcing two counterparts in two other countries to Malaria No More, led by leading philanthropists working in partnership with their own governments and leading philanthropic and non-governmental institutions. And it's our hope, actually working with Tim Shriver and the network that he's built through Special Olympics, to ignite in every single country a counterpart to Malaria No More. Imagine a Malaria Non Plus, a Malaria No Mas, translated into other languages that ignites a grassroots response to support and help play a role in ending this disease.

Many of these commitments are joint commitments. Admiral Ziemer has reminded me again and again, it's African leadership and African boots on the ground that has to lead and guide and set the priorities. So most of these announcements at the summit are joint announcements, Americans following Africans, Africans working in partnership with Americans in a way that will make sure it's sustainable and workable.

And so while Thursday is really the summit for most organizations, for Malaria No More it's literally our base camp, where this is a first step in a few-week undertaking, really a three-month undertaking, to help galvanize and organize the private sector. And I think based on this initial response, we're really hopeful and have created four specific public platforms following the summit that will provide us an ability to mobilize more private sector support and give more focus on malaria, not just on Thursday, which is -- by the way, it's just so rare you convene all these multilateral institutions, they'll be there at the summit -- but have other public platforms to ensure that we have -- keep -- do our job on the private sector side to follow this extraordinary leader here in fulfilling the vision and prosecuting the plan.

So we're excited. Sorry to take so much time, but we're -- we actually think -- and I'll just end with this, and the Admiral said it, as well -- I know some are suspicious of civic journalism, but I, again, have never, ever seen an issue where, with just one little effort to educate people on what they can do to make a difference, you could literally play a huge role yourselves in saving lives. So thank you for your interest.

MS. McBRIDE: Thank you, John. Thank you Admiral Ziemer. And I think, Susan, we have some time for some questions, if anybody needs to ask us a question or two.

Yes, sir.

Q Is the focus specifically on malaria in Africa? Because, of course, the disease does affect people in South Asia and other places.

ADMIRAL ZIEMER: I'll speak from PMI, but I think it's important that we understand that it is a worldwide global problem. The PMI is focusing in on where the biggest need is, and so when we developed a strategy with the President's challenge, it focused in on where the majority of the infections and fatalities occurred. Therein, when you have a problem, you go to the source, or you go to where the tinderbox is, in terms of trying to get that under control.

So the answer to the question is, the President's Malaria Initiative is focused on 15 African countries. We also have malaria assistance and programming going into additional African countries.

The U.S. government also has malaria support going to the Mekong River Delta, where there is some very sophisticated work ongoing with the governments of Vietnam and Thailand and Cambodia, primarily -- and this is significant -- in research and monitoring to see what the resistance is occurring in that area. And that same type of investment is being done in the Mekong River Basin.

And so the United States government has a very broad reach in its investment of national treasury in malaria control. But right now, when you look at the global imperative of saving lives and doing something about malaria, it must focus in on the endemic countries in Africa.

MR. BRIDGELAND: And I would just say the private sector effort is going to follow that plan, because 90 percent of deaths occur in Africa, 75 percent of them are African children. And when you look at the cases globally, and their numbers, we not only want to focus on Africa, but focus in the order -- some order of priority, as PMI does, in terms of child mortality rates and the greatest needs.

Q I have a question about sort of the dollar accounting. There was some money for malaria in PEPFAR. Is that money being taken out, and is it in PMI? And how much of the $1.2 billion is the aggregation of other malaria accounts from other places?

ADMIRAL ZIEMER: We can get you the specific figures, but my response is that the $1.2 billion that the President committed was additional money over what was already being budgeted for PEPFAR and USAID malaria programs. So underneath the leadership of Ambassador Tobias, we have rolled up malaria control programs in the foreign assistance area, and USAID, into one malaria control program. Now, the PMI has clear objectives for the 15 focus countries, but that is all different money than PEPFAR. And I am working with Ambassador Dybul to look at ways that we can take.

When you're talking about survival, particularly child survival, and kids infected or threatened by HIV/AIDS, there is a natural component where we can work together. Bridge talked about going into the villages and looking at kids. Well, kids die of a number of things: malaria, diarrhea, TB.

So as we move forward, the answer to your question, this is different money, it's not being shell gamed from PEPFAR to PMI.

