Explanation of Position at a Meeting of the UN General Assembly on Agenda Item 13: Decade to Roll Back Malaria

Ambassador Kelley Currie
U.S. Representative for Economic and Social Affairs
U.S. Mission to the United Nations
New York City
September 10, 2018


The U.S. government remains honored to be a part of the massive and concerted global effort to end malaria and its devastating impact on individuals and communities. Progress over the past fifteen years has indeed been remarkable – malaria is no longer the leading cause of death in children under five in Africa – and several countries are transitioning their programs from focusing on controlling the disease to eliminating it. Yet this process is fragile, and has not been, and will never be, linear. The U.S. government recognizes that sustained support over time is necessary. The U.S. government has committed over $6.8 billion bilaterally for malaria control and elimination through the U.S. President’s Malaria Initiative, PMI. In addition, approximately one-third of the United States’ $15.6 billion total commitments to the Global Fund to Fight AIDS, Tuberculosis and Malaria benefits malaria endemic country programs.

Launched in 2005 in only three countries, PMI now supports 24 programs in malaria-endemic countries in sub-Saharan Africa and three programs in the Greater Mekong Subregion in Asia, where resistance threatens the efficacy of antimalarial drugs.

In joining consensus in adoption of this resolution, the United States commends the efforts and commitment of Member States resolved to eliminate malaria and applauds their progress to date; urges Member States to sustain their political commitment and funding; and recognizes the threats posed by resistance to insecticides and anti-malarial drugs. We acknowledge progress made in parts of Africa and Latin America, especially the following countries that have most recently been certified malaria-free or are poised to receive certification in the near future: Paraguay, El Salvador, and Argentina. The U.S. government also acknowledges the progress made in the South-East Asia Region of the World Health Organization, where eight of the nine malaria-endemic countries are on target to achieve at least a 40-percent reduction in case incidence by 2020, and India is on track for a reduction in the range of 20-40 percent.

The United States joins the resolution in recognizing the need to strengthen malaria surveillance and data-quality, and urges the global malaria community to use data to make evidence-based decisions. Given the influx of data and advancements in the development of new malaria-control products, the U.S. government stands ready to work with the WHO and other institutions to ensure that global technical recommendations evolve at pace with incoming data and advancements in research and development.

Regarding the right to health language contained in OP22 of this resolution, in light of Article 2(1) of the International Covenant on Economic, Social, and Cultural Rights, the United States interprets references to the obligations of States as applicable only to the extent they have assumed such obligations. We note that countries have a wide array of policies and actions that may be appropriate in promoting the progressive realization of the right to the enjoyment of the highest attainable standard of physical and mental health.

Finally, as we have stated for several consecutive years, it is not appropriate for a UN document to speak to ongoing or future work of the World Trade Organization, or to undermine the independent mandate and processes of the WTO. Discussion of the amendment to Article 31 of the WTO Agreement on OP34 is imbalanced and biased, and it is inappropriate for the UN to call on WTO Members to take action on the issue. Therefore, as was the case last year, the United States must disassociate from OP34, and we insist the inclusion of this language in this resolution does not serve as a basis for future negotiations.

We find it unfortunate that so many negotiations are stalled by the same issues around intellectual property, which unnecessarily inflames the discussion of serious health challenges. This year’s resolution on malaria highlights the way some countries have chosen to pursue those other agendas, even when they have little or no relevance to the topic at hand. In the case of malaria, we note that for the anti-malarial medicines on WHO’s Model List of Essential Medicines, there is not a single patent in a single country that is still in force. It therefore defies logic to assert that intellectual property can be a barrier to access to these anti-malarial medicines. On the other hand, intellectual property is essential for the development of new medicines, including for the new medicines we will need to treat malaria when resistance develops to current regimens. The United States is therefore concerned that the threat or use of compulsory licenses will choke the research and development that will be needed to save lives in the future.

We request this statement be made part of the official record of the proceedings of this meeting.