MR. BRIDGELAND: Just two other footnotes. Global Fund spent $308 million on malaria control in 2005, and the U.S. government provides one-third of that funding. That's another significant U.S. government investment. And also when we did look at the cross cut, you look at the investment in the National Institutes of Health and the Centers for Disease Control and Prevention, it goes on and on and on, including the huge private sector side of this. So the U.S. commitment overall is really quite significant.

ADMIRAL ZIEMER: Let me just punctuate that. In addition to -- of the money coming through Global Fund -- and they've dispersed a lot, and we've got to celebrate that -- $480 million of what's been dispersed through Global Fund in TB, HIV/AIDS has gone to malaria -- not all of it to Africa, by the way, but to the countries who have applied and their grants have been accepted. That is U.S. -- that's the U.S. component. So we're not just doing PMI, plus we have the money flowing through the World Bank and the U.N., UNICEF. So the United States government is making a significant contribution to this fight against malaria.

Q I'm from Burkina Faso in West Africa, so I'm very concerned about this topic. In my country there is research focus on vaccine, again, malaria. I want to know if you are aware of this project, and how can you work to improve this project of vaccine against malaria? Also, the World Health Organization recently allowed the use of DDT, which is a pesticide, very efficient known mosquito killer, but also known like something very dangerous for human health. What's your viewpoint on this --

ADMIRAL ZIEMER: 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, but I think I have the answers to both of your questions. And if you need more, we'll get some scientific data.

First of all, it's very important that we continue to support and do vaccine research. Someday, when we find the right vaccine, how we treat malaria will change. But until then, we must support the national host countries' national malaria control plans that can save lives. So the majority of the money coming through the U.S. government through PMI is going to prevention and treatment.

We invest between $7 million and $8 million of my budget to vaccine research. That's not enough, but it's been a consistent investment through different universities and institutions and labs. I think it's important for us to celebrate and acknowledge the Gates Foundation investment in vaccine research, among other foundations.

So you need to understand that the PMI is not increasing its funding to vaccine research. But it's something that we must all work together to continue to build the awareness and the need, because the future generations are expecting us to solve that riddle.

On DDT, I think it's important to understand that much of malaria in the 1950s and '60s was done away with because of an aggressive spraying program in this country. DDT is a safe insecticide. It's one of 12 insecticides that's been approved by the WHO and the POPs Treaty, of which the United States government is a signatory to.

When you deal with any chemical agent, like an insecticide, it's very important that you comply with the environmental regulations and the specifications of that particular chemical and/or insecticide. DDT is very effective, it's approved, and when used properly in the small amounts that the manufacturers specify, it is a safe and proven insecticide.

Many of the people who are concerned about DDT recall history when we had massive spraying programs and agriculture, and there was runoff into rivers and our agricultural plants. That's different. We must learn from history. And today, we have to understand that DDT is one of 12 insecticides that saves lives. And it would be unconscionable if we didn't use it to save lives.

MR. BRIDGELAND: I just have two footnotes, if I could, on the moon shot, the malaria shot, which is the vaccine, extraordinary, if we could -- given the Gates Foundation investment and other efforts. And foundations are uniquely positioned, I think, as independent organizations that can invest in such things, because they don't need to see an immediate return, like government does.

But the second point there is Malaria No More wants to ensure that if we do get to a vaccine there is significant licensure and distribution issues. And we want to point our efforts toward using those distribution networks to get the vaccine out. But experts tell us it's years away.

Just a footnote on DDT. When I asked the CDC that question about the harmful nature of in indoor spraying, as the Admiral said, a hundred times in the use of today in agricultural spraying was what prompted the silent spring and all the concerns. I'd also just note that when the WHO came out with its endorsement of DDT spraying, they did so and noted that environmental defense in these organizations that led the way in raising concerns about DDT and agricultural spraying were also endorsing the use of that non-toxic indoor residual spraying that the Admiral talked about. And I think that's an important point to educate Americans on, that the environmental groups that have a vested interest in protecting habitat and wildlife and human beings are supportive, as well.

Q Do you have any India-specific plan in the President's Initiative on Malaria? Because India is still faced with malaria (inaudible) and a major health problem.

ADMIRAL ZIEMER: We acknowledge that India has a malaria problem. They also have a bit more in terms of the resources and the technical capacity. And they have demonstrated resolve and a commitment nationally to do something about it. So in the prioritization of where do we bring to bear resources and technology, at this point we've focused in on Africa. We will share technologies, we share -- the information that's obtained through CDC and all of the labs is shared at a common level. I'm really encouraged to see the mutual sharing through many of the forums.

But to answer your question, the PMI in the USAID budget at this point doesn't include money for India malaria control programs.

Q I'd like to follow up on the part about educating the public -- I think you might want to answer this, Mr. Bridgeland -- about the poll numbers you cited, that Americans don't consider this a problem, they're not familiar with it, it's not a problem in this country. What's the strategy on that front, beyond the summit, beyond a potential splash of media, when you move on past that, to get people to care and do something?

MR. BRIDGELAND: It's interesting, we've been having these Monday marketing calls, because part of this effort is marketing, education, and awareness. And because of the philanthropists and business leaders who are involved have -- extraordinary people from the Harvard School of Public Health to the woman who co-led the Nike campaign. And so learning a lot about, how is it that we talk about this disease; how do we light the spark in every single individual to care about it, and then be prompted to do something about it?

And it's interesting, having seen my own experience of how my kids, when they come home from school and they prompt me to do something, I do think the 6 million young people going into their homes all across the country with this renewed concern will be one spark.

Another will be leading corporations. Richard Holbrooke's 220 corporations that are going to be opening their networks of employees and customers and other distributors that will be sending not only clear messages about -- just very quickly -- it kills more than a million, infects 300 million. It's a disease of contradiction that's preventable and treatable, and we're not mobilizing the international will to end it. I think that piques people's interest.

And then the very next point is -- and there's something very direct that you can do about it to save somebody's life. And if you organize your whole division, you can save a village. I've never seen a civic enlistment so powerful and strong. And so that, I think, is very exciting to us.

But also to your point, we are organizing four specific additional forums that will bring, both in Africa and in the United States, a lot of additional attention to these issues in a way that will help. Every time -- we view these forums as action-forcing events where we -- so if there's going to be a forum and we want to mobilize and get more commitments and efforts to work in concert, that could be announced at that forum. And just like the White House summit, we want to use those occasions to further galvanize the private sector and hope to get those survey numbers up, so that people see it's a serious disease, but, as importantly, that they actually can do something directly about it.

MS. McBRIDE: Admiral Ziemer wants to add something to say to that. But I'd like to say this one thing, if I could. When we planned the summit, we looked at it, and the way that this would be a kick-start. This would be one event similar to what we did with Mrs. Bush's global literacy summit. Our partner in that was UNESCO. And our conversations with them, like our conversations with Malaria No More, is we will host this event, we will bring all the groups together, the multilaterals and the foundations and the grassroots organizers. But help us develop a plan, or would you develop a plan that has a follow-up, that has a continuum, that will come together and have some creative ideas of how you can keep the momentum, continue the education and continue to bring in the support for the disease.

So that was a requirement that we had with our partner, and which they have more than met with what they'll be rolling out.

ADMIRAL ZIEMER: I'd like to answer the question a little bit differently, because I think it's a critical question. What you're really asking is a sustainment question. You know, the summit, yippee, we had an event. That is exactly the opposite message we want to send. And I think -- and here's my real answer to your question -- I think it depends kind of on you.

The media, the press, don't underestimate what you must and can do to keep this malaria problem up and in the news, people reading about it, holding us accountable. All of our spending is on the web, and I would like to know when you're pleased that the spending of the U.S. government treasury is achieving the goals that we set out to do; and if we're not, ask us the hard questions. Accountability will keep us focused, will help us help the host countries build their capacity and sustain where they're going. But we need -- this is really a partnership and your role is critical to get the message out, encourage people to engage and then hold us accountable to delivering what we say we're going to deliver.

MR. BRIDGELAND: Let me also add just quickly, the White House summit is a wonderful occasion to bring a lot of parties together that don't always come together and don't always talk and don't always coordinate effectively, quite frankly.

We also saw an opportunity, led by businesspeople, to have a post-summit review. So right after that National Geographic event at 12:30 p.m., for five hours, the Global Fund and the World Bank and PMI and all these leaders, in concert with private sector business types, are going to sit together and talk about what's the common plan and how are these different institutions coordinating and working in concert with the President's Malaria Initiative.

We're serious about it. This isn't just a show or an event for puffery; it's got real commitments from real people. And we're going to stay on it until we make a big difference.

The other thing I'd mention, too, please go to our website, malarianomore.org; we have a very tough board that's constantly keeping us accountable. But I would encourage you to look at it, call and ask us questions, question our assumptions and give us your thoughts on how we can do a better job.

Q With the President's billion dollar investment, and the fact that malaria is treatable and preventable, what is the main obstacle to solving the problem? Is it lack of resources? Is it distribution or that there's no vaccine? What's the problem?

ADMIRAL ZIEMER: I feel like I'm dominating everything -- is that okay?

MS. McBRIDE: No, between the two of you --

ADMIRAL ZIEMER: What's changed? I guess the real question is, what's changed? One point two billion dollars is a lot of money that the Congress needs to approve so that we can get on with this task.

But I think we have to understand that we are mobilizing -- there's a sense of change out there in the field because of the Global Fund funding, because of movements like Malaria No More, because of what Exxon Mobil is doing, because of what Gates is doing, because of what the President is doing in leading this fight with the country, something has changed -- that's awareness, that's leadership, and it's cash.

When you try to contemplate a malaria investment in Africa with $1 million, it's unconscionable. But suddenly, we have more money so that we can do spraying, so that we can do saturation of markets in places with nets so that we can drive down the cost of expensive ACT drugs, to get them out where the poorest of the poor can either be handed the drugs, or with some sort of sharing or voucher system, buy the drugs.

So what's changed is leadership, awareness, more money, and, more importantly, I sense that we're coming together, partnering with the host countries in different ways than we've ever done before. This is really a host country issue. It is not an American issue. We're here to help stabilize, help communities develop. This is -- don't get me started -- but this is all about poverty reduction. When a poor family in northern Mozambique spends as much as 30 percent of their annual income to treat malaria, there's not a whole lot of cash left for doing anything else. So this is a one of many poverty reduction opportunities for us to engage together to help the countries where we are privileged to serve.

MR. BRIDGELAND: I would add a footnote, human capital. Human capital. It's interesting that when you look at the President's Malaria Initiative 2005, the Global Fund, which I think started in 2002, Booster Program at the World Bank, all these institutions coming forward with huge amounts of new resources pointing at malaria. But when you look at it on the ground, as the Admiral said, again, I saw nets in warehouses and ACTs not on shelves. And if we don't deploy massive numbers of people who are trained -- well trained, have credibility in their villages, can reach into the homes where most people are -- and I saw this figure the other day that most treatment of malaria is going to be home-based and managed in the home. So they have these home packets that they get into the homes and train people on how to treat their child if they have symptoms.

So one of our big focuses on the private side, because I think the private side can uniquely do this, is to mobilize massive numbers of well trained people who will sustain malaria control efforts in country over time, and ensure that as those commodities come sweeping in, people know how to use them and can take some steps themselves to control malaria through eliminating breeding grounds.

Q In actual numbers, though, how many are you talking?

MR. BRIDGELAND: Just in the last number of weeks, we've mobilized 150,000 additional volunteers, reaching 12.5 million people in Africa with new prevention and treatment. Twelve point five million people is, for less than a quarter of a year, is pretty extraordinary. The other thing I'll just note is these faith-based networks that we want to unleash, that have been unleashed. I just got a call from Kenya about the problem in Kenya, and the faith-based networks who are working effectively with the flooding. How can we unleash these faith-based networks in a way, systematically, so in a place like Rwanda, where 90 percent of people live in rural poverty, you look at the map and see all these institutions called the church? You're mobilizing hundreds of people in each of those areas to be agents of malaria control.

Q Admiral, are you able to measure at all what progress has been made -- I know it's early in the process -- towards the 50 percent reduction in malaria deaths in those particular countries? And also, how much money has been spent to date of the $1.2 billion envisioned in this?

ADMIRAL ZIEMER: When the announcement was made regarding the PMI, we took the existing money in USAID and invested $30 million to begin and jump-start the PMI. This year we're expecting close to $300 million to engage with the first three countries, and then the next four, so that will be a total of seven. So that will be a total -- again, you have to understand, the money hasn't been quite approved yet by our Congress, but when we expect that this will be supported, we're talking close to $330 million to do year one and two. So that is now -- we are starting to accelerate.

Now, again, in terms of input, that's cash. What has that done? If you look at your fact sheet, you can get a lot of numbers of some significant houses sprayed, nets distributed.

In the first three to four months, 6 million beneficiaries were touched. We expect in the next three, because we're starting to accelerate, another 6 million people. But then the real question is, so what? Are the nets being used? Is the rate of infection coming down?

We're looking at a significant component of the PMI's budget being invested in the MNE point, because when you talk about sustainability, if we can't show how that the rates of infection have been drawn down, and in fact the mortality rate is going down, then the chances of us getting congressional support and the generous donations of the private sector are going to be a little more difficult. But when we start producing results, and hopefully with the investment we're making, particularly in the PMI countries, we can tell you where the trends are and what the trends are.

Now, you're going to -- we're going to feature someone at the summit who will give you some pretty dramatic reports of actual drops in infection rates from several clinics. And we're talking about 21,000 cases down to 1,200 cases over a similar time period from one year to the other. And I have been in a couple of these little hut clinics, and, yes, they keep magnificent records. And when I asked the question, how many deaths have you had, the answer was zero in this little village I was at.

Q Just to follow-up, Congress hasn't approved any funding?

ADMIRAL ZIEMER: Well, I'll defer on the budget --

MS. WHITSON: We can get you that information through the PMI office or USAID office. We'll find out what that is, because I don't know offhand.

MS. McBRIDE: We had another question.

Q When the White House announced the summit in August, you mentioned that you wanted the private sector to match the PMI, the $1.2 billion. Is that going to be one of the main things discussed at the summit, or urged?

MR. BRIDGELAND: Yes, I'd say a couple of things. One, the resources that have been raised in the first quarter of one year, I'm certainly encouraged by them. And if you were to -- if you stayed on that track, you'd raise $400 million in a year, and over the course of three years, you'd perfectly match the public sector investment.

But I'd also -- again, when you see this unfold on the ground, resources are vitally important. And one thing that the Admiral said to us, one role the private sector can play is you can help us with the commodities, with the nets and the ACTs. And we want to play that role, and are playing that role, and have concrete announcements in connection with the provision of more nets, for example. But we also want to focus very much on infrastructure and human capital and mobilizing more people on the ground to make sure these things actually work.

ADMIRAL ZIEMER: Let me answer that just a little differently. I think we need to understand that this is a partnership, and so when the President got up and said, we're going to declare our commitment to do something about malaria, and I'm going to commit $1.2 billion over four or five years of the budget to this, he recognizes we can't do it alone. It's imperative that we engage effectively with our partners. So the $1.2 billion -- when he made his announcement in June, he challenged the private sector and other partners to step up to the plate, too. That recognizes we can't do it alone and we need the help of everybody to take this on.

So I think that is an important part of this event and the ongoing future of our successes, together with more money, with more technology, with more resources coming together our host countries will be a whole lot better off.

MS. McBRIDE: Just one last point. The role of government in this process can't be understated; it is a main driver, it is what's bringing everybody together. But the PMI program, what was attractive to a private partner, a major private partner was the business model that is part of the PMI. It's the accountability factor, which goes back to some of your question -- how are you going to measure this, what are you going to see. And you will have some dramatic testimony at the summit that will illustrate that kind of example.

But that's what makes a program like this, or a summit like this attractive. And it's meant to be the kick-start and it's meant to mobilize the other forces -- whether it's business leaders who will look at a bottom line and they'll want to see a success rate. And we think this is what is exciting about this summit, and, again, by no means intended to be the last act. We'll have a great deal of follow on.

MS. WHITSON: Thank you so much. And, again, if you're interested and have not gotten information about the summit, we have put out a media advisory. If you'd like to register to get in, please call Mrs. Bush's press office, 456-6313, and we can help get you registered for the conference as a member of the media. Thank you.

MS. McBRIDE: And you can buy nets. Mrs. Bush's office has together, rather than buying presents for Christmas, we've all purchased enough nets for 50 families. So you can do that within your own office.

END 12:02 P.M. EST


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